侧卧位直接前方入路与直接外侧入路在初次全髋关节置换术中的应用  

A Comparison of Direct Anterior Approach and Direct Lateral Approach for Primary Total Hip Arthroplasty in the Lateral Decubitus Position

作　　者：唐雪彬[1] 岳喜军[1] 黄凯 魏东[1] 李华[1] TANG Xuebin;YUE Xijun;HUANG Kai(Department of Orthopaedics,the Second Affiliated Hospital of Xuzhou Medical College,Xuzhou City,Jiangsu Province 221006)

机构地区：[1]徐州医学院第二附属医院骨科,江苏省徐州市221006

出　　处：《医学理论与实践》2020年第10期1579-1581,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探讨在侧卧体位下分别应用直接前方入路(Direct anterior approach,DAA)和直接外侧入路(Direct lateral approach,DLA)行初次全髋关节置换术的临床效果。方法:按纳入标准选取2016年1月—2018年6月期间在本院行初次全髋关节置换术的患者61例,分为DAA组30例,DLA组31例。分别记录手术切口长度、手术时间、术中失血量、术后切口引流量,采用Harris评分评价髋关节功能恢复情况,并观察记录脱位、股外侧皮神经损伤、下肢静脉血栓形成等并发症情况。结果:DAA组在手术切口长度、术中失血量、术后切口引流量优于DLA组,差异有统计学意义(P<0.05);在手术时间方面,差异无统计学意义(P>0.05)。DAA组术后半个月、1个月、3个月Harris评分结果均优于DLA组(P<0.05),但随着时间的推移,在术后6个月时两组Harris评分比较差异无统计学意义(P>0.05)。结论:在全髋关节初次置换术时,侧卧位DAA入路与直接外侧入路相比,具有切口小、出血少、康复快、早期髋关节功能恢复好等优点,更符合快速康复的理念。Objective:To compare the clinical effect of the direct anterior approach(DAA)and direct lateral approach(DLA)for primary total hip arthroplasty in the lateral decubitus position.Methods:A total of 61 patients were treated with total hip replacement.30 patients received direct anterior approach in the lateral decubitus position,the other patients received direct lateral approach.The length of incision,Operating time,blood loss during the operation,post-operative drainage,Harris hip score,complications were recorded and compared.Results:There was statistical significance in incision length,blood loss,post-operative drainage between the two groups(P<0.05).There was no statistical significance in operating time(P>0.05).Harris hip scores at half month,1 month and 3 months postoperatively was statistically significant difference between the two groups(P<0.05).However,there was no statistically significant difference at 6 months postoperatively(P>0.05).Conclusion:Compared with DLA,DAA can shorten the incision length,decrease blood loss,enhance recovery and so on,which is more in line with the concept of rapid recovery for the hip arthroplasty operation.

关 键 词：初次全髋关节置换 侧卧体位 直接前方入路 直接外侧入路 

分 类 号：R687.4[医药卫生—骨科学]