直接前入路与后外侧入路对人工全髋关节置换手术影响的临床比较  

Clinical Comparison of the Effects of Direct Anterior Approach and Posterolateral Approach on Total Hip Arthroplasty

作　　者：陈红钧[1] CHEN Hong-jun(Baoshan People's Hospital,Baoshan,Yunnan Province,678000 China)

机构地区：[1]保山市人民医院,云南保山678000

出　　处：《系统医学》2020年第8期77-79,共3页Systems Medicine

摘　　要：目的研究直接前入路与后外侧入路对人工全髋关节置换手术影响的临床比较。方法该次研究对象是该院2018年3月—2019年9月期间收治的进行人工全髋关节置换手术的患者120例,给予患者两组不同的手术方式,并且以此为依据将其分成观察组和对照组两组。观察组患者接受直接前入路手术治疗,对照组患者接受后外侧入路手术治疗,对比两组患者的治疗效果、临床观察指标、不良反应发生率、关节稳定性情况。结果观察组的治疗效果为96.67%,与对照组的81.67%相比差异有统计学意义(χ^2=6.988,P=0.008)。观察组在手术时间、术中出血量、切口长度、住院时间、VAS评分、Harris评分等临床观察指标分别为(120.5±23.1)min、(142.1±35.3)mL、(10.1±1.1)cm、(9.2±2.3)d、(3.2±0.5)分、(92.64±18.6)分,与对照组(110.4±22.2)min、(203.5±42.2)mL、(12.9±2.7)cm、(13.5±2.8)d、(4.9±1.2)分、(79.55±12.2)分比较,差异有统计学意义(t=2.442、8.644、7.439、9.192、10.129、4.558,P<0.05)。观察组的下肢静脉血栓、髋关节脱位、皮下血肿等不良反应发生率为5.00%,低于对照组的21.67%(χ^2=7.212,P=0.007)。观察组的股骨头假体直径、髋臼外展角、髋臼前倾角等关节稳定性分别为(30.7±5.2)cm、(35.1±6.1)°、(20.1±3.1)°,均要优于对照组(32.2±5.3)cm、(37.8±6.2)°、(23.8±3.4)°(t=1.565,P>0.05;t=2.404、6.229,P<0.05)。结论直接前入路与后外侧入路对人工全髋关节置换手术影响的临床比较发现直接前入路的效果更加显著,可以进行推广发展。Objective To study the clinical comparison of the effects of direct anterior approach and posterolateral approach on total hip arthroplasty.Methods 120 patients who underwent artificial total hip arthroplasty in the hospital from March 2018 to September 2019 were given to the two groups of patients with different surgical methods:the observation group and control group.Patients in the observation group received direct anterior surgery,and patients in the control group received posterolateral surgery.The therapeutic effects,clinical observation indicators,incidence of adverse reactions,and joint stability were compared between the two groups.Results The treatment effect in the observation group was 96.67%,which was significantly different from the control group's 81.67%(χ^2=6.988,P=0.008).The clinical observation indicators of the observation group such as operation time,intraoperative blood loss,incision length,length of hospital stay,VAS score,Harris score were(120.5±23.1)min,(142.1±35.3)mL,(10.1±1.1)cm,(9.2±2.3)d,(3.2±0.5)points,(92.64±18.6)points,compared with the control group(110.4±22.2)min,(203.5±42.2)cm,(12.9±2.7)cm,(13.5±2.8)d,(4.9±1.2)points,(79.55±12.2)points,the difference was statistically significant(t=2.442,8.644,7.439,9.192,10.129,4.558,P<0.05).The incidence of adverse reactions such as venous thrombosis of the lower limbs,dislocation of the hip joint,and subcutaneous hematoma in the observation group was 5.00%,which was lower than 21.67%in the control group(χ^2=7.212,P=0.007).The joint stability of the femoral head prosthesis diameter,acetabular abduction angle,and acetabular anteversion angle in the observation group were(30.7±5.2)cm,(35.1±6.1)°,and(20.1±3.1)°,which were better than those in the control group(32.2±5.3)cm,(37.8±6.2)°,(23.8±3.4)°(t=1.565,>0.05;t=2.404,6.229,P<0.05).Conclusion The clinical comparison of the effect of direct anterior approach and posterolateral approach on total hip arthroplasty surgery has found that the effect of direct anterior approach is

关 键 词：直接前入路 后外侧入路 人工全髋关节置换手术 临床比较 

分 类 号：R68[医药卫生—骨科学]