SuperPATH微创入路人工全髋关节置换术加速康复的优化特点  

Optimization Characteristics of Accelerated Rehabilitation of Artificial Hip Replacement with Super PATH Minimally Invasive Approach

作　　者：彭超[1] 何智勇[1] 王郑浩 龙涛[1] 兰海[1] 李开南[1] Peng Chao;He Zhiyong;Wang Zhenghao(Department of Orthopedics,Affiliated Hospital of Chengdu University,Chengdu,Sichuan 610081,China)

机构地区：[1]成都大学附属医院骨科,四川成都610081

出　　处：《四川医学》2020年第8期829-834,共6页Sichuan Medical Journal

摘　　要：目的探讨Super PATH微创入路全髋关节置换术围手术期加速康复特点。方法回顾性分析2016年1月至2018年8月于我院收治的行Super PATH微创入路全髋关节置换术与传统改良Gibson后侧入路全髋关节置换术两组手术资料,围手术期两组均行加速康复处理。比较两组患者术前评分、失血量、输血率、血红蛋白含量、各并发症发生情况、住院时间、髋关节功能Harris评分的差异。结果符合纳入标准Super PATH组65例,Gibson组57例。年龄60~89岁,平均74.59岁,随访时间12~26个月,平均18个月。两组比较年龄、性别、术前血红蛋白含量、VAS疼痛评分、ASA分级等术前一般情况,差异无统计学意义(P>0.05)。Super PATH组手术时间,输血率,心血管、感染性、血栓、消化道、伤口相关并发症发生率,术后12个月Harris评分,两组差异无统计学意义(P>0.05)。Super PATH组与Gibson组的总失血量、术后VAS疼痛评分、住院天数均有下降,术后血红蛋白含量、术后1个月及3个月髋关节功能Harris评分均有提高,差异有统计学意义(P<0.05)。结论在ERAS理念指导下Super PATH入路相对于传统入路可进一步加速患者康复,缓解患者术后疼痛,降低总失血量,减少住院天数,促进髋关节功能短期内恢复。Objective To explore the characteristics of accelerated rehabilitation during the perioperative period of total hip replacement with Super PATH minimally invasive approach.Methods From January 2016 to August 2018,surgical data of total hip replacement with Super PATH minimally invasive approach( Super PATH group) and traditional modified Gibson posterior approach( Gibson group) were retrospectively analyzed.All patients underwent accelerated rehabilitation during the perioperative period.Differences in preoperative score,blood loss,blood transfusion rate,hemoglobin content,complications incidence,hospital stay,and hip joint function Harris score were compared.Results 65 cases in the Super PATH group and 57 cases in the Gibson group met the inclusion criteria.The age was 60 ~ 89 years with an average of 74. 59 years,and the follow-up time was 12 ~ 26 months with an average of 18 months.Two groups compared age,gender,preoperative hemoglobin content,VAS pain score,ASA classification.General preoperative conditions had no statistical Difference( P > 0. 05). In Super PATH group,operation time,blood transfusion rate,cardiovascular,infectivity,thrombus,digestive tract,incidence of wound related complications,Harris score at 12 months after operation.Total blood loss,postoperative VAS pain score,and hospitalization days in Super PATH and Gibson group decreased,while postoperative hemoglobin content,hip joint function Harris scores were improved at postoperative 1 months and 3 months.Difference was statistically significant. Conclusion Compared with traditional approach,Super PATH approach under the guidance of the ERAS concept could further accelerate patient’s recovery,relieve postoperative pain,reduce total blood loss and hospitalization days,and promote hip joint function recovery in a short time.

关 键 词：加速康复 人工髋关节置换手术 手术入路 微创 并发症 

分 类 号：R687.4[医药卫生—骨科学]