直接前方入路初次全髋关节置换术关节囊切除与保留的疗效比较  

Clinical effect comparison of resecting or reserving joint capsule in the primary total hip arthroplasty via direct anterior approach

作　　者：黄润华 尚希福 廖中亚[1] 王小合[1] HUANG Run-hua;SHANG Xi-fu;LIAO Zhong-ya;WANG Xiao-he(Dept of Joint Surgery,the People′s Hospital of Bozhou City,Bozhou,Anhui 236800,China)

机构地区：[1]亳州市人民医院关节外科,安徽亳州236800 [2]中国科学技术大学附属第一医院骨科,安徽合肥230000

出　　处：《临床骨科杂志》2020年第5期650-655,共6页Journal of Clinical Orthopaedics

摘　　要：目的比较直接前方入路行初次全髋关节置换术(THA)关节囊切除与保留的疗效。方法将患者根据住院号末位数奇偶性分为切除关节囊组(57例)和保留关节囊组(55例)。比较两组切口长度、手术时间、术中出血量、术后引流量、术后主要并发症、Harris评分和疼痛VAS评分。结果患者均获得随访,时间9~12(10.8±1.1)个月。手术时间切除关节囊组短于保留关节囊组(P<0.05);切口长度、术中出血量切除关节囊组短(少)于保留关节囊组,但差异无统计学意义(P>0.05);术后引流量切除关节囊组多于保留关节囊组(P<0.05);两组均未出现输血及术后早期髋关节脱位患者。术后2周,Harris评分切除关节囊组高于保留关节囊组(P<0.05);VAS评分切除关节囊组明显低于保留关节囊组(P<0.05)。结论直接前方入路初次THA术中切除关节囊能缩短手术时间,术中暴露清晰,疼痛程度轻,且不增加术后脱位发生。从近期的疗效看来,切除关节囊是安全可靠的。Objective To compare the clinical effect of resecting or reserving hip capsule in primary total hip arthroplasty via direct anterior approach.Methods The 112 cases of primary total hip arthroplasty were divided into two groups,the resecting joint capsule group(57 cases)and reserving joint capsule group(55 cases).The following data of the two groups patients were compared:incision length,operation time,intraoperative blood loss,postoperative drainage volume,postoperative major complications,the Harris hip scores and pain VAS.Results All patients were followed up for 9~12(10.8±1.1)months.The operative time of the resecting joint capsule group was shorter than that of the reserving joint capsule group(P<0.05).The incison length and intraoperative blood loss of the resecting joint capsule group were shorter(less)than those of the reserving joint capsule group,but the differences were not statistically significant(P>0.05).The postoperative drainage volume of the resecting joint capsule group was more than that of the reserving joint capsule group(P<0.05).The two groups had no blood transfusion and postoperative early hip dislocation.At 2 weeks after operation,the Harris score of the resecting joint capsule group was higher than that of the reserving joint capsule group(P<0.05);the VAS of the resecting joint capsule group was lower than that of the reserving joint capsule group(P<0.05).Conclusions In the total hip arthroplasty with direct anterior approach,resection of the joint capsule can shorten the operation time,with the clear intraoperative visual field exposure,and light pain,and which does not increase postoperative dislocation.Resection of the joint capsule is safe and reliable for the short-term efficacy.

关 键 词：直接前方入路 侧卧位 全髋关节置换术 关节囊切除术 关节囊切开术 

分 类 号：R687.4[医药卫生—骨科学]