经微创Supercap入路半髋关节置换治疗老年移位股骨颈骨折的临床观察  

Clinical observation on the treatment of displaced femoral neck fracture in the elderly with hemiarthroplasty via minimally invasive supercap approach

作　　者：耿晓林[1] 周迎峰[1] 禹萌[2] 陶金刚[1] 徐海斌[1] Geng Xiaolin;Zhou Yingfeng;Yu Meng;Tao Jingang;Xu Haibin(Department of Orthopedics,the First Affiliated Hospital of Xinxiang Medical College,Xingxiang,Henan 453100,China;Department of Neurology,Zhengzhou People s Hospital,Zhengzhou 450003,China)

机构地区：[1]新乡医学院第一附属医院骨科一病区,河南新乡453100 [2]郑州人民医院神经内科,郑州450003

出　　处：《创伤外科杂志》2021年第1期37-40,共4页Journal of Traumatic Surgery

基　　金：河南省科技攻关计划项目(172102310510)。

摘　　要：目的探讨经微创Supercap入路半髋关节置换治疗老年移位股骨颈骨折的临床效果。方法回顾性分析2017年1月—2019年10月新乡医学院第一附属医院收治老年移位股骨颈骨折患者80例,男性42例,女性38例;年龄70~86岁,平均75.6岁。按照手术方法的不同分为微创组和传统组,各40例。传统组给予传统后外侧入路行半髋关节置换术治疗,微创组经微创Supercap入路半髋关节置换术治疗。比较两组患者手术情况、术后1周内发症发生率,手术优良率,术前及术后2、4、8、12周VAS评分,术前及术后3个月生活质量评分。结果微创组手术时间(78.9±10.3)min、术中失血量(188.4±29.1)mL、手术切口长度(5.2±1.2)cm、住院时间(10.4±2.8)d,均少于传统组(86.1±14.2)min、(219.2±34.5)mL、(6.3±1.7)cm、(14.7±2.9)d(P<0.05)。微创组并发症发生率8%(3/40)低于传统组25%(10/40);手术效果优良率93%(37/40)高于传统组73%(29/40),差异均有统计学意义(P<0.05)。微创组术后2、4、8、12周VAS评分均低于传统组(P<0.05)。术后3个月微创组生活质量各项评分均高于传统组(P<0.05)。结论经微创Supercap入路半髋关节置换术治疗老年移位股骨颈骨折能降低患者手术创伤,手术安全性及手术效果优良率较高,减轻患者术后疼痛感,提高患者生活质量,值得临床推荐。Objective To investigate the clinical effect of hemiarthroplasty through minimally invasive supercap approach in the treatment of displaced femoral neck fractures in the elderly.Methods Totally 80 elderly patients with displaced femoral neck fracture were treated in the First Affiliated Hospital of Xinxiang Medical University from Jan.2017 to Oct.2019,including 42 males and 38 females.The patients were 70-86 years,with an average age of 75.6 years.According to different surgical methods,they were divided into minimally invasive group and traditional group,with 40 cases in each group.The traditional group was given the traditional posterolateral approach for hemiarthroplasty,and the minimally invasive group was given hemiarthroplasty through the minimally invasive supercap approach.The operation progress,incidence of surgical complications,excellent and good rate of operation,VAS before and after operation and quality of life score were compared between the two groups.Results The operation time(78.9±10.3)minutes,intraoperative blood loss(188.4±29.1)mL,incision length(5.2±1.2)cm,and hospital stay(10.4±2.8)days in the minimally invasive group were less than those in the traditional group[86.1±14.2)minutes,(219.2±34.5)mL,(6.3±1.7)cm,(14.7±2.9)days](P<0.05).The complication rate of minimally invasive group was 8%(3/40),which was lower than that of traditional group(25%,10/40),and the difference was statistically significant(P<0.05).The excellent and good rate of minimally invasive group was 93%(37/40),which was higher than that of traditional group(73%,29/40),and the difference was statistically significant(P<0.05).The VAS score of minimally invasive group was lower than that of traditional group at 2,4,8,12 weeks after operation(P<0.05).At 3 months after operation,the scores of quality of life in minimally invasive group were higher than those in traditional group(P<0.05).Conclusion The clinical effect of hemiarthroplasty through minimally invasive supercap approach in the treatment of elderly displaced femor

关 键 词：股骨颈骨折 半髋关节置换 微创 老年 

分 类 号：R683.42[医药卫生—骨科学]