前侧微创入路全髋关节置换术对股骨颈骨折患者Hb、CRP、IL-6水平及髋关节屈伸活动度的影响  

Effect of THR through Anterior Minimally Invasive Approach on the Levels of HB,CRP,IL-6 and the Range of Hip Joint Motion Flexion and Extension in Patients with Femoral Neck Fracture

作　　者：王胜涛 殷勇 张波 蔡杰勇 肖波 石波[2] 康斌[2] WANG Sheng-tao;YIN Yong;ZHANG Bo(Department of Orthopedics,The 3rd Affiliated Hospital of Chengdu Medical College Pidu District People's Hospital,Chengdu Sichuan,611700)

机构地区：[1]成都医学院第三附属医院成都市郫都区人民医院骨科,四川成都611700 [2]绵阳市中心医院骨科,四川绵阳621000

出　　处：《医学临床研究》2020年第12期1840-1843,共4页Journal of Clinical Research

摘　　要：【目的】探讨前侧微创入路全髋关节置换术(THR)对股骨颈骨折患者血红蛋白(Hb)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平及髋关节屈伸活动度的影响。【方法】回顾性分析2017年1月至2019年12月在本院行前侧微创入路TRH患者(观察组,n=42)与传统后侧入路THR患者(对照组,n=42)的临床资料。比较两组患者围术期指标(手术时间、切口长度、术中出血量、术后引流量、住院时间)及术前、术后血液指标[Hb、血细胞比容(Hct)]、炎性指标(CRP、IL-6)和髋关节屈伸活动度及髋关节功能评分(Harris评分)。【结果】两组患者围术期各指标(除手术时间外)比较差异均有统计学意义(P<0.05);术后24 h,两组患者Hb、Hct水平较术前均显著下降(P<0.05),但观察组患者显著高于对照组(P<0.05);术后24 h、7 d,两组患者CRP、IL-6水平较术前均显著上升(P<0.05),但观察组患者显著低于对照组(P<0.05);术后3、6、12个月,两组患者髋关节屈伸活动度和Harris评分较术前均显著上升(P<0.05),术后3个月观察组患者上述指标均显著高于对照组(P<0.05),术后6、12个月观察组髋关节屈伸活动度显著高于对照组(P<0.05),但两组Harris评分比较差异无统计学意义(P>0.05)。【结论】前侧微创入路THR更有助于患者术后康复,缩短住院时间,并可减轻炎性反应,增加髋关节屈伸活动度,缩短髋关节功能恢复时间,值得临床推广应用。【Objective】To investigate the effect of total hip arthroplasty(THR)through anterior minimally invasive approach on the levels of hemoglobin(HB),C-reactive protein(CRP),interleukin-6(IL-6)and the range of motion of hip joint flexion and extension in patients with femoral neck fracture.【Methods】The clinical data of TRH patients(observation group,n=42)and traditional posterior approach thr patients(control group,n=42)were retrospectively analyzed from January 2017 to December 2019 in our hospital.The perioperative indexes(operation time,incision length,intraoperative blood loss,postoperative drainage,length of hospital stay),preoperative and postoperative blood indexes(Hb,Hct),inflammatory indexes(CRP,IL-6),hip flexion and extension range of motion and hip function score(Harris score)were compared between the two groups.【Results】There were statistically significant differences in the perioperative indexes(except operation time)between the two groups(P<0.05);after 24 h,the levels of Hb and Hct in the two groups were significantly lower than those before operation(P<0.05),but the observation group was significantly higher than the control group(P<0.05);24 h,7 d after operation,the levels of Hb and Hct in the two groups were significantly lower than those before operation(P<0.05).The levels of CRP and IL-6 in the two groups were significantly higher than those before operation(P<0.05),but the observation group was significantly lower than the control group(P<0.05);after 3,6,12 months,the hip joint flexion and extension activity and Harris score of the two groups were significantly increased(P<0.05),the above indexes of the observation group were significantly higher than those of the control group at 3 months after operation(P<0.05),and the hip of the observation group at 6 and 12 months after operation was significantly higher than that of the control group(P<0.05)The range of motion of joint flexion and extension was significantly higher than that of the control group(P<0.05),but there was no significant

关 键 词：关节成形术 置换 髋 股骨颈骨折/外科学 C反应蛋白质/血液 白细胞介素6/血液 

分 类 号：R683.421[医药卫生—骨科学]