常规器械SuperPATH入路与前外侧入路行股骨头置换:随机对照疗效比较  

Conventional instrument SuperPATH approach versus the anterolateral approach for femoral head replacement:a randomized controlled comparison of efficacy

作　　者：季冬 夏良政[1] 江云云 汪康 邓英虎[1] 朱东起[1] 袁中山[1] 李胜华[1] Ji Dong;Xia Liangzheng;Jiang Yunyun;Wang Kang;Deng Yinghu;Zhu Dongqi;Yuan Zhongshan;Li Shenghua(Orthopedic Center of Tongling People’s Hospital,Tongling 244000,Anhui Province,China)

机构地区：[1]铜陵市人民医院骨科中心,安徽省铜陵市244000

出　　处：《中国组织工程研究》2021年第30期4833-4838,共6页Chinese Journal of Tissue Engineering Research

基　　金：铜陵市卫健委卫生科研项目(卫科研[2014]08),项目负责人:夏良政。

摘　　要：背景:前外侧入路股骨头置换的切口较大,切断的肌肉需要时间愈合,康复慢;SuperPATH入路的切口很小,不切断肌肉,康复快,但需特殊的人工假体及专用器械,费用高。目的:比较常规器械SuperPATH入路与前外侧入路进行股骨头置换的疗效。方法:2016年12月到2018年8月收治老年股骨颈骨折患者43例,随机分为SuperPATH入路组(试验组)21例,前外侧入路组(对照组)22例,均使用常规器械、人工双极股骨头进行股骨头置换手术,记录切口长度、术中出血量、切开皮肤到关闭切口的时间、手术前后血红蛋白及红细胞的变化、术后开始下地的时间、疼痛评分、髋关节功能评分。结果与结论:患者均获得了24-36个月的随访。手术切口长度、切开皮肤到关闭切口的时间、术后开始下地的时间、术后1周目测类比评分、术后1周以及术后3个月的Harris评分,两组比较差异有显著性意义(P﹤0.05),试验组优于对照组;术中出血量、手术前后红细胞和血红蛋白变化、术后3个月目测类比评分及术后6个月Harris评分,两组比较差异无显著性意义(P﹥0.05)。结果提示,使用常规器械、人工股骨头进行SuperPATH入路股骨头置换,相比前外侧入路,具有切口短、创伤小、康复快等优势。BACKGROUND:The incision of anterolateral approach for femoral head replacement is larger;the cut muscle needs time to heal;and the recovery time is longer.The incision of the SuperPATH approach is very small,and it does not cut off the muscle,so it can recover quickly.However,it needs special artificial prosthesis and special instruments,and the cost is high.OBJECTIVE:To compare the efficacy of conventional instrument SuperPATH approach and anterolateral approach for femoral head replacement.METHODS:From December 2016 to August 2018,43 elderly patients with femoral neck fracture were randomly divided into experimental group(21 cases,SuperPATH group)and control group(22 cases,anterolateral group).All patients were operated with conventional instruments and femoral head,The incision length,intraoperative blood loss,the time from skin incision to incision closure,the changes of hemoglobin and red blood cells before and after operation,the time of getting off the ground after operation,pain score and hip joint function score were recorded.RESULTS AND CONCLUSION:All patients were followed up for 24 to 36 months.Among them,the length of incision,the time from skin incision to incision closure,the time to get off the ground after operation,Visual Analogue Scale score at 1 week,Harris score at 1 week and 3 months after operation were significantly different between the two groups(P<0.05),and the experimental group was better than the control group.There was no significant difference in blood loss during operation,changes of erythrocytes and hemoglobin before and after operation,Visual Analogue Scale score at 3 months after operation and Harris score at 6 months after operation between the two groups(P>0.05).These findings confirm that compared with anterolateral approach,SuperPATH approach has the advantages of shorter incision,less trauma and faster recovery.

关 键 词：股骨颈骨折 常规器械 双极股骨头置换 SuperPATH 前外侧 入路 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]