SuperPATH入路行全髋关节置换术的手术学疗效及对创伤应激、血清CPR、ESR的影响研究  

Surgical efficacy of total hip arthroplasty through SuperPATH approach and its influences on trauma stress,serum CPR and ESR

作　　者：杨孙强 欧裕福[2] 唐国钦 Yang Sun-qiang;Ou Yu-fu;Tang Guo-qin(Department of orthopedics,the First Peopled Hospital of Fangchenggang City,Fangchenggang 538021,China;Department of orthopedics,Peopled Hospital of Guangxi Zhuang Autonomous Region,Nanning 530012,China)

机构地区：[1]广西防城港市第一人民医院骨科,防城港538021 [2]广西壮族自治区人民医院骨科,南宁530012

出　　处：《湖南师范大学学报（医学版）》2021年第1期127-130,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:观察SuperPATH入路行全髋关节置换术的手术学疗效及对创伤应激、血清C反应蛋白(CPR)、红细胞沉降率(ESR)的影响。方法:回顾性分析2018年8月~2020年8月之间在我院行全髋关节置换术的100例股骨头坏死患者的临床资料,根据手术方式分为2组,SuperPATH组(48例)利用SuperPATH入路的全髋关节置换术治疗,直前侧入路(DAA)组(52例)选用常规DAA入路的全髋关节置换术治疗,比较两组患者围术期指标、创伤应激指标及CPR、ESR水平变化、治疗效果及并发症发生率。结果:SuperPATH组患者切口长度、术后住院时间均显著低于DAA组,手术时间、术中出血量均显著高于DAA组。术前、术后1d、术后5d、术后3月,两组患者血清CPR、ESR水平的组间和组内比较,差异有统计学意义;SuperPATH组术后1d、术后5d的血清CPR、ESR水平均现显著低于DAA组。术后1d,两组血清COR、ACTH水平均显著高于术前,其中,SuperPATH组血清皮质醇(COR)、促肾上腺皮质激素(ACTH)水平均显著低于DAA组。术后3个月,两组VAS评分均显著低于术前、Harris评分显著高于术前;两组VAS、Harris评分、并发症发生率比较未见显著差异。结论:与DAA入路相比,SuperPATH入路的全髋关节置换术切口更小,缩短患者住院时间,显著降低术后应激反应与炎症因子水平,安全性较高。Objective To observe the surgical efficacy of total hip arthroplasty (THA) through SuperPATH approach and its influences on trauma stress,serum C-reactive protein (CPR) and erythrocyte sedimentation rate (ESR).Methods The clinical data of 100 patients with femoral head necrosis who underwent THA in the hospital between August 2018 and August 2020 were retrospectively analyzed.According to different surgical methods,they were divided into SuperPATH group (48 cases,THA through SuperPATH approach) and direct anterior approach (DAA) group (52 cases,THA through routine DAA approach).The changes in perioperative indexes,trauma stress indexes,CPR and ESR levels,curative effect and incidence of complications were compared between the two groups.Results The incision length and postoperative hospitalization time in SuperPATH group were significantly lower than those in DAA group,while operation time and intraoperative blood loss were significantly higher than those in DAA group.Before surgery,at 1d,5d and 3 months after surgery,the differences in levels of serum CPR and ESR between the two groups and within the same group were statistically significant.At 1d and 5d after surgery,levels of serum CPR and ESR in SuperPATH group were significantly lower than those in DAA group.At 1d after surgery,levels of serum cortisol (COR) and adrenocorticotropic hormone (ACTH) in both groups were significantly higher than those before surgery,which were significantly lower in SuperPATH group than DAA group.At 3 months after surgery,VAS scores were significantly lower than those before surgery,while Harris scores were significantly higher than those before surgery in both groups.There were no significant differences in VAS and Harris scores,and incidence of complications between the two groups.Conclusion Compared with DAA approach,incision of THA through SuperPATH approach is smaller,which can shorten hospitalization time,significantly reduce postoperative stress response and levels of inflammatory factors,with higher safety.

关 键 词：SuperPATH入路 全髋关节置换术 应激反应 红细胞沉降率 

分 类 号：R614[医药卫生—麻醉学]