人工全髋关节置换术改良Hardinge入路与后外侧入路疗效对比研究  

Comparative study on the curative effect of modified Hardinge approach and posterolateral approach in total hip arthroplasty

作　　者：袁景[1] 陆军[1] 汤月平[1] 沈文东[1] 张军强[1] 姚喆 王一帆 高剑峰[1] YUAN Jing;LU Jun;TANG Yue-ping;SHEN Wen-dong;ZHANG Jun-qiang;YAO Zhe;WANG Yi-fan;GAO Jian-feng(Department of Orthopaedics,Nanjing Medical University Affiliated Suzhou Municipal Hospital,Suzhou Jiangsu 215000,China)

机构地区：[1]南京医科大学附属苏州医院骨科,江苏苏州215000

出　　处：《局解手术学杂志》2021年第12期1030-1034,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：江苏省科技支撑计划(社会发展)项目(BE2011672)。

摘　　要：目的对比改良Hardinge入路与后外侧入路人工全髋关节置换术(THA)的临床疗效。方法回顾性分析行THA的114例患者的临床资料。根据入路方式的不同,将患者分为对照组(采用后外侧入路,55例)和改良组(采用改良Hardinge入路,59例)。观察2组围术期指标、并发症情况以及髋关节功能Harris评分。结果改良组的术后引流量、术中出血量少于对照组,切口长度、手术时间、住院时间短于对照组(P<0.05)。2组术后3个月、6个月、12个月Harris评分均较术前升高(P<0.05),术后3个月、6个月、12个月Harris评分组间比较,差异无统计学意义(P>0.05);2组优良率比较,差异无统计学意义(P>0.05)。改良组并发症发生率低于对照组(P<0.05)。结论采用改良Hardinge入路与后外侧入路行THA均可改善患者髋关节功能,疗效较好,但改良Hardinge入路较后外侧入路创伤更小、手术时间更短、术中出血量更少、并发症更少、术后恢复更快,安全可靠。Objective To compare the clinical effect of total hip arthroplasty(THA)via modified Hardinge approach and posterolateral approach.Methods The clinical data of 114 patients who underwent THA were retrospectively analyzed.The patients were divided into the control group(55 cases with posterolateral approach)and the modified group(59 cases with modified Hardinge approach)according to the different approaches.The perioperative indicators,complications,and Harris score of hip joint function of the two groups were observed.Results The postoperative drainage volume and intraoperative blood loss of the modified group were less than those of the control group(P<0.05),and the incision length,operation time and hospital stay of the modified group were shorter than those of the control group(P<0.05).The Harris scores of the two groups 3 months,6 months and 12 months after operation were higher than those before operation(P<0.05),while there was no statistically significant difference in the Harris scores 3 months,6 months and 12 months after operation between the two groups(P>0.05);there was no statistically significant difference in the excellent and good rate between the two groups(P>0.05).The incidence of complications in the modified group was lower than that in the control group(P<0.05).Conclusion Both the modified Hardinge approach and the posterolateral approach for THA can improve the function of hip joint in patients,with good curative effect.However,compared with the posterolateral approach,the modified Hardinge approach has less trauma,shorter operation time,less intraoperative blood loss,fewer complications,and faster postoperative recovery,which is safe and reliable.

关 键 词：人工全髋关节置换术 改良HARDINGE入路 后外侧入路 疗效 

分 类 号：R323.45[医药卫生—人体解剖和组织胚胎学]