SuperPATH入路与后外侧入路全髋关节置换术对患者炎性反应、髋关节功能及生活质量的影响  

Effects of SuperPATH approach versus posterolateral approach in total hip replacement on inflammatory response,hip function,and quality of life in patients with hip diseases

作　　者：孙付杰[1] 邹士东 汪明星[1] 张振华[1] 聂文波[1] Sun Fujie;Zou Shidong;Wang Mingxing;Zhang Zhenhua;Nie Wenbo(Department of Orthopedics,Huxi Hospital Affiliated to Jining Medical College(Shanxian Central Hospital),Heze 274300,Shandong Province,China)

机构地区：[1]单县中心医院骨科,菏泽274300

出　　处：《中国基层医药》2022年第2期271-275,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：济宁医学院教师科研扶持基金项目(JYFC2018FKJ090)。

摘　　要：目的探讨SuperPATH入路与传统后外侧入路全髋关节置换术对髋关节疾病患者炎性反应、髋关节功能及生活质量的影响。方法回顾性分析单县中心医院2017年3月至2019年5月收治的行全髋关节置换术治疗的髋关节疾病患者140例的临床资料。根据手术入路方式将其分为后外侧入路组(n=70)和SuperPATH入路组(n=70),比较两组手术相关指标、炎性反应指标、髋关节功能、生活质量及疼痛情况。结果SuperPATH入路组术中出血量为(105.40±15.11)mL,少于后外侧入路组的(196.89±24.26)mL(t=26.74,P<0.001),切口长度、术后下地时间、住院时间分别为(6.85±1.42)cm、(2.92±0.28)d、(6.67±1.36)d,均短于后外侧入路组的(13.07±1.89)cm、(8.36±1.45)d、(10.91±1.34)d(t=19.36、30.82、18.58,均P<0.001),而手术时间为(69.38±8.62)min,长于后外侧入路组的(60.45±7.79)min(t=6.43,P<0.001)。SuperPATH入路组术后6个月社会功能、总体健康、生命活力、精神健康、躯体疼痛、情感功能、生理职能、生活功能8个维度评分均高于后外侧入路组(t=9.12、11.80、11.64、11.69、6.45、11.79、6.04、10.74,均P<0.001)。两组术后3 d、术后14 d的C反应蛋白、红细胞沉降率差异均无统计学意义(均P>0.05)。SuperPATH入路组术后1个月髋关节功能Harris评分为(76.42±4.17)分,高于后外侧入路组的(69.37±5.11)分(t=8.94,P<0.001)。SuperPATH入路组术后3 d视觉疼痛模拟评分法评分为(3.18±0.21)分,低于后外侧入路组的(4.26±0.29)分(t=25.23,P<0.001)。结论与传统后外侧入路相比,SuperPATH入路用于全髋关节置换术,虽然手术时间更长,但可减轻患者的术后早期疼痛,促进髋关节功能恢复,提高患者生活质量。Objective To investigate the effects of SuperPATH approach versus conventional posterolateral approach in total hip replacement on inflammatory response,hip function,and quality of life in patients with hip diseases.Methods The clinical data of 140 patients with hip diseases who underwent total hip replacement in Shanxian Central Hospital from March 2017 to May 2019 were retrospectively analyzed.These patients were divided into SuperPATH approach(n=70)and posterolateral approach(n=70)groups.Operation-related indexes,inflammatory response indexes,hip function,quality of life,and pain were compared between the two groups.Results Intraoperative blood loss was significantly less in the SuperPATH approach group than in the posterolateral approach group[(105.40±15.11)mL vs.(196.89±24.26)mL,t=26.74,P<0.001].Incision length,postoperative time to getting out of bed,length of hospital stay in the SuperPATH approach group were(6.85±1.42)cm,(2.92±0.28)days,and(6.67±1.36)days,respectively,which were significantly shorter than those in the posterolateral approach group[(13.07±1.89)cm,(8.36±1.45)days,(10.91±1.34)days,t=19.36,30.82,18.58,P<0.001].Operative time was significantly longer in the SuperPATH approach group than in the posterolateral approach group[(69.38±8.62)minutes vs.(60.45±7.79)minutes,t=6.43,P<0.001).The scores of social role functioning,general health perceptions,vitality,mental health,bodily pain,emotional role functioning,physical functioning,and physical functioning measured 6 months after surgery were significantly higher in the SuperPATH approach group than in the posterolateral approach group(t=9.12,11.80,11.64,11.69,6.45,11.79,6.04,10.74,all P<0.001).There were no significant differences in C-reactive protein and erythrocyte sedimentation rate measured 3 and 14 days after surgery between the two groups(both P>0.05).Harris score used for evaluation of hip function 1 month after surgery was significantly higher in the SuperPATH approach group than in the posterolateral approach group[(76.42±4.17)

关 键 词：关节成形术 置换 髋 骨关节炎 髋 股骨颈骨折 失血 手术 手术时间 疼痛 手术后 炎性反应 生活质量 

分 类 号：R687.4[医药卫生—骨科学]