两种入路全髋关节置换术治疗老年股骨颈骨折的疗效比较  

Comparison of the efficacy of two approaches foRtotal hip arthroplasty in the treatment of femoral neck fractures in the elderly patients

作　　者：董佩龙[1] 唐晓波[1] 王健[1] 李志云 朱波涛 赵建宁 DONG Pei-long;TANG Xiao-bo;WANG Jian;LI Zhi-yun;ZHU Bo-tao;ZHAO Jian-ning(Dept of Orthopaedics,Jianhu Hospital Affiliated of Nantong University,Yancheng,Jiangsu 224700,China)

机构地区：[1]南通大学附属建湖医院骨科,江苏盐城224700 [2]中国人民解放军东部战区总医院骨科,江苏南京210002

出　　处：《临床骨科杂志》2022年第4期477-481,共5页Journal of Clinical Orthopaedics

基　　金：江苏省科技厅第五期“333工程”科研项目资助计划(编号:BRA2018250);江苏省盐城市科技局医学科技发展计划资助项目(编号:YK2017080)。

摘　　要：目的比较直接前方入路与后外侧入路全髋关节置换术(THA)治疗老年股骨颈骨折的临床疗效。方法将64例行初次THA的老年股骨颈骨折患者根据入路不同分为观察组(采用直接前方入路THA,32例)和对照组(采用后外侧入路THA,32例)。结果患者均获得随访,时间8~12个月。切口长度、手术时间:两组比较差异均无统计学意义(P>0.05)。术后24 h血红蛋白:两组均较术前降低(P<0.05),观察组高于对照组(P<0.001)。术中出血量、并发症发生率:观察组少(低)于对照组(P<0.05)。疼痛VAS评分和Harris评分:术后24 h、1个月观察组均优于对照组(P<0.001),术后6个月两组比较差异均无统计学意义(P>0.05)。结论与后外侧入路相比,直接前方入路THA治疗老年股骨颈骨折术中出血量少、并发症发生率低、术后短期疼痛程度轻,更利于患者髋关节功能的早期恢复。Objective To compare the clinical efficacy of the direct anterioRapproach(DAA)and the posterolateral approach foRtotal hip arthroplasty(THA)in the treatment of femoral neck fractures of elderly patients.Methods The 64 elderly patients with femoral neck fractures who underwent primary THA were divided into two groups:observation group(32 cases were treated with THA via DAA)and control group(32 cases were treated with THA via posterolateral approach).Results All patients were followed up foR8~12 months.The incision length and operation time were not statistically different between the two groups(P>0.05).The hemoglobin of 24 h afteRoperation:the two groups were decreased than the preoperation(P<0.05),and the observation group was higheRthan the control group(P<0.001).The intraoperative blood boss and the incidence rate of complications in the observation group were less(lower)than those in the control group(P<0.05).The pain VAS and Harris score:at 24 h and 1 month postoperation,the observation group were all betteRthan the control group(P<0.001),and there were no differences between two groups at 6 months postoperation(P>0.05).Conclusions Compared with the posterolateral approach,the DAA foRprimary total hip arthroplasty in elderly patients can reduce intraoperative blood boss and the incidence of complications,cause mild short-term pain afteRoperation.It is beneficial to the early recovery of hip joint function.

关 键 词：股骨颈骨折 直接前方入路 后外侧入路 全髋关节置换术 老年人 

分 类 号：R683.42[医药卫生—骨科学] R687.4[医药卫生—外科学]