直接前入路全髋关节置换术治疗髋关节骨关节炎的效果评价  

Evaluation of the effect of direct anterior total hip arthroplasty in the treatment of hip osteoarthritis

作　　者：李志强 荆波 张永平 Li Zhiqiang;Jing Bo;Zhang Yongping(Joint Surgery,Yuncheng Central Hospital,Yuncheng 044000,China;Department of Orthopedics,541 Genera Hospital,Yuncheng 044000,China)

机构地区：[1]运城市中心医院关节外科,运城044000 [2]五四一总医院骨科,运城044000

出　　处：《中华地方病学杂志》2023年第3期226-229,共4页Chinese Journal of Endemiology

摘　　要：目的:评价直接前入路全髋关节置换术治疗髋关节骨关节炎的临床疗效。方法:选择2017年12月至2020年12月于五四一总医院骨科接受全髋关节置换术治疗的82例髋关节骨关节炎患者作为观察对象,其中41例行直接前入路全髋关节置换术治疗的患者作为观察组,41例行外侧入路全髋关节置换术治疗的患者作为对照组。比较两组患者围手术期一般指标(离床活动时间、住院时间、术中出血量、手术耗时),以及临床疗效评价指标[视觉模拟评分(VAS)、Harris髋关节功能评分、西安大略和麦克马斯特大学关节炎指数(WOMAC)评分]。结果:观察组和对照组患者离床活动时间分别为术后(15.54 ± 2.67)、(19.32 ± 3.18)h,住院时间分别为(6.87 ± 0.87)、(8.03 ± 1.04)d,组间比较差异均有统计学意义( t = 5.83、5.48,均 P < 0.001);两组患者术中出血量、手术耗时比较差异均无统计学意义( t = 0.81、0.13,均 P > 0.05)。观察组和对照组患者术后各时间点VAS(术后3 d、1个月、6个月),Harris髋关节功能(术后1、6个月)及WOMAC评分(术后1、6个月)比较差异均有统计学意义( t = 7.50、11.03、10.70,6.20、7.34,7.10、8.34,均 P < 0.001);同组患者术后1、6个月Harris髋关节功能及WOMAC评分与术前比较差异均有统计学意义(均 P < 0.05)。 结论:直接前入路全髋关节置换术治疗髋关节骨关节炎的效果良好,且较外侧入路全髋关节置换术能显著改善患者髋关节功能、减轻髋关节疼痛。Objective To evaluate the clinical effect of direct anterior total hip arthroplasty in the treatment of hip osteoarthritis.Methods ls From December 2017 to December 2020,82 patients with hip osteoarthritis who received total hip arthroplasty in the department of orthopedics,541 General Hospital,including 41 patients with direct anterior total hip arthroplasty as the observation group,and 41 patients with lateral total hip arthroplasty as the control group.The general indicators of the two groups of patients during the perioperative period(time of ambulatory activity,hospitalization,amount of intraoperative bleeding,and operation time)and the clinical efficacy evaluation indicators visual analogue score(VAS),Harris hip joint function score,Western Ontario and McMaster Universities Arthritis Index(WOMAC)score were compared.Results The time of ambulatory activity was(15.54±2.67)and(19.32±3.18)h,after operation,respectively,and the time of hospitalization was(6.87±0.87)and(8.03±1.04)d,respectively,in the observation group and the control group.The differences between the two groups were statistically significant(t=5.83,5.48,P<0.001);there was no statistically significant difference between the two groups in the amount of intraoperative bleeding and operation time(t=0.81,0.13,P>0.05).There were statistically significant differences between the observation group and the control group in VAS(3 d,1 month,6 month afer operation),Harris hip joint function score(1,6 month after operation)and WOMAC score(1,6 month after operation,t=7.50,11.03,10.70,6.20,7.34,7.10,8.34,P<0.001).The Harris hip joint function score and WOMAC score of patients in the same group between 1,6 month after operation and pre-operation were significantly different(P<0.05).Conclusion Direct anterior total hip arthroplasty is effective in the treatment of hip osteoarthritis,and can significantly improve the function of the hip joint and relieve the pain of the hip joint compared with lateral total hip arthroplasty.

关 键 词：骨关节炎 髋关节 全髋关节置换术 

分 类 号：R687.4[医药卫生—骨科学]