机器人辅助与常规全髋关节置换术早期疗效及患者满意度的比较  

Comparison of short-term clinical outcomes and patient satisfaction between robotic-assisted and conventional total hip arthroplasty

作　　者：王鑫光 何宜蓁 董子漾 耿霄[1] 王程 李杨[1] 李子剑[1] 田华[1] Wang Xinguang;He Yizhen;Dong Ziyang;Geng Xiao;Wang Cheng;Li Yang;Li Zijian;Tian Hua(Department of Orthopaedics,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院骨科,北京100191

出　　处：《中华骨科杂志》2023年第8期492-499,共8页Chinese Journal of Orthopaedics

基　　金：北京市自然科学基金(19L2160)。

摘　　要：目的探讨机器人辅助全髋关节置换术(total hip arthroplasty, THA)与常规THA术后早期疗效及患者满意度的差异。方法回顾性分析北京大学第三医院骨科在2019年9月至2022年2月因骨关节炎、股骨头坏死等原因接受由同一名术者使用同一品牌假体单侧初次THA手术患者171例。根据手术方式分为机器人辅助组和常规手术组。术后摄骨盆正位及髋关节穿桌侧位X线片, 观察两组患者总失血量、输血率、住院时间、术后并发症、术后髋臼假体前倾角及外展角、髋臼假体位于Lewinnek和Callanan安全区的比例、疼痛视觉模拟评分(visual analogue scale, VAS)、Harris髋关节功能评分、生活质量评分(quality of life, QOL)及患者满意度评分。结果两组患者性别、年龄、身高、体重、体质指数、手术侧别、术前血容量及术前Harris髋关节功能评分的差异均无统计学意义(P>0.05)。2例患者因骨质疏松症导致机器人定位螺钉松动, 术中改为常规手术。常规手术组87例术后随访时间为(19.7±6.8)个月, 机器人辅助组84例为(18.6±5.4)个月, 差异无统计学意义(t=1.16, P=0.249)。机器人辅助组的手术时间为(106.99±31.91)min, 较常规手术组的(73.79±29.48)min延长, 差异有统计学意义(t=7.07, P<0.001)。常规手术组住院时间为(6.40±2.40)d, 机器人辅助组(6.49±1.95)d, 差异无统计学意义(t=0.26, P=0.796);术后第3天时两组患者总失血量、输血率的差异无统计学意义(P>0.05)。常规手术组患者髋臼外展角为38.79°±6.93°、前倾角为14.81°±6.49°, 机器人辅助组分别为39.41°±3.01°和13.33°±4.32°, 差异无统计学意义(t=0.58, P=0.449;t=3.06, P=0.082)。机器人辅助组髋臼假体位于Lewinnek安全区的比例为96.4%, 位于Callanan安全区为92.9%, 高于常规手术组的73.6%和65.5%,差异均有统计学意义(χ^(2)=15.60, P<0.001;χ^(2)=17.61, P<0.001)。常规手术组与机器人辅助组患者术后VAS评分、HaObjective To compare short-term clinical outcomes and patient satisfaction between robotic-assisted total hip arthroplasty(THA)and conventional THA.Methods Patient data of unilateral primary THA with the same prosthesis by the same operator due to osteoarthritis,osteonecrosis of the femoral head,and other diseases in Peking University Third Hospital from September 2019 to February 2022 was retrospectively analyzed.Patients were divided into robot-assisted THA group and conventional THA group according to surgical methods.The preoperative general data,operation time,intraoperative complications and other intraoperative data were collected.Anteroposterior X-ray of pelvis and cross-table X-ray of hip were taken.Main outcome measures consisted of total blood loss,blood transfusion rate,hospitalization stay,postoperative complications,and the inclination and anteversion angle of the acetabular cup,while the dislocation rate outside the Lewinnek and Callanan safe zone was also analyzed.Other outcomes measures included visual analogue scale,Harris score,quality of life score(QOL)and satisfaction score.Results There was no significant difference in gender,age,height,weight,body mass index(BMI),operation side,preoperative blood volume and Harris score between the two groups(P>0.05);Loosening of positioning screws occurred in 2 patients due to osteoporosis in robot-assisted THA group,so conventional THA was performed.Therefore,84 cases in robot-assisted THA group and 87 cases in conventional THA group were enrolled in this study at last.There was no significant difference in follow-up time between conventional THA group and robot-assisted THA group(19.7±6.8 months vs.18.6±5.4 months,t=1.16,P=0.249);The operation time of robot-assisted THA group was longer than that of conventional THA group(106.99±31.91 min vs.73.79±29.48 min,t=7.07,P<0.001),but there was no significant difference in hospitalization stay between conventional THA group and robot-assisted THA group(6.40±2.40 d vs.6.49±1.95 d,t=0.26,P=0.796).There was a

关 键 词：关节成形术 置换 髋 机器人手术 治疗结果 病人满意度 

分 类 号：R687.4[医药卫生—骨科学]