人工股骨头置换术中下肢长度不同均衡策略对髋关节功能及术后双下肢长度的影响  

Effect of different lower limb length equalization strategies on hip function and postoperative bilateral lower limb length during artificial femoral head replacement

作　　者：张红荣 钟宝 苗立帅 张勇 ZHANG Hong-rong;ZHONG Bao;MIAO Li-shuai;ZHANG Yong(Department of Orthopedic Trauma,Longgang District People's Hospital of Shenzhen,Shenzhen Guangdong 518000,China;Department of Orthopedics,Longgang Central Hospital,Shenzhen Guangdong 518116,China;Department of Orthopedics,Ankang Hospital of Traditional Chinese Medicine,Ankang Shaanxi 725000,China)

机构地区：[1]深圳市龙岗区人民医院创伤骨科,广东深圳518000 [2]龙岗中心医院骨科,广东深圳518116 [3]安康市中医医院骨科,陕西安康725000

出　　处：《局解手术学杂志》2023年第5期404-408,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：广东省医学科学技术研究基金项目(A201810113)。

摘　　要：目的探讨人工股骨头置换术中下肢长度不同均衡策略对髋关节功能及术后双下肢长度的影响。方法选取86例行单侧人工股骨头置换术的患者,根据术中采用的下肢长度均衡策略分为对照组和改良组,每组43例,对照组按照传统方法均衡下肢长度,改良组以健侧头颈比为对照均衡下肢长度。比较2组患者手术一般情况、手术前后双下肢长度差异、Harris评分、满意率、步态、并发症发生率。结果改良组手术时间、术中出血量、住院费用及住院时间等手术一般情况与对照组比较,差异均无统计学意义(P>0.05);2组术后双下肢长度差异均较术前缩小(P<0.05),且改良组术后双下肢长度差异小于对照组(P<0.05);2组术后Harris评分均高于术前(P<0.05),且改良组高于对照组(P<0.05);改良组满意率为97.67%,高于对照组的81.40%(P<0.05);改良组术后步频、单腿支撑时间、步速均高/长于对照组(P<0.05);改良组术后并发症发生率为2.33%,与对照组的6.98%比较,差异无统计学意义(P>0.05)。结论人工股骨头置换术中以健侧头颈比为对照可有效均衡下肢长度,减少双下肢长度差异,增强髋关节功能重建效果,提升患者满意率,改善患者步态,安全可靠。Objective To investigate the effects of different lower limb length equalization strategies during artificial femoral head replacement on hip function and postoperative bilateral lower limb length.Methods A total of 86 patients who underwent unilateral artificial femoral head replacement were selected and divided into the control group and the modified group according to different lower limb length equalization strategies adopted during the operation,with 43 cases in each group.The lower limb length in the control group was equalized by traditional method,and the lower limb length in the modified group was equalized by the head neck ratio of the healthy side.The general conditions of surgery,the difference of lower limb length before and after surgery,Harris score,satisfaction rate,gait and incidence of complications of the two groups were compared.Results There was no significant difference between the two groups in terms of operation time,intraoperative blood loss,hospital expenses or hospital stay(P>0.05).The postoperative difference of lower limb length of the two groups were reduced compared with those before surgery(P<0.05),and the postoperative difference of lower limb length in the modified group was less than that in the control group(P<0.05).The Harris scores after surgery in both groups were higher than those before surgery(P<0.05),and the modified group was higher than the control group(P<0.05).The satisfaction rate in the modified group was 97.67%,which was higher than 81.40%in the control group(P<0.05).The postoperative stride frequency,single leg support time and step speed in the modified group were higher/longer than those in the control group(P<0.05).The postoperative incidence of complications in the modified group was 2.33%,which was no statistically significant difference compared with 6.98%in the control group(P>0.05).Conclusion In artificial femoral head replacement,using the head neck ratio of the healthy side as a control can effectively equalize the the lower limb length,reduce the diffe

关 键 词：人工股骨头置换术 下肢长度 头颈比 HARRIS评分 满意率 股骨颈骨折 

分 类 号：R687.4[医药卫生—骨科学]