直接前入路与后外侧入路人工全髋关节置换术治疗老年股骨颈骨折的早期疗效对比分析  

Comparative Analysis of the Early Efficacy of Total Hip Replacement with Direct Anterior Approach and Posterior Lateral Approach in the Treatment of Femoral Neck Fracture in Senile Patients

作　　者：邹士东 陈山成[1] 胡克正 孙付杰[1] 汪明星[1] 邓亦奇 ZOU Shidong;CHEN Shancheng;HU Kezheng;SUN Fujie;WANG Mingxing;DENG Yiqi(Department of Orthopedics,Shanxian Central Hospital,Shanxian,Shandong Province,274300 China)

机构地区：[1]单县中心医院骨科,山东单县274300

出　　处：《系统医学》2023年第3期94-97,102,共5页Systems Medicine

摘　　要：目的探讨在股骨颈骨折老年患者接受人工全髋关节置换术治疗期间,以直接前入路及后外侧入路方式施治的价值。方法回顾性分析2020年1月—2022年1月单县中心医院接受人工全髋关节置换术施治的股骨颈骨折老年患者80例的临床资料,采取数字奇偶法分为对照组与观察组,各40例。对照组采用后外侧入路术式,观察组采用直接前入路术式,对比两组手术相关指标差异。结果观察组手术切口长度短于对照组,出血量、术后引流量均低于对照组,下地时间早于对照组,差异有统计学意义(t=12.824、10.468、4.776、12.099,P<0.05);观察组手术时间为(115.34±23.17)min长于对照组(79.47±20.65)min,差异有统计学意义(t=7.309,P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(χ^(2)=5.165,P<0.05);术后1、3 d,观察组血清学指标CK、CRP、IL-6水平均低于对照组,差异有统计学意义(t=15.828、24.388、12.711、12.880、15.864、23.277,P<0.05);术后1、2个月,观察组髋关节功能评分均高于对照组,差异有统计学意义(t=3.948、4.876,P<0.05)。结论通过以直接前入路及传统后外侧入路方式实施人工全髋关节置换术均可得到一定手术效果,然而应用直接前入路方式所得早期疗效更为显著。Objective To investigate the value of direct anterior approach and posterior lateral approach during total hip replacement in elderly patients with femoral neck fracture.Methods A retrospective analysis was made of the clinical data of 80 elderly patients with femoral neck fractures who underwent total hip arthroplasty in Shan County Central Hospital from January 2020 to January 2022.The patients were divided into a control group and an observation group using the digital parity method,with 40 patients in each group.The control group used a posterolateral approach and the observation group used a direct anterior approach.The differences in surgical related indicators between the two groups were compared.Results The length of the surgical incision in the observation group was shorter than that in the control group,and the amount of bleeding and postoperative drainage flow were lower than those in the control group,the time of landing was earlier than that in the control group,the difference was statistically significant(t=12.824,10.468,4.776,12.099,P<0.05).The operative time in the observation group was(115.34±23.17)min longer than that in the control group(79.47±20.65)min,the difference was statistically significant(t=7.309,P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(χ^(2)=5.165,P<0.05).On the first and third days after surgery,the serum indicators CK,CRP,and IL-6 in the observation group were significantly lower than those in the control group,the difference was statistically significant(t=15.828,24.388,12.711,12.880,15.864,23.277,P<0.05).At 1 and 2 months after surgery,the hip joint function scores in the observation group were significantly higher than those in the control group,the difference was statistically significant(t=3.948,4.876,P<0.05)Conclusion Both the direct anterior approach and the traditional posterior lateral approach can achieve certain surgical effects,but the early efficacy obtained b

关 键 词：股骨颈骨折 老年患者 人工全髋关节置换术 直接前入路 后外侧入路 

分 类 号：R521[医药卫生—内科学]