两种不同入路全髋关节置换术治疗股骨颈骨折的效果比较  

Comparison on the Effects of Different Approaches of Total Hip Arthroplasty in the Treatment of Femoral Neck Fracture

作　　者：周志广 马国涛[1] 吴登科[1] 田朝奇 宋志勇 ZHOU Zhiguang;MA Guotao;WU Dengke;TIAN Chaoqi;SONG Zhiyong(1^(st) Department of Orthopedics,Pingdingshan First People's Hospital,Pingdingshan 467000,China)

机构地区：[1]平顶山市第一人民医院骨一科,河南平顶山467000

出　　处：《临床医学工程》2023年第11期1551-1552,共2页Clinical Medicine & Engineering

摘　　要：目的对比微创直接前侧入路(DAA)与传统后外侧入路(PLA)全髋关节置术治疗股骨颈骨折患者的临床效果。方法选择2020年6月至2022年12月于我院收治的股骨颈骨折患者86例,随机分为DAA组(43例,DAA入路全髋关节置换术)、PLA组(43例,PLA入路全髋关节置换术),比较两组的围术期指标、手术应激指标和炎性因子水平。结果DAA组手术时间长于PLA组,术中失血量、切口长度、术后1 d引流量低于PLA组(P<0.05)。DAA组血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、去甲肾上腺素(NE)、皮质醇(Cor)水平低于PLA组(P<0.05)。结论DAA全髋关节置换术治疗股骨颈骨折患者效果确切,与PLA比较,其手术创伤更小,术后患者应激反应及炎性反应更轻。Objective To compare the effects of minimally invasive direct anterior approach(DAA)and traditional posterolateral approach(PLA)total hip arthroplasty in the treatment of patients with femoral neck fracture.Methods 86 patients with femoral neck fracture admitted to our hospital from June 2020 to December 2022 were selected and randomly divided into DAA group(43 cases,total hip arthroplasty via DAA approach)and PLA group(43 cases,total hip arthroplasty via PLA approach).The levels of perioperative indicators,surgical stress indicators and inflammatory factors were compared between the groups.Results The surgery time of the DAA group was longer than that of the PLA group,and the intraoperative blood loss,incision length,and postoperative drainage volume at 1 day after surgery were lower than those of the PLA group(P<0.05).The serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),norepinephrine(NE)and cortisol(Cor)levels of the DAA group were lower of the PLA group(P<0.05).Conclusions DAA total hip arthroplasty in the treatment of patients with femoral neck fracture has exact effect.Compared with PLA,DAA has less surgical trauma,and few stress reactions and inflammatory reactions after surgery.

关 键 词：股骨颈骨折 全髋关节置换术 微创直接前侧入路 

分 类 号：R687.3[医药卫生—骨科学]