对髋关节镜手术导致股外侧皮神经损伤的风险分析  

Risk factors of injuries of lateral femoral cutaneous nerve during hip arthroscopy

作　　者：黄轶刚[1] 殷吉旻[1] 梁慕天 张长青[1] Huang Yigang;Yin Jimin;Liang Mutian;Zhang Changqing(Department of Orthopedics,Sixth Affiliated People's Hospital of School of Medicine of Shanghai Jiao Tong University,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第六人民医院骨科,200233

出　　处：《骨科临床与研究杂志》2024年第2期68-71,共4页Journal Of Clinical Orthopedics And Research

基　　金：国家自然科学基金(82072525)。

摘　　要：目的探讨髋关节镜手术导致股外侧皮神经损伤(LFCN)的风险因素。方法对2021年1月至2022年4月于上海交通大学医学院附属第六人民医院骨科接受初次髋关节镜手术的患股髋撞击综合征(FAI)或临界性髋关节发育不良(BDDH)167例连续病例资料进行回顾性分析,根据术后是否发生股外侧皮神经损伤将患者分为神经损伤组和无神经损伤组,对比术前基线资料、疾病类型及手术操作是否存在差异,分析神经损伤的风险因素。结果髋关节镜术后股外侧皮神经损伤的发生率为12.6%。神经损伤组采用标准前侧入口的患者比例(20%)明显高于采用中-前入口者(5.7%)(P=0.006)。股髋撞击综合征患者较临界性发育不良患者更容易出现神经损伤(分别为16.1%、4.1%,P=0.033)。两组间年龄、性别、BMI及手术时间差异无统计学意义。结论髋关节镜手术采用中-前侧入口有助于降低股外侧皮神经损伤风险。Objective To assess the risk factors of injury of the lateral femoral cutaneous nerve(LFCN)of injury during hip arthroscopy surgery Methods From January 2021 to April 2022,patients had hip arthroscopy due to femoroacetabular impingement syndrome(FAI)or borderline developmental dysplasia of the hip(BDDH)in Department of Orthopedics,Sixth Affiliated People's Hospital of School of Medicine of Shanghai Jiao Tong University.The patients were divided into 2 groups according to the presence or absence of LFCN injury.The clinical data were compared by statistical analysis.Results Injury to LFCN was found in 12.6% patients.Stand anterior portal showed higher rate(20%)of LFCN injury than mid-anterior approach(5.7%)(P<0.06).FAI patients showed a higher rate of LFCN injury compared with BDDH patients(16.1%vs.4.1%,P=0.033).There were significant differences between the 2 groups stenosis.Conclusion Injuries to LFCN during hip arthroscopy surgery are frequent,especially in FAI patients used the standard anterior portal.

关 键 词：关节镜 神经痛 髋关节 股外侧皮神经 

分 类 号：R687.4[医药卫生—骨科学]