回顾性分析对比经直接前方入路与后外侧入路在股骨颈骨折患者全髋关节置换术中的应用效果  

Retrospective analysis and comparison of the application effects of direct anterior approach and posterolateral approach in total hip arthroplasty for patients with femoral neck fractures

作　　者：黄勇 Huang Yong(Department of Orthopedics,Guangshan County People's Hospital,Xinyang 465400,Henan,China)

机构地区：[1]光山县人民医院骨科,河南信阳465400

出　　处：《四川生理科学杂志》2025年第2期310-312,388,共4页

摘　　要：目的:探讨经直接前方入路、后外侧入路行髋关节置换术(Total hip arthroplasty,THA)治疗股骨颈骨折(Femoral neck fracture,FNF)患者的临床价值。方法:回顾性收集2019年10月至2023年9月期间本院收治的52例FNF患者的临床资料。根据不同手术方案将分为对照组(后外侧入路,25例)和研究组(经直接前方入路,27例)。对比两组的围手术期指标、骨特异性碱性磷酸酶(Bone alkaline phosphatase,BALP)、Ⅰ型前胶原氨基端原肽(Procollagen typeⅠN-terminal propeptide,PⅠNP)、疼痛视觉模拟评分法(Visual Analogue Scale,VAS)评分、Harris髋关节评分(Harris Hip Score,HHS)、Berg平衡量表(Berg balance scale,BBS)评分及并发症。结果:研究组的手术时间显著长于对照组,切口长度、术后首次下床时间、住院时间、术中出血量、术后引流量均显著短于对照组(P<0.05);研究组术后1 d、3 d、5 d、1 w的VAS评分均显著低于对照组(P<0.05);术后1 m、3 m、6 m,研究组的BALP、HHS、BBS明显高于对照组,PⅠNP水平低于对照组(P<0.05);研究组的并发症总发生率与对照组比较无显著差异(P>0.05)。结论:相较于后外侧入路,经直接前方入路行THA治疗FNF患者,能降低术中出血量,减轻患者疼痛感,促进骨代谢,改善髋关节功能和平衡功能,但会增加手术难度,延长手术时间。Objective:To explore the clinical value of total hip arthroplasty(THA)through direct anterior approach and posterolateral approaches for the treatment of femoral neck fracture(FNF).Methods:The clinical data of 52 patients with FNF who were admitted to our hospital from October 2019 to September 2023 were retrospectively collected.Based on different surgical plans,patients were divided into a control group(posterolateral approach,25 cases)and a study group(direct anterior approach,27 cases).The perioperative indicators,bone alkaline phosphatase(BALP),procollagen type I N-terminal propeptide(P I NP),Visual Analogue Scale(VAS)score,Harris Hip Score(HHS),Berg balance scale(BBS)score,and complications were compared between the two groups.Results:The operation time of the study group was significantly longer than that of the control group,while the incision length,first time out of bed after surgery,length of hospital stay,intraoperative blood loss,and postoperative drainage volume were significantly shorter than those of the control group(P<0.05).The VAS scores of the study group on postoperative day 1,3,5,and 1 week were significantly lower than those of the control group(P<0.05).At 1 m,3 m,and 6 m after surgery,the BALP,HHS,and BBS levels in the study group were significantly higher than those in the control group,while the PⅠNP level was lower than that in the control group(P<0.05).There was no significant difference in the overall incidence of complications between the study group and the control group(P>0.05).Conclusion:Compared with the posterior lateral approach,performing THA through a direct anterior approach for the treatment of FNF patients can reduce intraoperative blood loss,alleviate pain,promote bone metabolism,and improve hip joint function and balance function,but it can increase the difficulty of surgery and prolong the operation time.

关 键 词：直接前方入路 后外侧入路 股骨颈骨折 全髋关节置换术 

分 类 号：R68[医药卫生—骨科学]