直接前方入路全髋关节置换术治疗股骨头坏死患者的效果  

Effects of direct anterior approach total hip arthroplasty in treatment of patients with femoral head necrosis

作　　者：张晓伟 张琨 李辉 ZHANG Xiaowei;ZHANG Kun;LI Hui(Department of Orthopedics of General Hospital of Henan Shenhuo Group,Shangqiu 476600 Henan,China)

机构地区：[1]河南神火集团总医院骨科,河南商丘476600

出　　处：《中国民康医学》2025年第6期47-49,53,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察直接前方入路全髋关节置换术治疗股骨头坏死患者的效果。方法:回顾性分析2021年10月至2023年10月该院收治的80例股骨头坏死患者的临床资料,根据手术入路不同将其分为研究组和对照组各40例。研究组行直接前方入路全髋关节置换术治疗,对照组行后外侧入路全髋关节置换术治疗。比较两组手术优良率,围手术期指标(手术时间、首次下床活动时间、术中出血量、术后引流量)水平,手术前后髋关节功能[Harris髋关节功能量表(HHS)]评分、应激指标[去甲肾上腺素(NE)、β-内啡肽(β-EP)、皮质醇(Cor)]水平,以及并发症发生率。结果:研究组手术优良率为95.00%(38/40),高于对照组的77.50%(31/40),差异有统计学意义(P<0.05);研究组手术时间、首次下床活动时间均短于对照组,术中出血量、术后引流量均少于对照组,差异有统计学意义(P<0.05);术后,两组HHS评分均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);术后,两组NE、Cor、β-EP水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为10.00%(4/40),低于对照组的27.50%(11/40),差异有统计学意义(P<0.05)。结论:直接前方入路全髋关节置换术治疗股骨头坏死患者可提高手术优良率和髋关节功能评分,改善围手术期指标水平,降低应激指标水平和并发症发生率,效果优于后外侧入路全髋关节置换术治疗。Objective:To observe effects of direct anterior approach total hip arthroplasty in treatment of patients with femoral head necrosis.Methods:The clinical data of 80 patients with femoral head necrosis admitted to this hospital from October 2021 to October 2023 were retrospectively analyzed.According to the different surgical approaches,they were divided into study group and control group,40 cases in each group.The study group was treated with direct anterior approach total hip arthroplasty,while the control group was treated with posterolateral approach total hip arthroplasty.The excellent and good rates of operation,the levels of perioperative indexes(operation time,first out-of-bed time,intraoperative blood loss,postoperative drainage volume),the hip function[Harris hip scale(HHS)]scores,the stress indexes[norepinephrine(NE),β-endorphin(β-EP),cortisol(Cor)]levels before and after the surgery,and the incidence of complications were compared between the two groups.Results:The excellent and good rate of operation in the study group was 95.00%(38/40),which was higher than 77.50%(31/40)in the control group,and the difference was statistically significant(P<0.05).The operation time and the first out-of-bed time in the study group were shorter than those in the control group,the intraoperative blood loss and the postoperative drainage volume were less than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the HHS scores of the two groups were higher than those before the surgery,that in the study group was higher than that in the control group,and the differences were statistically significant(P<0.05).After the surgery,the levels of NE,Cor andβ-EP in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the study group was 10.00%(4/40),which was lower than 27.50%(11/40)in the control group,

关 键 词：直接前方入路 后外侧入路 全髋关节置换术 股骨头坏死 髋关节功能 应激 并发症 

分 类 号：R687.3[医药卫生—骨科学]