直接前方入路与改良Hardinge入路髋关节置换术治疗股骨头坏死的效果对比  

Comparison of the effects of direct anterior approach and modified Hardinge approach hip replacement in the treatment of femoral head necrosis

作　　者：杜滨 Du Bin(Department of JoinⅠ,Dushan Campus of Nanyang Traditional Chinese Medicine Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中医院独山院区关节一科,南阳473000

出　　处：《中国实用医刊》2025年第3期32-36,共5页Chinese Journal of Practical Medicine

摘　　要：目的比较直接前方入路(DAA)与改良Hardinge入路髋关节置换术治疗股骨头坏死的临床效果。方法前瞻性研究。抽取2022年7月至2023年10月于南阳市中医院独山院区拟接受髋关节置换术治疗的80例股骨头坏死患者作为研究对象,根据随机数字表法分为DAA组与改良组,每组40例。所有患者均接受髋关节置换术,DAA组采用DAA手术,改良组采用改良Hardinge入路手术。比较两组患者手术情况(包括手术时间、术中出血量、住院时间);术前,术后1、3个月采用视觉模拟评分法(VAS)评估患者的疼痛程度;患者术后持续接受6个月随访,记录术后并发症发生情况;于术前及术后3、6个月评估患者的髋关节功能[Harris髋关节评分(HHS评分)]。结果DAA组术中出血量少于改良组,住院时间短于改良组(P<0.05);两组术后1、3个月VAS评分低于术前,术后3个月VAS评分低于术后1个月,且DAA组术后各时点的VAS评分均低于改良组(P均<0.05)。两组术后并发症发生率比较差异未见统计学意义(P>0.05)。两组术后3、6个月HHS评分均较术前升高,术后6个月HHS评分高于术后3个月,且DAA组术后各时点的HHS评分均高于改良组(P均<0.05)。结论与改良Hardinge入路比较,采用DAA髋关节置换术治疗股骨头坏死,术中出血量少,住院时间短,患者术后疼痛感轻微,并发症少,有利于术后髋关节功能更好的重建与恢复。Objective To compare the clinical effects of direct anterior approach(DAA)and modified Hardinge approach hip replacement in the treatment of femoral head necrosis.MethodsA total of 80 patients with femoral head necrosis who were scheduled to receive hip replacement in Dushan Campus of Nanyang Traditional Chinese Medicine Hospital from July 2022 to October 2023 were selected as the research objects for the prospective study.According to the random number table method,the selected patients were divided into the DAA group and the modified group,with 40 cases in each group.All patients underwent hip replacement.The DAA group was treated by DAA approach surgery,and the modified group was treated by modified Hardinge approach surgery.The operation conditions including operation duration,intraoperative blood loss and hospital stay were compared between the two groups.Before operation,1 and 3 months after operation the visual analogue scale(VAS)was used to evaluate the pain degree of the two groups.The two groups were continuously followed up for 6 months after operation.Before operation,3 and 6 months after operation the postoperative complications and the hip joint function assessed by Harris hip score(HHS score)were compared between the two groups.ResultsThe intraoperative blood loss in the DAA group was less than that in the modified group,and the hospital stay was shorter than that in the modified group(P<0.05).The 1-and 3-month postoperative VAS scores were lower than preoperative VAS scores in the two groups(P<0.05);the 3-month postoperative VAS scores were lower than 1-month postoperative VAS scores in the two groups(P<0.05);and the VAS scores of the DAA group were lower than those of the modified group at each time point after operation(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).At 3 and 6 months after operation,the HHS scores of the two groups were higher than those before operation(P<0.05);6-month postoperative HHS score were highe

关 键 词：股骨头坏死 髋关节置换术 改良HARDINGE入路 直接前方入路 关节功能 并发症 

分 类 号：R687.4[医药卫生—骨科学]