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微创直接前入路与后外侧入路在初次全髋关节置换术中的疗效对比(1)
http://www.100md.com 2018年8月15日 《中国当代医药》 2018年第23期
     [摘要]目的 比较微创直接前入路与后外侧入路在初次全髋关节置换术中的疗效。方法 分析我院2016年2月~2018年2月收治的初次全髋关节置换术患者80例临床资料,依据治疗方式不同进行分组,直接前入路组40例和后外侧入路组40例。观察两组的平均股骨头假体直径、髋臼前倾角、髋臼外展角、髋关节功能效果、并发症情况。结果 两组的平均股骨头假体直径、髋臼前倾角、髋臼外展角比较,差异均无统计学意义(P>0.05),两组的髋关节功能总有效率比较,差异无统计学意义(P>0.05),直接前入路组并发症发生率低于后外侧入路组,差异有统计学意义(P<0.05)。结论 微创直接前入路与后外侧入路在初次全髋关节置换术中均有较好的疗效,但微创直接前入路术后关节脱位发生率较低,值得临床推广应用。

    [关键词]微创直接前入路;后外侧入路;初次全髋关节置换术;疗效

    [中图分类号] R687.4 [文献标识码] A [文章编号] 1674-4721(2018)8(b)-0095-03

    The curative effect comparison in initial total hip arthroplasty by direct anterior approach and posterolateral approach

    CHEN Jun-yan WU Zhi-bin CHEN Guo-jian

    Department of Orthopeadic Surgery, Kangmei Hospital of Jieyang City, Guangdong Province, Jieyang 515300, China

    [Abstract] Objective To compare the effect comparison in initial total hip arthroplasty by direct anterior approach and posterolateral approach. Methods The clinical data of 80 cases with initial total hip arthroplasty treated in our hospital from February 2016 to February 2018 were analyzed, which was to be divided into two groups by different treatment methods, direct anterior approach group 40 cases and posterolateral approach group 40 cases. The average femoral head prosthesis diameter, acetabulum abducent angles, hip joint function, complication of two groups initial total hip arthroplasty patients were detected. Results The average femoral head prosthesis diameter, acetabulum, acetabulum abducent angles between two groups were campared, the difference were no statistical significance (P>0.05), the comparison of hip joint function total effective rate, the difference were no statistical significance(P>0.05), the total incidence rate of complication in posterolateral approach group was higher than direct anterior approach group, the difference were statistical significance (P<0.05). Conclusion The curative effect comparison in initial total hip arthroplasty by direct anterior approach and posterolateral approach is good, but dearticulation rate after operation by direct anterior approach is low, it is worth to be used.

    [Key words] Direct anterior approach; Posterolateral approach; Initial total hip arthroplasty; Curative effect

    人工全髋关节置换术作为临床上治疗髋关节疾患的方式被广泛应用,随着全髋关节置换术式的不断发展和假体研究的进步,全髋关节置换术成为髋关节疾病的首选治疗方式,改善了患者的髋关节功能,提高了其生活质量[1-2]。但全髋关节置换术仍然有一定比例的并发症发生,如脱位在初次全髋关节置换術中的发生率接近5%,翻修的手术率达到近20%,给患者的日常生活和临床治疗带来了较大负担,同时多次手术也增高了并发症发生率,严重影响患者的生存率[3-4]。直接前方入路人工全关节置换术是近年来应用的微创关节置换术,其不需切断髋周肌肉组织,尤其是减少了后方肌肉和软组织的损伤,减少了髋关节脱位的发生[5-6]。本研究通过对我院收治的初次全髋关节置换术患者临床资料进行分析,比较微创直接前入路与后外侧入路在初次全髋关节置换术中的疗效,现报道如下。, http://www.100md.com(陈俊彦 吴志斌 陈国坚)
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