临床外科杂志 ›› 2019, Vol. 27 ›› Issue (4): 300-303.doi: 10.3969/j.issn.1005-6483.2019.04.010

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SuperPath微创入路全髋关节置换术治疗股骨头坏死的近远期效果分析

  

  1. 成都,四川大学华西医院金堂医院骨科
  • 收稿日期:2018-04-25 出版日期:2019-04-20 发布日期:2019-04-20

Short-and long-term results of SuperPath minimally invasive arthroplasty in the treatment of femoral head necrosis

  1. Department of Orthopedics,Jintang Hospital Affiliated to West China Hospital of Sichuan University,Chengdu 610400,China
  • Received:2018-04-25 Online:2019-04-20 Published:2019-04-20

摘要: 目的 研究SuperPath微创入路全髋关节置换术治疗股骨头坏死的近远期效果。方法 股骨头坏死病人50例,采用随机数字法将其分为对照组和观察组,每组各25例。对照组病人给予后外侧小切口入路人工全髋关节置换术治疗,观察组病人给予SuperPath切口微创人工全髋关节置换术治疗。比较两组病人的围术期手术指标和并发症发生率。随访1年,比较两组病人手术前后的Harris髋关节功能评分、Barthel指数及疼痛视觉模拟法(VAS)评分。结果 观察组病人引流量(211.83±23.76)ml、术中出血量(354.06±38.28)ml、住院时间(8.74±1.53)天、双下肢长度差异(12.97±3.05)mm,大腿周径差异(5.41±0.58)mm,对照组分别为(150.49±18.61)ml、(213.95±30.24)ml、(4.52±1.06)天、(8.12±2.30)mm和(2.87±0.51)mm,两组比较差异均有统计学意义(P<0.05);手术后1年,观察组Harris评分(89.30±4.19)、Barthel指数(90.63±4.95),对照组分别为(81.86±5.24)、(79.47±5.36),两组比较差异均有统计学意义(P<0.05),观察组VAS评分(0.85±0.43),明显低于对照组的(2.09±0.61),两组比较差异有统计学意义(P<0.05);两组病人的并发症发生率比较差异无统计学意义(P>0.05)。结论 SuperPath微创入路全髋关节置换术治疗股骨头坏死,创伤小、并发症低,效果显著,能减轻疼痛感,促进髋关节功能和生活质量恢复。

关键词: SuperPath微创入路, 全髋关节置换术, 股骨头坏死, 手术效果, 并发症

Abstract: Objective To study the short-and long-term effects of SuperPath minimally invasive arthroplasty for the treatment of femoral head necrosis.Methods The subjects were 50 patients with femoral head necrosis.Randomly divided into the control group and observation group with 25 cases in each group.The patients in the control group were treated with total hip replacement through anterolateral small incision.The patients in the observation group were treated with minimally invasive total hip replacement through SuperPath incision.Compared two groups of the perioperative indexes and the incidence of complications,and all patients were followed up for 6 months,compared before and after operation of the Harris hip function score and visual analogue method were evaluated.Results The observation group of the drainage flow[(211.83±23.76)ml],intraoperative blood loss[(354.06±38.28)ml],hospitalization time[(8.74±1.53)d],the difference of leg length[(12.97±3.05)mm] and thigh circumference[(5.41±0.58)mm] was significantly lower than the control group[(150.49±18.61)ml,(213.95±30.24)ml,(4.52±1.06)d,(8.12±2.30)mm and(2.87±0.51)mm,respectively](P<0.05).1 year after operation,the Harris score(89.30±4.19)and Barthel index(90.63±4.95) in the observation group were significantly higher than the control group(81.86±5.24,79.47±5.36)(P<0.05).VAS score was significantly lower in observation group(0.85±0.43) than that in control group(2.09±0.61)(P<0.05).The incidence of complications in the two groups was not significantly different(P>0.05).Conclusion SuperPath incision minimally invasive total hip arthroplasty for the treatment of avascular necrosis of the femoral head has advantages such as small trauma,low complication and significant effect.It can relieve pain and promote hip joint function and quality of life recovery.

Key words: SuperPath minimally invasive approach, invasive total hip replacement, femoral head necrosis, operative effect, complications

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