微创小切口全髋置换术近期临床疗效

Short term clinic effect of minimally invasive total hip arthroplasty through small incision

目的 观察前外侧入路微创小切口全髋关节置换术近期临床疗效。方法 6例行全髋置换术 ,记录切口长度、手术时间、术中出血量、术后引流量 ,并观察术后全身和局部并发症。结果 手术切口平均长度约8 5cm(7～ 9cm) ,手术时间平均 90min(80～ 10 0min) ,术中出血量平均 4 0 0ml(30 0～ 5 0 0ml) ,术后 2 4h引流量平均 15 0ml(10 0～ 2 5 0ml) ,术中术后平均输血量 30 0ml。切口平均 12d一期愈合。术后未发现心肺疾病或髋关节脱位等全身、局部并发症。术后随访 12～ 16周 ,患肢在 4～ 6周后均可部分负重行走 ,步态正常 ,Harris评分平均 96分 ,功能优良率 96 %。结论 临床观察证明 :只要严格掌握手术适应证 ,术者有良好的手术技巧 ,小切口微创全髋置换术是一安全有效的手术。

Objective To observe the short term clinic effect of minimally invasion total hip arthroplasty through small incision. Methods 6 cases were performed minimally invasion total hip arthroplasty through anterolateral small incision. The length of the incision, operation time, intraoperative blood loss and postoperative drainage were record-ed and systemic or local complication were observed. Results The length of incision ranged from 7 to 9 cm(mean 8.5 cm). The operation time was 80～100 min (mean 90 min). The intraoperation blood loss were 300～500 ml(mean 400 ml). The drainage of 24 hours after operation were 100～250 ml(mean 150 ml). The mean blood transfusion were 300 ml in operation and postoperation and the mean healing time of incision were 12 days. No heart and lung systemic complication or local complication such as dislocation of hip joint occurred. All patients were followed up and the patients could walk in 4～6 weeks with incompletely weight bearings. The Harris scores were 96 on average, and the excellent and good rate in function was 96%. Conclusion Minimally invasion total hip arthroplasty by anterolateral small incision is a safe and effective operation as long as the operaters could strictly control indication and grasp the operative technique well.