微创与常规全髋关节置换术临床疗效的比较

Comparison of clinical efficacy for total hip arthroplasty by minimally invasive operation and conventional way

目的探讨微创与常规全髋关节置换术(totalhip arthroplosty,THA)临床疗效。方法全髋关节置换术20例,按治疗方法不同分为髋关节前外侧小切口THA(微创组)10例和常规后外侧THA(常规组)10例;观察两组病例的手术时间、出血量、切口长度、并发症、术后疼痛程度、术后功能评价等。结果微创组优3例,良4例,中2例,差1例;常规组优2例,良3例,中3例,差2例。两组优良率比较差异有统计学意义(χ2=3.984,P<0.05);微创组术中出血量、引流量、输血量、切口长度[(315.5±223.1)ml、(259.5±170.1)ml、(88.5±13.2)ml、(9.9±0.4)cm]与常规组[(520.5±219.7)ml、(517.9±212.7)ml、(359.1±31.5)ml、(15.8±2.1)cm]有显著性差异(均P<0.05);微创组手术时间、术后3个月Harris评分与常规组无显著性差异(均P>0.05)。结论微创全髋关节置换术,具有创伤小、出血少、安全、并发症少等优点。

Objective To investigate the clinical efficacy of minimally invasive way for total hip arthroplasty （THA）. Methods Twenty cases of THA were performed with minimally invasive anterolateral surgical approach（ MIS group,n = 10）and conventional posterolateral surgery （ conventional group, n = 10）, respectively. The operation time, blood loss, incision length, complications, postoperative pain,postoperative functional evaluation were compared between two groups. Results The curative effects in MIS group were excellent in 3 cases, good in 4 cases, acceptable in 2 cases and poor in 1 case. Excellent rate was statistically different between two groups （ χ2 = 3. 984, P 〈 0.05 ）. The curative effects in conventional group were excellent in 2 cases, good in 3 cases, acceptable in 3 cases and poor in 2 cases. The blood loss,the drainage volume,the blood volume and incision length in MIS group[ （315.5±223.1 ）ml, （259.5 ±170.1 ） ml, （ 88.5 ±138.2 ） ml, （ 9.9± 0.4 ） em ] were significantly different from that in conventional group [ （ 520.5 ± 219.7 ） ml, （ 517.9 ± 212.7 ） ml, （ 359.1 ±317.5 ） ml, （ 15.8 ± 2.1 ） cm ] （ P 〈 0.05 ）. The operative time and Harris score after operation for three months showed no significant difference between 2 groups （ P 〉 0.05 ）. Conclusion The minimally invasive total hip arthroplasty has the advantages of less trauma, less bleeding, safety, and few complications.