全髋置换术中后外侧微创小切口的应用分析

Total hip replacement arthroplasty in minimally invasive posterolateral incision applied analysis

目的探讨后外侧微创小切口全髋置换术在临床的应用价值。方法将我科收治的64例全髋关节置换患者随机分为两组。治疗组32例,采用后外侧微创小切口全髋置换术;对照组32例,采用常规全髋置换术。记录两组患者的手术时间、术中术后失血量、切口长度、术后开始功能锻炼时间、术后Harris评分、并发症等。结果随访时间为3个月～2年,平均12个月。两组患者术后切口均为Ⅰ级切口甲级愈合,无1例发生切口及深部感染,两组患者术后Harris评分、术后并发症等无显著性差异。但治疗组(后外侧微创切口全髋置换术)在手术时间、术中术后失血量、手术切口长度、术后开始功能锻炼时间均显著低于常规全髋置换术,差异有统计学意义(P<0.05)。结论后外侧微创小切口行人工全髋置换术可明显缩短手术时间和降低术后并发症及假体位置不当的风险,具有手术创伤小、失血量少、可早期进行关节功能锻炼等优点。

Objective To explore minimally invasive posterolateral incision total hip arthroplasty in clinical application. Methods 64 cases of total hip replacement patients were randomly divided into two groups, 32 cases in the treatment group using minimally invasive posterolateral incision total hip arthroplasty, 32 patients in the control group using conventional total hip arthroplasty. Records of patients with sex, age, weight, duration of operation,intraoperative blood loss and postoperative drainage volume,length of the incisions,intraoperative and postoperative fractures,postoperative functional exercise time,postoperative complications, such as Harris score. Results All patients were followed up for 3 months to 2 years,average 12 months. Two groups of all patients with incision were grade I incision healing, 1 case of incision and deep infection,in 2 groups of patients in preoperative Harris score, postoperative complications, no significant difference. But the treatment group （posterolateral minimally invasive incision total hip arthroplasty） in operation time,intraoperative and postoperative blood loss,length of operation incision, postoperative functional exercise time was significantly lower than that of conventional total hip arthroplasty, the difference was statistically significant （P〈0.05）. Conclusion Minimally invasive posterior lateral small incision total hip arthroplasty in total hip replacement can shorten the operation time and reduce the postoperative complications and the risk of improper placement of a prosthesis, small operation wound,less blood loss,early joint exercise etc.