两种手术入路行髋关节置换术的对比分析

Comparative Analysis of Two Surgical Approach for Hip Replacement

目的比较经外侧、后侧两种不同手术入路行全髋关节置换术的优缺点。方法回顾性分析行髋关节置换术的112例患者(全部为单髋关节)的临床资料,比较两组患者手术时间、出血量、手术切口长度、术后引流量、患者疼痛程度、术后住院天数、患者满意度、髋臼假体前倾角、术前术后Harris评分等。结果两组患者术后住院天数(t=1.8511,P=0.0668)、髋臼假体前倾角(t=1.2190,P=0.2554)无明显差异(P>0.05)。两组手术时间(t=3.7184,P=0.0003)、手术出血量(t=4.5039,P=0.0001)、手术切口长度(t=37.7078,P=0.0001)及术后引流量(t=5.7998,P=0.0001)、术后3d VAS评分(t=7.0542,P=0.0001)、Hrris评分(t=6.6358,P=0.0001),外侧入路组均明显优于后侧入路组(均P<0.05)。结论外侧手术入路髋关节置换手术是一种安全可靠有效地手术入路,手术效果明显优于后外侧入路手术。

Objective Comparison of the anterolateral approache and the posterolateral approache which are two different surgical approaches for total hip arhroplasty in order to explore the best approach for hip arthroplasty. Methods Retrospective analysis of the clinical data of 112 patients which received hip arthroplasty （All are unilateral）, then compared the operating time, blood loss, incision length, postoperative drainage, the patient level of pain, postoperative hospital stay, patient satisfaction, the acetabular component, anteversion postoperative Harris score, etc of patients of the two groups. Results The postoperative hospitalization-time （t=1.8511, P=-0.0668）, the acetabular component anteversion （t=-1.2190, P=0.2554） are no significant difference between the two groups（P〉0.05）; operation time （t=-3.7184, P=-0.0003）, operative blood loss （t--4.5039, P=0.0001）, the length of the incision （t=37.7078, P=-0.0001） and postoperative drainage （t=-5.7998, P=-0.0001）, three days after VAS score （t=-7.0542, P=-0.0001）, Hrris score （t=6.6358, P=-0.0001）, hip function excellent rate （x^2=6.6184, P=0.0198）, and the anterolateral approach group were significantly better than the posterolateral approach group（P〈0.05）. Conclusion Anterolateral approach road is a safely for hip arthroplasty is superior to posterolateral approach.