外侧小切口与常规后外侧切口全髋置换疗效比较

A comparison of lateral minimal incision and traditional posterolateral incision in total hip arthroplasty

目的 比较外侧小切口微创方式全髋置换术（total hip arthroplasty,THA）与常规后外侧切口THA的临床疗效.方法 2009年8月～2012年6月,采用外侧微创小切口（A组）THA治疗髋部疾病26例,同期采用常规后外侧切口（B组）THA治疗33例,比较两组患者的年龄、体重指数、切口长度、手术时间、失血量、外展肌力、住院时间、术后Harris功能评分等.结果 手术切口一期愈合,无感染发生.两组间的切口长度、手术失血量、术后2周外展肌力、住院时间及术后2个月Harris评分比较,差异均有统计学意义;手术时间、术后6个月Harris评分两组间差异无统计学意义.结论 两种术式临床疗效大致相同,小切口微创方式THA具有损伤小、失血少、住院时间短、术后康复快的优点,适用于体形中等及偏瘦患者.

Objective To compare the clinical effects of total hip arthioplasty （THA） with lateral minimal incision and traditional posterolateral incision. Methods Between August 2009 and July 2012, 59 patients underwent THA were enrolled, in- cluding 26 （group A） with lateral minimal incision and 33 （group B） with traditional posterolateral incision. The age, body mass index, length of incision, operation time, blood loss, muscle strength, inpatient duration and Harris Hip Score （HHS） were re- corded and compared. Results The average inpatient duration in group A was shorter than group B （P 〈 0.05 ）, and blood loss was less in group A （P 〈0. 01 ）. Two weeks after surgery the abductor muscle strength in group A was higher than group B （P 〈 0. 01 ）. The HHS two months after operation in group A was higher than group B （P 〈 0. O1 ）, but there were no significant differ- ence 6 months later （P 〉 0.05）. Conclusion Total hip arthroplasty could be performed either with lateral minimal incision or traditional posterolateral incision satisfactorily. However, lateral minimal incision is more compatible with relatively thin people than traditional posterolateral incision, which make operations more convenient, decrease the blood loss and shorten inpatient dura- tion effictively.