前外侧微创入路与后外侧常规入路全髋关节置换的临床研究

Comparison of anterolateral minimally invasive approaches with conventional posterolateral approaches in total hip replacement

目的：比较前外侧微创入路与后外侧常规入路全髋关节置换术之间的临床疗效。方法2010年1～12月我科实施全髋关节置换术的39例患者，其中18例为前外侧微创入路（微创组），21例为后外侧常规入路（常规组）。比较两组临床指标（手术时间、切口长度、术中出血量及术前、术后3天、6个月、1年Harris评分）及主要并发症发生率。结果微创组切口长度、术中出血量明显低于常规组，术后3天Harris评分高于后外侧常规入路组，差异均有统计学意义（ P＜0.05）。其他临床指标及主要并发症发生率比较差异均无统计学意义（ P＞0.05）。结论前外侧微创入路全髋关节置换术早期疗效优于后外侧常规入路全髋关节置换术，但长期随访二者疗效无明显差异。

Objective To compare the effect of anterolateral minimally invasive approaches with conventional posterolateral approaches in total hip replacement .Methods Thirty-nine patients with total hip replacement between January 2010 and December 2010 were divided into anterolateral minimally invasive group （ minimally invasive group ） and conventional posterolateral approach group （ conventional group ） .The clinical indicators such as operation time ,incision length ,intraoperative blood loss ,Harris scores in preoper-ation and 3 days,6 months and one year of postoperation were compared .The incidence of major complications were also compared be-tween the two groups （ P ＆gt;0.05 ） .Results The incision length and intraoperative blood loss were lower while Harris scores in 3 days of postoperation higher in the minimally invasive group than that in the conventional group （ all P＆lt;0.05 ） .However ,there were no sta-tistically significant differences in other indexes and major complications between the two groups .Conclusion Anterolateral minimally invasive approach has better effects in early time after operation than conventional posterolateral approach does .However ,there was no significant difference in long-term follow-up between the two approaches .