改良Hardinge外侧入路同期双侧全髋置换术的效果及围手术期安全性研究

The modified Hardinge lateral approach over the peri-operative clinical safety study of simultaneous bilateral total hip arthroplasty

目的观察改良Hardinge外侧入路同期双侧全髋置换术治疗双侧髋关节疾患的效果及围手术期安全性研究。方法回顾性研究2002年8月-2015年1月上海交通大学附属上海市第一人民医院分院骨科收治的改良Hardinge外侧入路同期双侧全髋置换术(同期组)98例(196髋)与分期双侧全髋关节置换术(分期组)96例(192髋),观察并且比较2组患者手术时间、总失血量、输血量、手术前后Harris评分、住院天数、总费用、术后并发症等临床指标。结果 2组患者性别、年龄、病因、手术前后Harris评分、总失血量、输血量、术后引流量、术后并发症等方面比较差异均无统计学意义(P>0.05)。同期组的手术时间为(101.7±22.0)min,住院天数为(15.3±1.2)d,总费用为(6.1±1.3)万元;分期组的手术时间(166.0±32.1)min,住院天数为(32.6±2.5)d,总费用为(9.7±2.6)万元,2组比较差异有统计学意义(t=3.389、4.516、3.889,P均<0.05)。结论改良Hardinge外侧入路同期双侧髋关节置换术安全有效,并且能够减少手术时间、降低住院天数、节省住院费用。

Objective To observe the effect of modified Hardinge lateral approach for bilateral total hip arthroplasty in the treatment of bilateral hip joint disease and the safety of perioperative period.Methods The modified Hardinge lateral approach of one-stage simultaneous bilateral total hip arthroplasty were retrospectively studied from August 2002 to January 2015 admitted to the Department of orthopedics of Branch of Shanghai First Peopled Hospital affiliated to Shanghai Jiao Tong University（concurrent group） 98 cases（196 hips） and staged bilateral total hip arthroplasty（staging group） 96 cases（192hips）,observation and comparison of 2 groups of patients with operation time,the total amount of bleeding during,the amount of blood transfusion,surgery,Harris score,length of stay,total cost,postoperative complications and other clinical indicators.Results Two groups of patients＇ gender,age,etiology,Harris score before and after surgery,total blood loss,blood transfusion,postoperative lead flow,postoperative complications and so on were not statistically significant（P 〉0.05）.The operation time,cause period group（101.7 ±22.0） min,hospital stay was（15.3 ±1.2） d,the total cost was（6.1 ±1.3）× 10^4 yuan;the operation time stage group（166.0 ± 32.1） min,hospital stay was（32.6 ± 2.5） d,the total cost was（9.7±2.6） × 10^4 yuan,2 group＇s difference was statistically significant（t =3.389,t =4.516,t =3.889,P 0.05）.Conclusion The improved Hardinge lateral approach is safe and effective for bilateral hip replacement,and can reduce the operation time,reduce the length of hospital stay and save the hospitalization expenses.