全髋关节置换前后路手术入路的手术指标及预后对比分析

Analysis of Operative Indexes and Prognosis of Anterior and Posterior Approach of Total Hip Replacement

目的对全髋关节置换前后路手术入路的手术指标及预后进行对比分析。方法选取2012年3月～2016年8月在我院实施全髋关节置换术的患者108例，平均年龄（63．65±3．26）岁。按照数字随机表法分为观察组和对照组各54例，对照组通过后外侧入路进行髋关节置换手术，观察组通过前外侧入路进行髋关节置换手术，对两组患者的手术情况、髋关节Harris评分、并发症情况进行对比分析。结果观察组患者切口长度、术中失血量以及住院时间均显著小于对照组（P〈0．05），观察组患者手术时间显著长于对照组（P〈0．05）；手术前，两组Harris评分无显著差异（P〉0．05），手术后，观察组患者Harris评分显著高于对照组（P〈0．05）；观察组的并发症发生率显著低于对照组（P〈0．05）；手术前，两组患者的生活质量评分均无显著差异（P〉0．05），手术后3个月，两组患者的生活质量评分均显著高于手术前（P〈0．05），观察组的生活质量评分均显著高于对照组（P〈0．05）。结论通过前外侧入路行髋关节置换手术可有效改善患者的术中指标，促进患者术后恢复，并且可以减少不良反应的发生率，大大地提高了患者的生活质量。

Objective To study the operative indexes and prognosis of anterior and posterior approach of total hip replacement. Methods 108 Patients who underwent total hip replacement in our hospital from March in 2012 to August in 2016 were divided into the observation group and the control group according to the method of digital random table. The control group received the posterolateral approach of hip replacement and the observation group accepted the anterolateral approach of hip replacement. The operative condition, the Harris score and so on were compared between the two groups. Results The length of incision, blood loss and days of hospital stay in the observation group were significantly reduced than those in the control group （ P 〈 0. 05 ）. There was no significant difference in Harris score between the two groups before the operation （P 〉 0. 05）. After the operation, the Harris scores in the observation group were significantly higher than those in the control group （P 〈 0. 05 ） ; And the complications in the observation group were significantly decreased than those in the control group （P 〈 0.05 ）. There was no significant difference in the quality of life between the two groups before the operation （P 〉 0. 05 ）. The scores of PF, RP, BP, GH, VT, SF, RE and MH were significantly increased in the two groups after the operation than those before the operation （P 〈 O. 05）. After the operation, the scores in the ob- servation group were significantly higher than those in the control group （P 〈 0. 05 ）. Conclusion The anterolateral approach of hip replacement can effectively improve the patients＇ intraoperative indexes, promote postoperative recovery, reduce the incidence of ad- verse reactions and improve the quality of life of patients.