微创后外侧小切口全髋置换术治疗髋关节疾病的效果观察

Effect of minimally invasive posterolateral small incision hip arthroplasty for hip joint disease

目的 :分析用微创后外侧小切口全髋置换术治疗髋关节疾病的效果。方法 :选取2016年1月至2017年7月期间在镇江市第一人民医院及分院和江苏大学附属医院接受全髋置换术的60例患者作为研究对象。将其随机分为比较组(30例)和试验组(30例)。为比较组患者采用常规的全髋置换术进行治疗,为试验组患者采用微创后外侧小切口全髋置换术进行治疗。然后对比分析两组患者治疗的优良率、手术的时间、围手术期的出血量、切口的长度、术毕至开始肢体功能锻炼的时间、术后的Harris评分、术后并发症的发生率和各项生活质量评分(包括精神健康的评分、情感职能的评分、活力的评分、生理功能的评分、社会功能的评分和生活质量的总评分等)。结果 :1)试验组患者治疗的优良率为96.7%(29/30),比较组患者治疗的优良率为80.0%(24/30),组间差异有统计学意义(P<0.05)。2)试验组患者手术的时间、围手术期的出血量、切口的长度、术毕至开始肢体功能锻炼的时间、术后的Harris评分和术后并发症发生率的平均值分别为(71.4±15.4)min、(155.4±34.5)ml、(7.4±1.3)cm、(2.4±0.6)d、(90.2±6.3)分、3.33%(1/30),比较组患者手术的时间、围手术期的出血量、切口的长度、术毕至开始肢体功能锻炼的时间、术后的Harris评分和术后并发症发生率的平均值分别为(91.3±16.5)min、(495.6±59.4)ml、(16.1±1.6)cm、(7.6±1.4)d、(85.6±6.3)分、13.33%(4/30),组间差异有统计学意义(P<0.05)。3)治疗后,试验组患者精神健康的评分、情感职能的评分、活力的评分、生理功能的评分、社会功能的评分和生活质量总评分的平均值分别为(67.9±10.7)分、(69.2±14.3)分、(52.8±13.2)分、(69.2±12.6)分、(65.2±11.3)分、(324.3±12.4)分,比较组患者精神健康的评分、情感职能的评分、活力的评分、生理功能的评分、社会功能的评分和生活质量总评分的平均值分别为(59.4±10.3)分、(58.3±11.3)分、(48.7±12.6)分、(61.3±14.2)分、(49.4±13.6)分、(277.1±13.5)分,组间差异有统计学意义(P<0.05)。结论 :用微创后外侧小切口全髋置换术治疗髋关节疾病可有效地降低患者术后并发症的发生率,减少其围手术期的出血量,促进其肢体功能的恢复,提高其生活质量。

Objective To analyze effect of minimally invasive posterolateral small incision hip arthroplasty for hip joint disease. Methods Select 60 cases of the patients accepted hip arthroplasty in The First People＇s Hospital of Zhenjiang City and Affiliated hospital of Jiangsu University during January 2016 to July 2017 for research object.Randomly divide the cases in control group（30 cases）and experimental group（30 cases）. Treat control group with routine hip arthroplasty,treat experimental group with minimally invasive posterolateral small incision hip arthroplasty. Then compare and analyses excellent and good rate,operative time,bleeding volume in perioperative period,length of incision, postoperative adequate exercises time, Harris score,incidence of complications and every score for evaluate life quality（mental health score,emotion score,energy score,physical funtion score,social function score and total score of life quality） of 2 groups.Results 1）The excellent and good rate in experimental group is 96.7%（29/30）,in control group is 80.0%（24/30）,the difference between 2 groups have statistical significant（P 〈0.05）.2）The average value of operative time,bleeding volume in perioperative period,length of incision, postoperative adequate exercises time, Harris score,incidence of complications in experimental group respectively are（71.4±15.4）min,（155.4±34.5）ml,（7.4±1.3）cm,（2.4±0.6）d,（90.2±6.3）,and 3.33%（1/30）,the average value of operative time,bleeding volume in perioperative period,length of incision, postoperative adequate exercises time, Harris score,incidence of complications in control group respectively are（91.3±16.5）min,（495.6±59.4）ml,（16.1±1.6）cm、（7.6±1.4）d,（85.6±6.3）and 13.33%（4/30）,the difference between 2 groups have statistical significant（P〈 0.05）.3）After treatment,the average scores of mental health score,emotion score,energy score,physical funtion score,social function score and total score of life quality in experimental group respectively are（67.9±10.7）,（69.2±14.3）,（52.8±13.2）,（69.2±12.6）,（65.2±11.3）,（324.3±12.4）, the average scores of mental health score,emotion score,energy score,physical funtion score,social function score and total score of life quality in control group respectively are（59.4±10.3）,（58.3±11.3）,（48.7±12.6）,（61.3±14.2）,（49.4±13.6）,（277.1±13.5）, the difference between 2 groups have statistical significant（P 〈0.05）.Conclusion Minimally invasive posterolateral small incision hip arthroplasty for hip joint disease is effective for decrease incidence of complication,bleeding volume in perioperative period of the patients,and have effect for improving recovery of limb fuction and enhance life quality.