微创全髋关节置换术对股骨头缺血性坏死临床治疗效果及安全性分析

Clinical Effect and Safety Analysis of Minimally Invasive Total Hip Arthroplasty in the Treatment of Avascular Necrosis of Femoral Head

目的探讨微创全髋关节置换术对股骨头缺血性坏死患者的治疗效果。方法回顾性分析2014年2月至2017年2月在我院接受治疗的股骨头缺血性坏死患者的临床资料,所有患者均接受全髋关节置换术,根据其手术方式的不同分为传统手术组和微创手术组。观察两组患者手术一般情况,比较两组患者治疗前后Harris评分、FIM得分和不良事件发生率的差异。结果微创手术组患者手术时间和术后住院时间均较传统手术组短,差异有统计学意义(P<0.05),术中出血量和术后引流量均较传统手术组少,差异有统计学意义(P<0.05);两组患者手术前Harris评分、FIM得分无差别,术后3个月,微创手术组患者的Harris评分、FIM得分高于传统手术组,差异有统计学意义(P<0.05);两组患者假体感染、假体松动和髋关节脱位等不良事件发生率,差异无统计学意义(P>0.05)。结论微创全髋关节置换术对股骨头缺血性坏死患者的治疗效果较好,且手术创伤小,具有良好的应用价值。

Objective To investigate the effect of mininlally invasive total hip arthroplasty on avascular necrosis of femoral head. Methods The clinical data of patients with avascular necrosis of femoral head treated in our hospital from February 2014 to February 2017 were analyzed retrospectively. All patients underwent total hip replacement and were divided into traditional and mininlally invasive groups according to their different surgical methods. The general operating conditions of the two groups were observed,and the differences of Harris scores, FIM scores and the incidence rate of adverse events before and after treatment were compared between the two groups. Results The operative time and postoperative hospitalization time in the minimally invasive operation group were both shorter than those in the traditional operation group, statistically significant（ P 〈 0. 05 ）. The amount of intraoperative bleeding and postoperative drainage were both less than those of the traditional group, statistically significant （ P 〈 0. 05） ;No difference in Harris scores and FIM scores before operation between the two groups. Three months after operation, the Harris score and the FIM score of the patients in the minimally invasive operation group were higher than those in the traditional operation group （P 〈 0. 05 ） ;No significant difference in the incidence of adverse events such as prosthetic infection, prosthetic loosening and hip dislocation between the two groups （P 〉 0. 05 ）. Conclusion Minimally invasive total hip arthroplasty is effective in the treatment of avascular necrosis of femoral head with little trauma, which has good application value.