直接前入路与后外侧入路全髋关节置换术后隐性失血对比研究

A Comparative Study of Hidden Blood Loss between Direct Anterior Approach and Posterolateral Approach for Primary Total Hip Arthroplasty

目的探讨直接前入路与后外侧入路全髋关节置换术后隐性失血的差异.方法回顾性分析武汉大学人民医院2016年9月~2018年9月行初次全髋关节置换患者71例.依据所采用的手术入路分为直接前入路组(n=33)与后外侧入路组(n=38),通过分析术前术后血常规及术中出血资料,计算并比较两种术式隐性失血的差异.结果两种入路的显性失血量差异无统计学意义(P>0.05),在总失血量及隐性失血量上,直接前入路组均显著低于后外侧入路组(P<0.05).两种入路在术后接受输血治疗率及相关并发症发生率上差异无统计学意义.结论与后外侧入路比较,全髋置换术中采用直接前入路能显著减少隐性失血量与总失血量.

Objective To explore the difference of hidden blood loss between direct anterior approach and posterolateral approach for primary total hip arthroplasty(TH A).Methods Totally 71 cases that underwent primary total hip arthroplasty in Renmin Hospital of Wuhan University from September 2016 to September 2018 were enrolled in this study.They were divided into direct anterior approach group(n=33)and posterolateral approach group(n=38).The hidden blood loss was calculated through the analyse of intraoperative blood loss and the routine blood test.Results No significant difference of intraoperative blood loss was found between two groups(P>0.05).The hidden blood loss and total blood loss of direct anterior approach group were significantly fewer than that of posterolateral approach group(P<0.05).The rate of receiving blood transfusion therapy and the incidence rate of bleeding related complications were not significantly differently between two groups.Conclusion Compared with the posterolateral approach,the direct anterior approach in total hip arthroplasty can significantly reduce the hidden blood loss and total blood loss.