微创直接前方与后外侧入路在初次全髋关节置换中的早期疗效分析

Analysis of early curative effect in primary total hip arthroplasty between direct anterior approach and direct lateral approach

目的:比较分析微创直接前方(Direct anterior approach,DAA)与传统后外侧(Direct lateral approach,DLA)入路在初次全髋关节置换术中的早期临床疗效。方法:选取2015年至2018年在我院骨科行初次人工髋关节置换的60例患者,将其随机分为微创DAA组与传统DLA组(n=30)。DAA组行微创直接前方入路全髋关节置换术,DLA组行传统后外侧入路全髋关节置换术,比较两组患者满意度、住院时间、切口长度、手术时间、术中出血量、手术前后Harris评分与VAS评分、并发症、髋臼外展角及前倾角等指标。结果:DAA组切口长度、术中出血量、住院时间均显著优于DLA组(P<0.05)。术后DAA组患者1个月和3个月的Harris评分明显高于DLA组(P<0.05)。DAA组综合满意度优于DLA组(P<0.05)。DAA组与DLA组髋臼外展角、前倾角之间无统计学差异(P>0.05)。结论:在髋置换术中,DAA与DLA相比具有术中出血少、住院时间短、关节恢复快、及患者满意度高等优势,值得在基层临床中推广实施。

Objective:To analyze the early curative effect in primary total hip arthroplasty between direct anterior approach and direct lateral approach.Method:From February 2015 to February 2016,60 patients with primary hip arthroplasty were divided into DAA group(n=30)and,DLA group(n=30).Satisfaction,length of hospital stay,length of incision,duration of operation,intraoperative blood loss,Harris score and VAS score,complications,abduction angle and anterior inclination angle of acetabulum were compared between the two groups.Results:The hospitalization time,intraoperative blood loss and incision length in DAA group were significantly better than those in DLA group(P<0.05).There was a statistically significant difference between the two groups at 1 th and 3 th month after surgery(P<0.05),but there was no statistical difference between the two groups at 3 th year after surgery(P>0.05).The comprehensive satisfaction of DAA group was better than that of DLA group,and the difference was statistically significant(P<0.05).There was no significant difference in anteversion angle and acetabular abduction angle between the two groups(P>0.05).Conclusion:Compared with DLA,DAA has the advantages of speeding up the recovery of hip joint function,and it is worth popularizing and implementing in primary clinic,but its long-term curative effect needs to be further observed.