前方入路与后方入路全髋人工关节置换术的临床疗效比较

Analysis of the Clinical Effect of Direct Anterior Approach and Posterior Approach Total Hip Arthroplasty

目的:评价与分析全髋人工关节置换术(THA)患者采用前方入路(DAA)与后方入路(PA)术式的临床疗效。方法:收集肇庆市第一人民医院2018年6月至2019年6月诊断为股骨缺血性疾病、髋关节发育不良及髋部骨性关节炎的患者共60例,随机分配30例患者为DAA组。另外的30例患者为PA组。比较两组患者的手术时间、术中出血量、术后引流量、髋关节功能评分量表(HHS)、西安大略麦克马斯特大学骨关节炎指数(WOMAC)及术后满意度。结果:对60例患者进行随访,随访时间平均为6个月。两组手术时间差异无统计学意义(P>0.05);与PA组比较,DAA组术中出血量、术后引流量少,术后6个月HHS评分、WOMAC评分更有优势,差异具有统计学意义(P<0.05)。结论:THA患者采用DAA术式的早期疗效令人较为满意,而且具有髋部组织损伤少、出血量少、恢复时间短、回归日常活动时间提前等优势,患者术后满意度较高。

Objective To evaluate and analyze the clinical efficacy of patients undergoing total hip arthroplasty using direct anterior approach(DAA)and posterior approach(PA).Methods A total of 60 patients who were diagnosed and treated with femoral ischemic disease,hip dysplasia,and hip osteoarthritis from the first people’s hospital of Zhaoqing from June 2018 to June 2019 were collected,and 30 patients were randomly assigned as DAA surgery group.The other 30 patients were in the PA surgery group.Comparison of surgical time,intraoperative blood loss,postoperative drainage,Harris hip score(HHS),the western Ontario and McMaster universities osteoarthritis index(WOMAC)and postoperative satisfaction were compared between these two groups.Results Sixty patients were followed up for an average of 6 months.There was no significant difference in surgical time,and 6 months postoperative VAS score between the two groups(P>0.05).Compared with the PA group,the DAA group had less postoperative drainage,and the HHS score and WOMAC score at 6 months after surgery were more advantageous,and the differences were statistically significant(P<0.05).Conclusion The early curative effect of DAA is satisfactory,and it has the advantages of less hip tissue damage,less bleeding,short recovery time,and early return to daily activities.Favored by surgeons and patients.