前侧微创入路全髋关节置换术对股骨颈骨折患者Hb、CRP、IL-6水平及髋关节屈伸活动度的影响

Effect of THR through Anterior Minimally Invasive Approach on the Levels of HB,CRP,IL-6 and the Range of Hip Joint Motion Flexion and Extension in Patients with Femoral Neck Fracture

【目的】探讨前侧微创入路全髋关节置换术(THR)对股骨颈骨折患者血红蛋白(Hb)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平及髋关节屈伸活动度的影响。【方法】回顾性分析2017年1月至2019年12月在本院行前侧微创入路TRH患者(观察组,n=42)与传统后侧入路THR患者(对照组,n=42)的临床资料。比较两组患者围术期指标(手术时间、切口长度、术中出血量、术后引流量、住院时间)及术前、术后血液指标[Hb、血细胞比容(Hct)]、炎性指标(CRP、IL-6)和髋关节屈伸活动度及髋关节功能评分(Harris评分)。【结果】两组患者围术期各指标(除手术时间外)比较差异均有统计学意义(P<0.05);术后24 h,两组患者Hb、Hct水平较术前均显著下降(P<0.05),但观察组患者显著高于对照组(P<0.05);术后24 h、7 d,两组患者CRP、IL-6水平较术前均显著上升(P<0.05),但观察组患者显著低于对照组(P<0.05);术后3、6、12个月,两组患者髋关节屈伸活动度和Harris评分较术前均显著上升(P<0.05),术后3个月观察组患者上述指标均显著高于对照组(P<0.05),术后6、12个月观察组髋关节屈伸活动度显著高于对照组(P<0.05),但两组Harris评分比较差异无统计学意义(P>0.05)。【结论】前侧微创入路THR更有助于患者术后康复,缩短住院时间,并可减轻炎性反应,增加髋关节屈伸活动度,缩短髋关节功能恢复时间,值得临床推广应用。

【Objective】To investigate the effect of total hip arthroplasty(THR)through anterior minimally invasive approach on the levels of hemoglobin(HB),C-reactive protein(CRP),interleukin-6(IL-6)and the range of motion of hip joint flexion and extension in patients with femoral neck fracture.【Methods】The clinical data of TRH patients(observation group,n=42)and traditional posterior approach thr patients(control group,n=42)were retrospectively analyzed from January 2017 to December 2019 in our hospital.The perioperative indexes(operation time,incision length,intraoperative blood loss,postoperative drainage,length of hospital stay),preoperative and postoperative blood indexes(Hb,Hct),inflammatory indexes(CRP,IL-6),hip flexion and extension range of motion and hip function score(Harris score)were compared between the two groups.【Results】There were statistically significant differences in the perioperative indexes(except operation time)between the two groups(P<0.05);after 24 h,the levels of Hb and Hct in the two groups were significantly lower than those before operation(P<0.05),but the observation group was significantly higher than the control group(P<0.05);24 h,7 d after operation,the levels of Hb and Hct in the two groups were significantly lower than those before operation(P<0.05).The levels of CRP and IL-6 in the two groups were significantly higher than those before operation(P<0.05),but the observation group was significantly lower than the control group(P<0.05);after 3,6,12 months,the hip joint flexion and extension activity and Harris score of the two groups were significantly increased(P<0.05),the above indexes of the observation group were significantly higher than those of the control group at 3 months after operation(P<0.05),and the hip of the observation group at 6 and 12 months after operation was significantly higher than that of the control group(P<0.05)The range of motion of joint flexion and extension was significantly higher than that of the control group(P<0.05),but there was no significant difference in Harris score between the two groups(P>0.05).【Conclusion】Anterior minimally invasive THR is more conducive to postoperative rehabilitation,shorten hospital stay,reduce inflammatory reaction,increase the range of motion of hip joint flexion and extension,shorten the recovery time of hip joint function,which is worthy of clinical application.