不用牵引床直接前入路全髋关节置换的临床研究

Clinical Study of Total Hip Arthroplasty with Direct Anterior Approach Without Traction Table

目的分析不用牵引床直接前入路全髋关节置换的临床价值与效果。方法随机选取该院2018年3月—2020年1月接受治疗的60例(62髋)行髋关节置换手术治疗患者作为研究对象,通过随机数字法分为直接前入路(DAA)组(n=45)和后外侧保留梨状肌入路(Mis-PLA)组(n=15),比较两组患者手术指标、术后髋关节功能评分以及术后康复情况。结果DAA组术中出血量(472.98±42.63)mL,与Mis-PLA组比较差异无统计学意义(t=0.242,P>0.05)。DAA组手术时间(113.85±15.64)min、住院时间(8.65±2.57)d、下地时间(6.15±1.85)d,与Mis-PLA组比较,差异有统计学意义(t=3.574、7.717、6.751,P<0.05)。DAA组患者髋关节功能优良率93.33%,高于Mis-PLA组66.67%,差异有统计学意义(χ^(2)=4.808,P<0.05)。结论给予患者直接前入路全髋关节置换,能够起到良好临床效果,不仅能够提高各项手术指标,同时能够改善患者髋关节功能,对患者康复有积极作用,可以考虑积极推广。

Objective To analyze the clinical value and effect of total hip replacement without traction bed.Methods Selected randomly 60 patients(62 hips)who underwent hip replacement surgery in the hospital from March 2018 to January 2020 as the research object,randomly divided into the direct anterior approach(DAA)group(n=45)and the posterolateral piriformis preserving approach(Mis-PLA)group(n=15)by random number method.The surgical indicators,postoperative hip function scores and postoperative rehabilitation were compared between the two groups.Results The intraoperative blood loss in the DAA group was(472.98±42.63)mL,which was no statistically significant difference from that of Mis-PLA group(t=0.242,P>0.05).Operation time(113.85±15.64)min,hospitalization time(8.65±2.57)d,and ground time(6.15±1.85)d in DAA group,compared with Mis-PLA group,the difference were statistically significant(t=3.574,7.717,6.751,P<0.05).The excellent and good rate of hip function in the DAA group was 93.33%,which was higher than that of the Mis-PLA group by 66.67%,the difference was statistically significant(χ^(2)=4.808,P<0.05).Conclusion The direct anterior approach for total hip replacement can achieve good clinical results.It can not only improve various surgical indicators,but also improve the function of the patient’s hip joint,which has a positive effect on the rehabilitation of patients.Active promotion can be considered.