小切口人工全髋关节置换术治疗成人股骨头坏死的适应证及效果

Indications and Effects of Small Incision Total Hip Arthroplasty in the Treatment of Adult Femoral Head Necrosis

目的探究小切口人工全髋关节置换术在成人股骨头坏死治疗中的适应证及应用效果。方法研究纳入2019年12月—2021年11月收治的50例成人股骨头坏死患者,应用双盲法随机将其分为对照组(25例)与观察组(25例)。两组分别实施常规切口人工全髋关节置换术、小切口人工全髋关节置换术。比较两组治疗效果(临床手术指标、优良率、VAS评分以及Harris总评分)。结果观察组手术时间、切口长度、总失血量、输血量及术后引流量均显著优于对照组,差异有统计学意义(t=3.753、13.986、3.347、5.898、4.643,P<0.05);观察组临床优良率96.00%(24/25)明显高于对照组68.00%(17/25),差异有统计学意义(χ^(2)=4.878,P=0.027);治疗后观察组VAS评分、Harris总评分均显著优于对照组,差异有统计学意义(t=7.649、3.828,P<0.05)。结论在成人股骨头坏死治疗中,小切口人工全髋关节置换术具有确切疗效,适用于体格胖瘦适中患者。

Objective To explore the indications and application effects of small incision total hip arthroplasty in the treatment of adult femoral head necrosis.Methods A total of 50 adult patients with necrosis of the femoral head who were treated between December 2019 and November 2021 were included in the study,and they were randomly divided into the control group(25 cases)and the observation group(25 cases)by double-blind method.The two groups were treated with conventional incision to⁃tal hip arthroplasty and small incision total hip arthroplasty.The therapeutic effects(clinical surgery indicators,excellent and good rate,VAS score and Harris total score)were compared between the two groups.Results The operation time,incision length,total blood loss,blood transfusion volume and postoperative drainage volume of the observation group were significantly better than those of the control group,and the difference was statistically significant(t=3.753,13.986,3.347,5.898,4.643,P<0.05).The clinical excellent and good rate of the observation group was 96.00%(24/25),which was significantly higher than that of the control group 68.00%(17/25),and the difference was statistically significant(χ^(2)=4.878,P<0.05).After treatment,the VAS score and Harris total score of the observation group were significantly better than those of the control group,and the difference was statistically significant(t=7.649,3.828,P<0.05).Conclusion In the treatment of adult femoral head necrosis,small incision total hip arthroplasty has a definite curative effect,and it is suitable for patients with moderate physique.