改良比基尼入路行全髋关节置换术的疗效及安全性研究

Efficacy and safety of modified Bikini approach in total hip arthroplasty

目的研究改良比基尼入路行全髋关节置换术(THA)的疗效及安全性。方法回顾性分析汕尾市第二人民医院2017年2月至2021年1月期间收治的80例需行THA患者的临床资料,按照治疗方法的不同分为研究组和对照组各40例。对照组患者采用改良Hardinge入路,而研究组患者采用改良比基尼入路。比较两组患者的手术时间、术中出血量、切口长度、住院天数、髋关节功能(Harris)评分、视觉模拟(VAS)评分、髋臼前倾角度与外展角度及并发症发生情况。结果研究组患者的术中出血量、切口长度、手术时间、住院天数分别为(287.96±137.45)mL、(7.68±1.84)cm、(85.56±16.94)min、(7.65±1.23)d,明显少(短)于对照组的(459.67±116.75)mL、(13.64±2.06)cm、(112.46±13.98)min、(10.36±2.06)d,差异均有统计学意义(P<0.05);术前,两组患者的Harris评分与VAS评分比较差异均无统计学意义(P>0.05),术后,研究组患者的Harris评分与VAS评分分别为(96.45±1.06)分、(1.26±0.76)分,对照组患者分别为(85.67±1.46)分、(2.04±0.63)分,两组患者的Harris评分均明显升高,且研究组患者Harris评分明显高于对照组,而两组患者的VAS评分明显降低,且研究组患者VAS评分明显低于对照组,差异均有统计学意义(P<0.05);术后,两组患者的髋臼前倾角度与外展角度比较差异均无统计学意义(P>0.05);研究组患者术后并发症发生率为2.50%,略低于对照组的7.50%,但差异无统计学意义(P>0.05)。结论全髋关节置换术采用改良比基尼入路可获得更好的治疗效果,且安全性较高,具有临床应用价值。

Objective To study the efficacy and safety of modified Bikini approach in total hip arthroplasty(THA).Methods The clinical data of 80 patients treated in Shanwei Second People's Hospital from February 2017 to January 2021 were retrospectively analyzed.According to different treatment methods,they were divided into a study group and a control group,with 40 patients in each group.The patients in the control group used the modified Hardinge approach,while the patients in the study group used the modified Bikini approach.The operation time,intraoperative bleeding,incision length,length of hospital stay,Harris score,VAS score,acetabular anteversion angle,abduction angle,and complications were compared between the two groups.Results The amount of intraoperative bleeding,incision length,operation time,and length of hospital stay in the study group were(287.96±137.45)mL,(7.68±1.84)cm,(85.56±16.94)min,(7.65±1.23)d,which were significantly lower than(459.67±116.75)mL,(13.64±2.06)cm,(112.46±13.98)min,(10.36±2.06)d in the control group(P<0.05).Before operation,there was no significant difference between Harris score and VAS score between the two groups(P>0.05);after operation,the Harris score and VAS score were(96.45±1.06)points and(1.26±0.76)points of the study group and(85.67±1.46)points,(2.04±0.63)points of the control group;the Harris scores of the two groups were significantly increased,and the Harris score of the study group was significantly higher than that of the control group,with statistically significant differences(P<0.05);the VAS score of the two groups were significantly decreased,and the VAS score of the study group was significantly lower than that of the control group,with statistically significant differences(P<0.05).After operation,there was no significant difference in acetabular anteversion angle and abduction angle between the two groups(P>0.05).The incidence of postoperative complications in the study group was 2.50%,slightly lower than 7.50%in the control group,but the difference was not statistically significant(P>0.05).Conclusion The improved Bikini approach in total hip arthroplasty can obtain better therapeutic effect and high safety,which has clinical application value.