侧卧位直接前方入路与后外侧入路在初次全髋关节置换术中的应用价值

Application value of direct anterior approach in lateral decubitus position and posterolateral approach in primary total hip replacement

目的探讨侧卧位直接前方入路与后外侧入路在初次全髋关节置换术中的应用价值。方法选取2018年1月至2020年8月本院收治的82例初次全髋关节置换术患者作为研究对象,按单双号分为两组,每组41例。对照组采用后外侧入路,观察组采用侧卧位直接前方入路。比较两组手术指标、Harris评分、视觉模拟评分法(VAS)评分及并发症发生情况。结果两组手术时间比较差异无统计学意义;观察组术中出血量、术后引流量均少于对照组,切口长度、住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,观察组VAS评分低于对照组,Harris评分高于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义。结论侧卧位直接前方入路应用于全髋关节置换患者疗效显著,且患者手术创伤小、恢复快,有利于缓解疼痛,改善髋关节功能,安全性高,值得临床推广应用。

Objective To investigate the application value of direct anterior approach in lateral decubitus position and posterolateral approach in primary total hip replacement.Methods 82 patients with primary total hip replacement admitted to our hospital from January 2018 to August 2020 were selected as the research subjects,and they were divided into two groups according to odd-even number,with 41 cases in each group.The control group was treated with posterolateral approach,while the observation group was treated with lateral and direct anterior approach in lateral decubitus position.The surgical indexes,Harris score,visual analog scale(VAS)score and the incidence of complications were compared between the two groups.Results There was no significant difference in operation time between the two groups;the intraoperative blood loss and postoperative drainage volume in the observation group were less than those of the control group,and the incision length and hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the VAS score of the observation group was lower than that in the control group,and the Harris score was higher than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups.Conclusion The direct anterior approach in lat eral decubitus position is effective in patients with total hip replacement,and the surgical trauma is small,the recovery is fast,it is conducive to pain relief,improve hip function,and it is safe and worthy of clinical promotion and application.