直接上方入路与直接前方入路全髋关节置换术的短期疗效比较

Comparison of short-term outcomes between directive superior approach and directive anterior approach in total hip arthroplasty

目的:对比分析直接上方入路与直接前方入路全髋关节置换术(THA)的临床疗效。方法:回顾性分析2016年1月至2022年1月接受THA的62例患者的临床资料,男30例,女32例;年龄62~82岁,平均(63.5±4.8)岁,根据术式选择分为直接上方入路组32例,直接前方入路组30例,比较两组患者的手术情况、末次随访的髋关节功能Harris评分、Berg平衡量表评分及并发症发生率。结果:直接上方入路组患者的术中出血量、输血量、并发症发生率低于直接前方入路组,差异有统计学意义(P<0.05)。两组患者全部获得随访,随访时间6~24个月,平均(10.5±3.5)个月。末次随访时,直接上方入路组的髋关节功能Harris评分、Berg平衡量表评分高于直接前方入路组,差异有统计学意义(P<0.05)。结论:直接上方入路与直接前方入路THA比较,能够降低术中出血量、输血量,更大程度改善髋关节功能,降低并发症发生率,安全性高,值得推广。

Objective:To compare and analyze the curative effects of total hip arthroplasty by direct superior approach and direct anterior approach.Methods:The clinical data of 62 patients who received total hip arthroplasty from January 2016 to January 2022 were retrospectively analyzed,including 30 males and 32 females with the mean age of(63.5±4.8)years(range,62-82 years).According to the surgical approach,32 patients were classified into the direct superior approach group,while 30 patients were classified into the direct anterior approach group.The intraoperative conditions,Harris score and Berg balance scale score at the last follow-up,and incidence of complications were compared between the two groups.Results:The intraoperative bleeding volume,transfusion rate,and complication incidence of patients were lower in the direct superior approach group than in the direct anterior approach group,with statistically significant differences(P<0.05).All patients were followed up for 6-24 months,with an average time of(10.5±3.5)months.At the last follow-up,the Harris score and Berg balance scale score of the surgical hip in the direct superior approach group were statistically significantly higher than those in the direct anterior approach group(P<0.05).Conclusions:Compared with direct anterior approach,direct superior approach can reduce intraoperative bleeding and transfusion rate,obtain better surgical hip function,and reduce the incidence of complications,which is safe and worth popularizing.