侧卧位直接前方入路与后外侧入路在全髋关节置换术中的应用效果

Application Effect of Lateral Decubitus Position Direct Anterior Approach and Posterolateral Approach in Total Hip Arthroplasty

目的:探讨侧卧位直接前方入路(DAA)与后外侧入路(PLA)在全髋关节置换术中的应用效果。方法:选取2021年3月—2022年4月莆田市中医医院收治的行全髋关节置换术的66例患者为研究对象。根据随机抽签法将其分为DAA组和PLA组,各33例。DAA组给予侧卧位DAA全髋关节置换术。PLA组给予PLA全髋关节置换术。比较两组围手术期指标,术后1 d、3 d、5 d的疼痛程度,术后1个月、3个月、6个月的髋关节功能,并发症。结果:DAA组切口长度和住院时间均短于PLA组,术中失血量和术后切口引流量均少于PLA组,差异有统计学意义(P<0.05)。DAA组术后1 d、3 d、5 d视觉模拟评分法(VAS)评分低于PLA组,差异有统计学意义(P<0.05)。DAA组术后1个月、3个月、6个月Harris评分高于PLA组,差异有统计学意义(P<0.05)。DAA组并发症发生率为6.06%,低于PLA组的24.24%,差异有统计学意义(P<0.05)。结论:相比PLA,侧卧位DAA在全髋关节置换术中的应用效果显著,能够有效改善相关手术指标,缓解患者疼痛程度的同时降低并发症发生率,利于髋关节功能恢复。

Objective:To investigate the application effect of lateral decubitus position direct anterior approach(DAA)and posterolateral approach(PLA)in total hip arthroplasty.Method:A total of 66 patients undergoing total hip arthroplasty admitted to Putian City Hospital of Traditional Chinese Medicine from March 2021 to April 2022 were selected as the study objects.They were divided into DAA group and PLA group according to random drawing method,with 33 cases in each group.DAA group was given lateral decubitus position DAA total hip arthroplasty.PLA group was given PLA total hip arthroplasty.Perioperative indexes,pain degree at 1 d,3 d and 5 d after surgery,hip joint function at 1 month,3 months and 6 months after surgery and complications were compared between the two groups.Result:The incision length and hospital stay in DAA group were shorter than those in PLA group,and the intraoperative blood loss volume and postoperative incision drainage volume were less than those in PLA group,the differences were statistically significant(P<0.05).The visual analogue scale(VAS)scores of DAA group at 1 d,3 d and 5 d after surgery were lower than those of PLA group,and the differences were statistically significant(P<0.05).The Harris scores of DAA group at 1 month,3 months and 6 months after surgery were higher than those of PLA group,and the differences were statistically significant(P<0.05).The incidence of complication of DAA group was 6.06%,which was lower than 24.24%of PLA group,and the difference was statistically significant(P<0.05).Conclusion:Compared with the PLA,the lateral decubitus position DAA has a significant application effect in total hip arthroplasty,which can effectively improve the relevant surgical indicators,relieve the pain degree of patients,and reduce the incidence of complications,and facilitate the recovery of hip joint function.