DAA全髋关节置换术中应用自体关节囊翻转技术保护阔筋膜张肌的临床研究

Clinical Study on the Protection of Tensor Fascia Lata with Autologous Joint Capsule Turnover Technique in Patients with Total Hip Replacement by DAA

目的:探究及分析直接前方入路(DAA)全髋关节置换术中应用自体关节囊翻转技术保护阔筋膜张肌的临床效果。方法:将2021年1月—2022年1月宜春市人民医院收治的80例DAA全髋关节置换术患者随机分为A组40例和B组40例。A组进行常规手术治疗,B组则采用自体关节囊翻转技术进行治疗。比较两组术后引流量、术后首次下床活动时间、住院时间、并发症总发生率,以及手术前后血红蛋白、肌红蛋白、乳酸脱氢酶、肌酸激酶、Harris髋关节功能评分及视觉模拟评分法(VAS)评分结果构成。结果:B组术后引流量显著少于A组,B组术后首次下床活动时间及住院时间均显著短于A组,B组并发症总发生率显著低于A组,差异均有统计学意义(P<0.05)。术前两组血红蛋白、肌红蛋白、乳酸脱氢酶、肌酸激酶、Harris髋关节功能评分及VAS评分结果构成比较,差异均无统计学意义(P>0.05);术后1、3及7 d,B组血红蛋白均显著高于A组,肌红蛋白、乳酸脱氢酶、肌酸激酶均显著低于A组,B组VAS评分结果构成均优于A组;术后1、3个月,B组Harris髋关节功能评分均显著高于A组,差异均有统计学意义(P<0.05)。结论:DAA全髋关节置换术中应用自体关节囊翻转技术保护阔筋膜张肌的临床效果较好,有助于减少手术并发症及缩短术后康复时间,因此在DAA全髋关节置换术患者中应用价值较高。

Objective:To investigate and analyze the clinical effect on protection of tensor fascia lata with autologous joint capsule turnover technique in patients with total hip replacement by direct anterior approach(DAA).Method:A total of 80 patients with total hip replacement by DAA who were admitted in Yichun People's Hospital from January 2021 to January 2022 were randomly divided into the group A with 40 cases and the group B with 40 cases.The group A was treated with routine operation,the group B was treated with autologous joint capsule turnover technique.The postoperative drainage volume,time of first ambulation after the operation,hospitalization time,total complication rate,hemoglobin,myoglobin,lactate dehydrogenase,creatine kinase,Harris hip joint function score and visual analogue scale(VAS)score results of two groups before and after the operation were compared.Result:The postoperative drainage volume of the group B was significantly less than that of the group A,the time of first ambulation after the operation and hospitalization time of the group B were significantly shorter than those of the group A,the total complication rate of the group B was significantly lower than that of the group A,the differences were statistically significant(P<0.05).The hemoglobin,myoglobin,lactate dehydrogenase,creatine kinase,Harris hip joint function score and VAS score results of two groups before the operation were compared,the differences were not statistically significant(P>0.05);at 1,3 and 7 days after the operation,the hemoglobin of the group B were significantly higher than those of the group A,the myoglobin,lactate dehydrogenase and creatine kinase of the group B were significantly lower than those of the group A,the VAS score results in the group B were better than those in the group A,the Harris hip joint function scores of the group B at 1 and 3 months after the operation were significantly higher than those of the group A,the differences were statistically significant(P<0.05).Conclusion:The application of autologous joint capsule turnover technique in total hip replacement by DAA to protect the tensor fascia lata has a good clinical effect,and it is helpful to reduce surgical complications and shorten postoperative recovery time,so its application value in the patients with total hip replacement by DAA is higher.