前外侧与后外侧入路小切口髋关节置换术的应用效果比较

Comparison of application effects of small incision hip replacement through anterolateral and posterolateral approaches

目的:比较前外侧与后外侧入路小切口髋关节置换术的应用效果。方法:回顾性分析2020年2月至2023年7月于该院行髋关节置换术的110例患者的临床资料,按照手术方法不同将其分为研究组和对照组各55例。对照组行后外侧入路小切口髋关节置换术治疗,研究组行前外侧入路小切口髋关节置换术治疗。比较两组手术相关指标(手术时间、切口长度、术中出血量、骨折愈合时间和住院时间)水平,手术前后髋关节功能[Harris髋关节功能量表(HHS)]、疼痛[视觉模拟评分法(VAS)]评分,以及并发症发生率。结果:研究组切口长度、骨折愈合时间、住院时间短于对照组,术中出血量少于对照组,手术时间长于对照组,差异均有统计学意义(P<0.05);术后1、3、6个月,两组HHS评分均高于术前,且研究组术后1、3个月HHS评分均高于对照组,差异有统计学意义(P<0.05);术后3、7 d,两组VAS评分均低于术前,且研究组低于对照组,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(P>0.05)。结论:前外侧入路小切口髋关节置换术可改善手术相关指标水平,提高髋关节功能评分,降低疼痛评分,效果优于后外侧入路小切口髋关节置换术,但需延长手术时间。

Objective:To compare application effects of small incision hip replacement through anterolateral and posterolateral approaches.Methods:The clinical data of 110 patients who underwent hip replacement in this hospital from February 2020 to July 2023 were retrospectively analyzed.According to different surgical methods,they were divided into study group and control group,55 cases in each group.The control group was treated with small incision hip replacement through posterolateral approach,while the study group was treated with small incision hip replacement through anterolateral approach.The operation related indexes(operation time,incision length,intraoperative blood loss,fracture healing time and hospitalization time)levels,the hip function[Harris hip scale(HHS)]and the pain[visual analogue scale(VAS)]score before and after the surgery,and the incidence of complications were compared between the two groups.Results:The incision length,the fracture healing time and the hospitalization time of the study group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the operation time was longer than that of the control group,and the differences were statistically significant(P<0.05).At 1,3 and 6 months after the surgery,the HHS scores of the two groups were higher than those before the surgery,the HHS scores of 1 and 3 months after the surgery of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).At 3 and 7 days after the surgery,the VAS scores of the two groups were lower than those before the surgery,those of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Small incision hip replacement though anterolateral approach can improve the levels of surgical related indexes,improve the hip function scores,and reduce the pain scores.It is superior to small incision hip replacement through posterolateral approach,but the operation time needs to be prolonged.