直接前侧入路全髋关节置换术对股骨颈骨折患者术后疼痛及关节功能的影响

Effect of Direct Anterior Approach Total Hip Replacement on Postoperative Pain and Joint Function in Patients with Femoral Neck Fracture

目的:探讨直接前侧入路全髋关节置换术(THA)对股骨颈骨折(FNF)患者术后疼痛及关节功能的影响。方法:回顾收集景德镇市第二人民医院2021年7月—2023年10月行THA治疗的93例FNF患者的临床资料,按不同手术入路方式分为A组(n=49,直接前侧入路)、B组(n=44,后外侧入路)。统计并比较两组围手术期指标、术后疼痛状况、炎症因子、关节活动度及关节功能。结果:两组手术用时比较差异无统计学意义(P>0.05);A组术中出血量少于B组,首次下床时间早于B组,总住院时间短于B组(P<0.05)。术后6、24 h,A组视觉模拟评分法(VAS)评分均低于B组(P<0.05);术后1 d,A组C反应蛋白(CRP)、红细胞沉降率(ESR)水平均低于B组(P<0.05);术后3个月,A组髋关节屈伸度、Harris髋关节评分量表(HHS)评分均高于B组(P<0.05)。结论:FNF患者行直接前侧入路THA可缩短康复时间,减轻术后疼痛,降低炎症反应,促使髋关节功能恢复。

Objective:To investigate the effects of direct anterior approach total hip replacement(THA)on postoperative pain and joint function in patients with femoral neck fracture(FNF).Method:Clinical data of 93 patients with FNF treated with THA from July 2021 to October 2023 in the Second People's Hospital Jingdezhen were retrospectively collected,and divided into group A(n=49,direct anterior approach)and group B(n=44,posterolateral approach)according to different surgical approaches.Perioperative indexes,postoperative pain,inflammatory factors,joint motion and joint function were compared between two groups.Result:There was no significant difference in operation time between two groups(P>0.05).The operative blood loss in group A was less than that in group B,and the first time of getting out of bed in group A was earlier than that in group B,total hospital stay in group A was shorter than that in group B(P<0.05).At 6 and 24 h after operation,the visual analogue scale(VAS)score of group A were lower than those of group B(P<0.05).The levels of C reactive protein(CRP)and erythrocyte sedimentation rate(ESR)in group A were lower than those in group B(P<0.05).Three months after operation,hip flexion and extension and Harris hip score(HHS)score in group A were higher than those in group B(P<0.05).Conclusion:Direct anterior approach THA in patients with FNF can shorten the recovery time,reduce postoperative pain,reduce inflammatory response,and promote the recovery of hip function.