文章摘要
敬文波,蔡 炜,胡 波,陈 捷,唐旭东.前外侧肌间隙入路式微创全髋关节置换术对患者髋关节功能及炎性细胞因子水平的影响[J].,2018,(19):3754-3758
前外侧肌间隙入路式微创全髋关节置换术对患者髋关节功能及炎性细胞因子水平的影响
Effects of Minimally Invasive Total Hip Arthroplasty on Hip Function and Inflammatory Cytokine Levels in Patients with Anterolateral Interspace Interspace Approach
投稿时间:2018-02-26  修订日期:2018-03-22
DOI:10.13241/j.cnki.pmb.2018.19.035
中文关键词: 前外侧肌间隙入路  全髋关节置换术  髋关节功能  炎性因子
英文关键词: Anterolateral interspace interspace approach  Minimally invasive total hip arthroplasty  Hip function  Inflammatory cytokine levels
基金项目:四川省卫生厅科研基金项目(1202922)
作者单位E-mail
敬文波 内江市第一人民医院骨科 四川 内江 641000 perjud@163.com 
蔡 炜 内江市第一人民医院骨科 四川 内江 641000  
胡 波 内江市第一人民医院骨科 四川 内江 641000  
陈 捷 内江市第一人民医院骨科 四川 内江 641000  
唐旭东 内江市第一人民医院骨科 四川 内江 641000  
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中文摘要:
      摘要 目的:探讨前外侧肌间隙入路式微创全髋关节置换术对患者髋关节功能及炎性细胞因子水平的影响。方法:选取2015年1月至2017年1月间在我院行全髋关节置换术的98例患者作为此次研究的研究对象。采用随机数字表法对患者进行分组,其中49例患者作为对照组,行传统全髋关节置换术治疗;49例患者作为观察组,行前外侧肌间隙入路式微创全髋关节置换术治疗。观察并比较两组患者围术期指标,包括切口长度、手术时间、术中失血量、术后1 d引流量。检测并比较两组患者手术前及术后24 h检测血清炎症因子TNF-α、IL-1、IL-6水平。术前及术后3个月和6个月均采用Harris评分评价所有患者髋关节功能。记录并比较两组患者治疗及随访过程中的不良反应发生情况。结果:观察组术中失血量及术后1 d引流量均明显低于对照组,切口长度明显短于对照组,但手术时间明显长于对照组(P<0.05)。术后24 h,观察组血清TNF-α、IL-1、IL-6水平明显降低,且明显低于对照组(P<0.05)。术后3个月、6个月,两组患者的Harris评分逐渐升高(P<0.05),且与同时期的对照组患者比较,观察组患者的Harris评分明显较高(P<0.05)。观察组不良反应发生率为8.16%,明显低于对照组的28.57%(P<0.05)。结论:前外侧肌间隙入路式微创全髋关节置换术能明显改善患者的围术期指标、降低手术早期的炎性反应,同时能明显促进患者髋关节功能恢复,且安全性良好,值得临床推广。
英文摘要:
      ABSTRACT Objective: To explore the effects of minimally invasive total hip arthroplasty on hip function and inflammatory cy- tokine levels in patients with anterolateral interspace interspace approach. Methods: 98 cases of total hip arthroplasty in our hospital from January 2015 to January 2017 were selected as the research subjects. Patients were grouped by random digital table, 49 patients were treated as the control group with traditional total hip replacement therapy, 49 patients were treated as the observation group with mini- mally invasive total hip arthroplasty with anterolateral interspace interspace approach. The perioperative indexes of the two groups were observed and compared, including the length of the incision,operation time, the amount of blood loss during the operation, and the flow rate of 1d after the operation. The serum inflammatory factors TNF-α, IL-1, and IL-6 levels in two groups before and 24 h after opera- tion were compared. Harris scores were used to evaluate the hip function of all patients before operation, 3 months and 6 months after op- eration. The incidence of adverse reactions during the treatment and follow-up of two groups was recorded and compared. Results: The amount of blood loss and the flow rate of 1 d after operation in the observation group were significantly lower than that of the control group, the length of the incision was significantly shorter than that of the control group, but the operation time was significantly longer than that of the control group (P<0.05). 24 h after operation, the serum levels of TNF-α, IL-1 and IL-6 in the observation group were sig- nificantly lower than those in the control group (P<0.05). 3 months and 6 months after operation, the Harris score of the two groups in- creased gradually(P<0.05), compared with the control group in the same period, the Harris score of the patients in the observation group was significantly higher(P<0.05). The incidence of adverse reaction in the observation group was 8.16%, which was significantly lower than 28.57% of the control group(P<0.05). Conclusion: Minimally invasive total hip arthroplasty with the anterolateral interspace ap- proach can significantly improve the perioperative indicators and lower the early inflammatory response, it can obviously promote the re- covery of the hip joint function and safety, it is worthy of clinical promotion.
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