文章摘要
戴醒明,杨效宁,孙一公,刘大成,李国民.前外侧与后外侧路小切口髋关节置换术治疗老年股骨颈骨折的疗效比较研究[J].,2017,17(34):6727-6730
前外侧与后外侧路小切口髋关节置换术治疗老年股骨颈骨折的疗效比较研究
Aged Femoral Neck Fracture: Comparison of Curative Effect of Minimally Invasive Hip Arthroplasty with Anterolateral and Posterolateral Surgical Approach
投稿时间:2017-05-16  修订日期:2017-06-10
DOI:10.13241/j.cnki.pmb.2017.34.027
中文关键词: 髋关节置换术  手术入路  老年股骨颈骨折  疗效
英文关键词: Hip arthroplasty  Surgical approach  Aged femoral neck fracture  Curative effect
基金项目:
作者单位E-mail
戴醒明 徐州市第一人民医院骨科 江苏 徐州 221002 wradfg@163.com 
杨效宁 徐州市第一人民医院骨科 江苏 徐州 221002  
孙一公 徐州市第一人民医院骨科 江苏 徐州 221002  
刘大成 徐州市第一人民医院骨科 江苏 徐州 221002  
李国民 徐州市第一人民医院骨科 江苏 徐州 221002  
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中文摘要:
      摘要 目的:研究前外侧入路(ASA)与后外侧入路(PSA)小切口髋关节置换术对老年股骨颈骨折的治疗效果,为临床手术入路的选择提供参考。方法:选自我院于2014年3月至2016年6月间收治的老年股骨颈骨折患者共98例作为研究对象,并根据其治疗的手术入路方式分为ASA组和PSA组,各49例。记录两组患者切口长度、手术时间、术中出血量、引流量,并对患者进行为期半年的随访。采用Harris评分对患者髋关节功能恢复情况进行评价。观察记录患者并发症发生情况。结果:ASA组患者围术期切口长度短于PSA组患者,手术时间、术中出血量和引流量均明显少于PSA组患者,差异具有统计学意义(P<0.05)。两组患者术后Harris评分均较术前显著提高,且随着随访时间的延长Harris评分逐步增加(P<0.05),但组间同时期比较差异无统计学意义(P>0.05)。ASA组患者并发症发生率为2.04%,低于PSA组的14.29%,差异具有统计学意义(P<0.05)。结论:ASA与PSA小切口髋关节置换术治疗老年股骨颈骨折具有较好的治疗效果,均有利于患者的髋关节功能恢复,但ASA小切口髋关节置换术具有切口小、手术时间短、术中出血量和引流量低的优点,同时安全性较高,在老年股骨颈骨折的治疗中具有较高的临床价值。
英文摘要:
      ABSTRACT Objective: To study the curative effect of minimally invasive hip arthroplasty with anterolateral surgical approach (ASA) and posterolateral surgical approach (PSA) on aged femoral neck fracture,in order to provide reference for the choice of clinical surgical approach. Methods: A total of 98 patients with aged femoral neck fracture,who were treated in First People's Hospital of Xuzhou from March 2014 to June 2016, were selected and divided into ASA group(n=49) and PSA group(n=49) according to the surgical approach.The incision length, operation time, blood loss and flow volume of the two groups were recorded, and the patients were followed up for half a year. The recovery of hip function was evaluated by the Harris score. The complications of the patients were recorded. Results: The length of incision of the ASA group was significantly shorter than that of the PSA group. The time of operation, intraoperative blood loss and the drainage flow in the ASA group were significantly less than those in the PSA group, the difference was statistically significant (P<0.05). The Harris scores of the two groups were significantly higher than those before surgery, and the Harris score increased gradually with the follow-up time prolonged (P<0.05),but there was no significant difference between the two groups in the same period (P>0.05). The complication rate(2.04%) of ASA group was lower than that(14.29%) of PSA group, the difference was statistically significant (P<0.05). Conclusion: Both minimally invasive hip arthroplasty with ASA and minimally invasive hip arthroplasty with PSA for aged femoral neck fracture have a good curative effect and are beneficial to the recovery of hip function, but minimally invasive hip arthroplasty with ASA has the following advantages: shorter incision, shorter operation time, less intraoperative blood loss and lower drainage flow, and higher security, which has a higher clinical value in the treatment of aged femoral neck fracture.
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