小切口常规全髋关节置换术研究论文.docx

小切口常规全髋关节置换术研究论文【摘要】目的比较改良小切口与常规全髋关节置换术的手术经验及短期临床随访结果。方法采用改良小切口对15例15髋进行全髋关节置换术(totalhiparthroplostyTHA)男10例女5例；年龄65～75岁平均72岁体重指数20.5～26.5kg/m2平均23.5kg/m2。股骨颈骨折10例股骨头缺血性坏死3例骨关节炎2例。术前Harris评分平均33.5分。同期采用常规后外侧入路行THA15例15髋男11例女4例；年龄66～78岁平均73岁体重指数20.8～25.8kg/m2平均23.8kg/m2。股骨颈骨折12例股骨头缺血性坏死3例。术前Harris评分平均33.8分。两组年龄、性别及体重指数均衡(P＞0.05)疾病谱相似。对两组病例的术中出血量、手术时间、切口长度、术后早中期的功能锻炼情况及影像学评价进行比较。结果术后随访6～10个月平均8.2个月。改良小切口THA组切口长度平均9.5cm较常规THA组短(P＜0.05)；术中出血量(318±223.1)mL引流量(252±169.1)mL均较常规THA组少(P＜0.05)；平均手术时间两组并无统计学意义。小切口THA组术后早期功能恢复较常规THA组快而中期结果相似。术后及随访时两组假体位置均良好。小切口THA组除有2例患者术中发生切口近端皮肤擦伤无并发症常规THA组有1例患者术后脱位。结论改良小切口技术可选择性用于部分病例的人工全髋关节置换术创伤小围手术期出血少切口小且不影响假体位置术后早期功能锻炼。但应严格选择手术适应证由拥有相应设备条件的医院及有一定经验的医生开展。【关键词】关节成形术；置换；髋；外科手术；小切口；随访研究RetrospectiveComparisonofTotalHipArthroplastyThroughaModifiedMiniincisionVersusStandardPosterolateralApproachYEXiaoyuLAIXianliangSHENXinshengetal(DepartmentofOrthopaedicsWenzhouHospitalofChineseTraditionalCombinedWesternMedicineWenzhou325000China)Abstract：ObjectiveTosummarizeandreportthesurgicalexperienceandclinicaloutcomeofTHAthroughamodifiedminiincisionposterolateralsurgicalapproach.MethodsFifteencasesofTHAwereperformedthroughamodifiedminiincisionposterolateralsurgicalapproach(MISgroup).Amongthemtherewere10malesand5femalesthemeanagewas72yearsrangingfrom65to75years.Theaveragebodymassindex(BMI)was23.5kg/m2rangingfrom20.5to26.5kg/m2.AndthemeanHarrisscorewas33.5.Forcomparisonanother15casesofTHAwereperformedthroughastandardposterolateralatthesameperiod(standardgroup).ThemeanageBMIandHarrisscoreweresimilartotheMISgroup.Operationtimebloodlossincisionlengthfunctionalrecoveryandprostheticpositionwereanalysedandcomparedbetweentheabovetwogroups.ResultsThesepatientswerefollowedupforaverage8.2months.Theaverageincisionlengthwas9.5cminMISgroupwhichisshorterthanstandardgroup.Thedifferencewassignificantstatistically(P＜0.05)；andamountofbleedingwas(318±223.1)mLThepostoperativedrainagewas(252±169.1)mLP＜0.05intwogroups.Theoperationtimewassimilarintwogroups