【摘要】 [目的]探讨小切口人工全髋关节置换手术的优缺点。[方法]比较32例37髋小切口人工全髋关节置换术与普通切口人工全髋关节置换术在切口长度、手术时间、术中出血量、术后引流量、住院时间及并发症等方面的异同。[结果]小切口组平均切口长度为7.7cm,普通切口组为11.5cm(P<0.05);小切口组平均手术时间为95min,普通切口组为51min(P<0.05);小切口组术中平均出血量为380ml,普通切口组为299ml(P<0.05);小切口组及普通切口组在术后引流量及住院时间方面无显著性差异(P>0.05);小切口组1例术中出现大转子尖骨折、股骨颈截骨过多、髋臼内凸,1例因髋臼安放角度异常于术后第3d出现髋关节脱位,行扩大切口调整髋臼假体角度后恢复正常;普通切口组术中、术后无1例出现并发症。[结论]与普通长度切口全髋关节置换手术相比,小切口手术在出血量、组织损伤程度、手术时间方面并无明显优势;由于切口小,术野受限,手术操作比较困难,易出现假体安装位置异常等问题。在熟练做好普通切口全髋置换手术、不增加手术损伤的前提下,可尽量减小手术切口长度,没有必要刻意追求小切口全髋置换手术。更多还原

【Abstract】 [Objective]To explore the advantages and disadvantages of minimal incision surgery(MIS) for total hip replacement.[Methods]Thirty-two patients(37 hips) who had undergone a MIS were compared with 32 patients(37hips) who had undergone conventional incision surgery with similar condictions.The length of incision,operation time,intraoperative blood loss,postoperative drainage,hospitalized days and complications were observed.[Results]The average incision length was 7.7 cm for MIS group and 11.5 cm for conventional incision group(P<0.05).The average surgical time was 95 minutes for MIS group and 51 minutes for conventional incision group(P<0.05).The average intraoperative blood loss was 380ml for MIS group and 299ml for conventional incision group(P<0.05).There was no significant difference in postoperative drainage,hospitalized days between these two groups(P>0.05).In MIS group,greater trochanter fracture occured in 1 patient during operation.Dislocation occurred in another patient with anterolateral approach 3 days postoperatively because of malposition of the cup,the cup was then adjusted to proper position by re-operation with extended incision length.In conventional incision group,no complication occured during or after operations.[Conclusion]Total hip replacement with the incision length of 6～8.5 cm is a very demanding technique.There were no much advantages of MIS for total hip replacement concerning surgical time,blood loss or trauma compare with a conventional incision surgery.The incision length for total hip replacement should not be stressed.The most important thing for total hip replacement is not the length of the incision and the length of incision should not be reduced at the price of more soft tissue injury.更多还原