【摘要】 目的比较后外侧小切口全髋关节置换术(THA)与传统THA的临床疗效及并发症。方法 2004年11月至2009年6月,对38例(40髋)患者行后外侧小切口(6～10cm)THA,47例(48髋)患者行传统切口(11～15cm)THA。所有病例均由同一位主刀医生完成手术。结果术后随访平均21.2个月(18～24个月),两组病例均未出现感染、假体脱位及神经损伤等并发症,小切口THA组有2例患者术中发生切口近端皮肤擦伤,传统THA组有1例患者术后发生深静脉血栓。小切口THA组和传统THA组手术时间分别为72(60～100)min和69(70～175)min,术中出血量分别为350(250～520)ml和393(270～600)ml,差异均无统计学意义(P>0.05);手术切口分别为9.2(6.8～10)cm和16.4(14～24)cm,术后12h引流量分别为211(120～300)ml和249(140～400)ml,平均住院时间分别为6.6d和7.5d,差异均有统计学意义(P<0.05);术后第1、2、3天疼痛视觉模拟评分(VAS)分别为4.0分、3.1分、2.3分和4.6分、3.7分、2.4分,术后1、3个月Harris评分分别为90.5分、91.1分和88.2分、91.2分。术后影像学表现无统计学差异。结论后外侧小切口THA在适宜手术适应证前提下与传统THA相比,具有减少软组织损伤、缩短住院时间、减轻术后疼痛和加快术后康复的优势。更多还原

【Abstract】 Objective To study the efficacy and complications of mini-incision total hip arthroplasty(THA) compared with conventional approach THA.Methods From November 2004 to June 2009,38 patients(40 hips) received THA using the modified posterolateral mini-incision approach(6-10 cm) and 47 patients(48 hips) received THA using conventional approach(11 15 cm).All the surgery were performed by the same surgeon.Results The mean duration of follow-up was 21.2 months(range, 18-24).No infection,prosthetic dislocation or nerve injury was occurred in either group.Two cases had superficial wound scratches in mini-incision group,and in conventional group one patient had deep venous thrombosis.The mean operation time of mini-incision group and conventional group was 72 minutes(range,60-100) vs 69 minutes(range,70-175),and blood loss averaged 350 ml(range,250-520) vs 393 ml(range,270-600),there was no statistical difference(P>0.05).The mean length of skin incision of mini-incision group and conventional group was 9.2 cm(range,6.8-30) vs 16.4 cm(range,14-24),and the mean postoperative 12-hour drainage flow was 211 ml(range,120-300) vs 249 ml(range,140-400),and hospitalization time was mean 6.6 days vs 7.5 days.The differences between groups were statistically significant(P<0.05).The visual analogue scale (VAS) of the first three days after surgery were 4.0,3.1 and 2.3 in mini-incision group vs 4.6,3.7 and 2.4 in conventional group.The mean Harris hip score after 1 and 3 months was 90.5 and 91.1 in mini-incision group vs 88.2 and 91.2 in conventional group.There was no difference in functional or radiographic results.Conclusion The posterolateral mini-incision approach THA can minimize surgical trauma to the soft tissues,shorten hospitalization time,reduce postoperative pain and improve rehabilitation compared with the conventional approach THA in appropriate indication.更多还原