【摘要】 目的比较改良外侧小切口与后外侧Gibson入路全髋关节置换术(THR)的临床疗效。方法 18例(20髋)行改良外侧小切口THR(A组),19例(22髋)行标准后外侧Gibson入路THR(B组),比较两组手术时间、切口长度、失血量、术中和术后并发症、X线片髋臼外展角和前倾角,以及术后6周,3、12个月的Harris髋关节功能评分和疼痛视觉模拟评分(VAS)。结果 A、B两组切口长度差异有统计学意义(P<0.05),而手术时间、失血量方面差异无统计学意义。B组有2例发生后脱位,而A组无脱位发生,两组均有2例发生跛行。Harris和VAS评分术前两组间均无显著差异,两组术后均较各自术前明显改善,术后6周Harris与VAS评分A组均优于B组,差异有统计学意义(P<0.05);术后3、12个月两组Har-ris和VAS评分均进一步改善,但差异无统计学意义。结论外侧小切口THR在术后6周较后外侧入路THR髋关节功能恢复更快和疼痛更轻,这种显著差异对于老年患者可以有效减少手术和卧床并发症,降低病死率。更多还原

【Abstract】 Objective To compare clinical effects of total hip replacement(THR) using modified lateral mini-incision with posterolateral Gibson incision.Methods There’re 18 cases(20 hips) were treated with modified lateral mini-incision THR(group A),while 19 cases(22 hips) with classic posterolateral Gibson incision(group B).The operation time,incision length,amount of blood losing,intra-operation and post-operation complications,results of X-ray films measurement,along with Harris hip function scores and visual analogue scales(VAS) in postoperative follow-up were compared between the above two groups.Results Operation time and blood losing did not differ between the groups,with the exception of incision length(P < 0.05).Two cases of dislocation occurred in group B while no dislocation occurred in group A.Two cases walked with limp gait respectively in the two groups.No statistically significant differences were found in preoperative Harris and VAS scores,nevertheless a significant improvement occurred postoperatively in the above groups.Patients with lateral incision THR regained better hip function and less pain degree by the 6 weeks follow-up than those with posterolateral THR(P <0.05) although no significant difference existed in the following 3 months and 1 year review between the groups.Conclusion Modified lateral mini-incision THR has faster function recovery of hip and less pain degree than posterior-lateral approach by the postoperative 6 weeks,which could lower operation and bed-related complications effectively,further decrease mortality.更多还原