【摘要】 目的本文通过采用后外侧小切口和传统切口施行全髋关节置换术对比研究,探讨后外侧小切口全髋关节置换术的临床效果。方法选择我科2008年12月至2010年12月施行人工全髋关节置换术(THA)的80例患者并分成两组,每组40例患者,分别采用后外侧小切口和传统切口,对切口长度,术中的失血量,术后的伤口引流量,手术时间,髋臼外展角,髋臼前倾角,术后第1、3、6个月Harris评分进行比较。结果所有病人均获随访,平均随访12个月(6~24)。小切口组切口长度为6.8~10.3 cm,平均8.5 cm;传统切口组切口长度15.6~23.8 cm,平均18.2 cm;小切口组的术中失血、术后引流血量分别为163.8±15.6 mL,325.4±20.3 mL,传统切口组分别为283.5±13.5 mL,410.4±27.6 mL,两组均有差异(P<0.05);小切口组手术时间为89.4±14.2min,传统切口组为123.5±10.3 min(两组比较,P<0.05);小切口组术后X线片髋臼外展角为43.8±8.5°,传统切口组为46.5±6.7°;小切口组前倾角为22.8±3.5°,传统切口组前倾角为23.5±2.9°,两组间有统计学差异。术后第1、3个月随访,小切口组的Harris评分为69.5±8.9、84.8±7.3分,传统切口组为58.7±6.6、75.4±10.4分,两组间有统计学差异;术后第6个月、12个月随访Harris评分在两组间无统计学差异。两组患者均无脑血管意外、股骨假体周围骨折、神经损伤、下肢深静脉血栓形成、及下肢不等长等并发症。结论小切口全髋关节置换术减少了术中、术后的伤口出血及手术的暴露时间,有助于术后功能锻炼。更多还原

【Abstract】 Objective To compare the mini-incision and traditional posterolateral surgical approach for total hip arthroplasty and investigate the characteristic of the mini-incision short clinical efficacy. Methods Eighty cases were divided into two groups, in which 40 cases(MIS-THA group)underwent a mini-incision,.and 40 cases(THA group) received THA with standard posterolateral incision.The length of incision,.blood loss, operation time, anteversion angle of acetabulum cup, abduction angle of acetabulum cup,.Harris score and complications were observed and compared between two groups..Results All patients were followed with an average of 12 months(range from 6 to 24). Average length of incision for MIS-THA group was 8.5 cm(6.8-10.3 cm) and 18.2 cm(15.6-23.8 cm) for THA group. Hemorrhage amount and postoperative drainage blood loss in MIS-THA group and THA group were 163.8±15.6 ml, 325.4±20.3 ml and 283.5±13.5 ml, 410.4±27.6 ml respectively(comparison between two group, P<0.05)..Operative time for MIS-THA group was 89.4±14.2 min and 123.5±10.3min for THA group(P<0.05)..According to the postoperative x-ray,.the abduction angle of acetabulum cup for MIS-THA group was 43.8±8.5° and 46.5±6.7° for THA group. The anteversion angle of cup was 22.8 ±3.5° for MIS group and 23.5 ±2.9° for THA group(P <0.05)..Regarding Harris hip score postoperation,.there were significant differences between two group at the first and the third month of fellow-up.(P <0.05),.but no significant differences at the sixth and twelfth month of fellow-up..No infection, fracture dislocation and neurovascular injury occurred in both groups. Conclusion Mini-incision THA approach reduces intraoperative blood loss,.postoperative drainage and operative time and this approach whould be beneficial to postoperative training rehabilitation.更多还原