【摘要】 目的探讨SuperPATH入路髋关节置换术治疗高龄老年股骨颈骨折短期临床疗效。方法 2013年8月至2015年10月,收集44例80岁及以上股骨颈骨折行髋关节置换术(全髋关节置换术4例,人工股骨头置换术40例)患者资料,其中21例采用SuperPATH入路,23例采用改良Hardinge入路。将人工股骨头置换术患者分为SuperPATH组20例,改良Hardinge组20例,比较两组手术时间、出血量、并发症、疼痛视觉模拟评分(VAS)、Harris髋关节评分和患者满意度。结果 SuperPATH组手术时间、切口关闭时间均短于改良Hardinge组,前者分别为(67.4±9.5)min和(12.9±2.7)min,后者分别为(71.9±5.1)min和(25.0±3.8)min。SuperPATH组术后1、5 d血红蛋白(Hb)分别下降(12.6±3.7)g/L和(15.2±3.8)g/L,下降值低于改良Hardinge组,后者分别为(16.9±4.5)g/L和(21.0±5.3)g/L。SuperPATH组术后6周内疼痛程度轻于改良Hardinge组,但术后3、6个月两组疼痛差异无统计学意义;SuperPATH组术后3个月Harris髋关节评分明显优于改良Hardinge组,分别为(70.4±4.8)分和(61.9±7.1)分,但两组术后6个月Harris髋关节评分差异无统计学意义;SuperPATH组患者满意度均优于改良Hardinge组。结论 SuperPATH入路髋关节置换术治疗高龄老年股骨颈骨折可获得良好的短期临床疗效。更多还原

【Abstract】 Objective To investigate the short-term clinical outcome of hip arthroplasty through the SuperPATH approach for femoral neck fractures in very elderly patients.Methods From August 2013 to October 2015,44 cases of hip arthroplasty,including total hip arthroplasty in 4 cases and femoral head replacement in40 cases,through either the SuperPATH approach(21 cases)or the modified Hardinge approach(23 cases)for femoral neck fractures in patients aged 80 years or older were retrospectively reviewed.Among the 40 patients undergoing hemiarthroplasty,20 cases through the SuperPATH approach and 20 cases through the modified Hardinge approach were compared in terms of operation time,blood loss,complications,pain visual analogue scale,Harris hip scores and patient satisfaction.Results For operation time,the SuperPATH group was averaged67.4±9.5 min,which was less than the modified Hardinge group that was averaged71.9±5.1 min(P<0.05),and the surgical closure time of the SuperPATH group was on average 12.9±2.7 min,which was much shorter than the modified Hardinge group that was on average 25.0±3.8 min.The decline of heamoglobin on the 1 st postoperative day and 5 th postoperative day from preoperative level in the SuperPATH group were 12.6±3.7 g/L and 15.2±3.8 g/L,respectively,which were significantly better than those in the modified Hardinge group that were 16.9±4.5 g/L and 21.0±5.3 g/L,respectively.Compared with the modified Hardinge group,the patients in the SuperPATH group suffered less pain within 6 weeks,similar pain in 3 and 6 months,and obtained better Harris hip scores 70.4±4.8in 3 months but similar scores in 6 months.The patients in the SuperPATH group were more satisfied with the treatment during the whole follow up period.Conclusion Through the SuperPATH approach,hip arthroplasty for femoral neck fractures in very elderly patients showed favorable short-term effect.更多还原