【摘要】 目的比较不同入路(SuperPath入路与小切口后外侧入路)下人工股骨头置换术对老年股骨颈骨折患者的影响。方法选择2015年4月至2018年4月我院收治的老年股骨颈骨折患者64例为研究对象,依据手术入路的不同分为观察组(n=32,以SuperPath入路行人工股骨头置换术)和对照组(n=32,以小切口后外侧入路行人工股骨头置换术),比较两组患者围术期指标、疼痛值、髋关节功能及术后并发症。结果观察组患者(56.68±8.32)min的手术时间、(102.35±16.32)mL的术中出血量、(7.71±0.68)cm的切口总长、(88.90±10.23)mL的术后24h引流量及(4.65±0.52)h的始负重时间均显著低于对照组对应值(P<0.05);术后1个月,两组患者VAS评分、TUG下降(P<0.05),Harris评分均显著升高(P<0.05),且观察组术后1个月的VAS评分、TUG均低于对照组(P<0.05),Harris评分高于对照组(P<0.05);观察组0.00%的术后并发症发生率显著低于对照组的12.50%(P<0.05)。结论 SuperPath入路下人工股骨头置换术治疗老年股骨颈骨折患者创口小、恢复好、并发症少,与小切口后外侧入路相较优势更为突出。更多还原

【Abstract】 Objective To compare the effects of artificial femoral head replacement under different approaches(SuperPath approach and small incision posterolateral approach) on elderly patients with femoral neck fractures. Methods A total of 64 elderly patients with femoral neck fractures admitted to our hospital from April 2015 to April 2018 were selected for the study. According to the different surgical approaches, the patients were divided into observation groups(n=32, given artificial femoral head replacement via SuperPath approach) and control group(n=32, given artificial femoral head replacement via small incision posterolateral approach). Perioperative indexes, pain value, hip joint function and postoperative complications were compared between the two groups. Results The operative time, intraoperative blood loss, total incision length, drainage volume at 24 h after operation and initial weight-bearing time were(56.68±8.32) min,(102.35±16.32) mL,(7.71±0.68) cm,(88.90±10.23) mL and(4.65±0.52) h in observation group, which were significantly lower than those in control group(P<0.05). At 1 month after operation, the VAS score and TUG were decreased in the two groups(P<0.05) while the Harris score was increased significantly(P<0.05), and the VAS score and TUG in observation group were lower than those in control group at 1 month after operation(P<0.05) while the Harris score was higher than that in control group(P<0.05). The incidence rate of postoperative complications in observation group was significantly lower than that in control group(0.00% vs 12.50%)(P<0.05). Conclusion SuperPath approach has small wound, good recovery and few complications in the treatment of elderly patients with femoral neck fractures. And it is more prominent than small incision posterolateral approach.更多还原