【摘要】 目的 分析髋关节外科脱位技术应用在髋关节手术中的效果。方法 72例股骨头坏死患者,通过随机抽样方式分为常规组与研究组,每组36例。常规组在进行死骨清理打压植骨治疗时,选择直前入路；研究组在进行死骨清理打压植骨治疗时,选择髋关节外科脱位技术。比较两组患者髋关节改善优良率、并发症发生率、术后疼痛评分以及治疗前后髋关节功能评分、活动度、血清炎症因子水平。结果 研究组髋关节改善优良率97.22%高于常规组的77.78%,差异具有统计学意义(P<0.05)。研究组出现切口积液1例,并发症发生率为2.78%(1/36)；常规组出现切口积液3例、切口感染2例、关节松动1例、深静脉血栓1例,并发症发生率为19.44%(7/36)。研究组并发症发生率低于常规组,差异具有统计学意义(χ~2=5.062, P=0.024<0.05)。研究组术后8、12、24、48 h疼痛评分分别为(3.35±0.86)、(2.85±0.83)、(2.46±0.74)、(2.03±0.60)分,均低于常规组的(4.63±1.29)、(4.18±1.25)、(3.79±1.22)、(3.26±1.14)分,差异均具有统计学意义(P<0.05)。治疗后,研究组髋关节功能评分(83.85±9.57)分、髋关节活动度(54.36±13.58)°均优于常规组的(74.38±8.82)分、(40.70±12.08)°,差异均具有统计学意义(P<0.05)。治疗后,研究组C反应蛋白、白细胞介素-6、降钙素原水平分别为(4.57±1.08)mg/L、(20.54±2.68)ng/L、(2.26±0.51)μg/L,均低于常规组的(6.09±1.36)mg/L、(23.61±3.06)ng/L、(3.05±0.60)μg/L,差异均具有统计学意义(t=5.251、4.528、6.019, P=0.000、0.000、0.000<0.05)。结论 在髋关节手术治疗中采用髋关节外科脱位技术,可以改善患者术后疼痛情况和炎性因子水平,能够提升患者髋关节改善效果,临床应用价值较高。更多还原

【Abstract】 Objective To analyze the effects of surgical dislocation applied in the hip joint in hip surgery.Methods 72 patients with femoral head necrosis were randomly divided into a routine group and a study group,with 36 cases in each group. In the routine group, the direct anterior approach was used for cleaning the necrotic bone and impaction bone grafting; while in the study group, the surgical dislocation of hip joint was selected for cleaning the necrotic bone and impaction bone grafting. The excellent rate of hip joint improvement, the incidence of complications, postoperative pain score, and hip joint function score, range of motion and levels of serum inflammatory factors before and after treatment were compared between the two groups. Results The excellent rate of hip joint improvement of the study group was 97.22%, which was higher than 77.78% of the routine group,and the difference was statistically significant(P<0.05). In the study group, there was 1 case of incision effusion,so the incidence of complications was 2.78%(1/36). In the routine group, there were 3 cases of incision effusion,2 cases of incision infection, 1 case of joint loosening and 1 case of deep venous thrombosis, thus, the incidence of complications was 19.44%(7/36). The incidence of complications of the study group was significantly lower than that of the routine group, and the difference was statistically significant(χ2=5.062, P=0.024<0.05). The pain scores of patients of the study group at 8, 12, 24 and 48 h after the surgery were(3.35±0.86),(2.85±0.83),(2.46±0.74) and(2.03±0.60) points, respectively, which were lower than(4.63±1.29),(4.18±1.25),(3.79±1.22)and(3.26±1.14) points of the routine group, respectively; and the differences were statistically significant(P<0.05). After treatment, the hip joint function score was(83.85±9.57) points and the range of hip joint motion(54.36±13.58)° in patients of the study group, which were better than(74.38±8.82) points and(40.70±12.08)° in patients of the routine group; and the differences were statistically significant(P<0.05). After treatment, the levels of C-reactive protein, interleukin-6 and serum procalcitonin of the study group were(4.57±1.08) mg/L,(20.54±2.68) ng/L and(2.26±0.51) μg/L, respectively, which were lower than(6.09±1.36) mg/L,(23.61±3.06) ng/L,(3.05±0.60) μg/L of the routine group, respectively; and the differences were statistically significant(t=5.251, 4.528, 6.019, P=0.000, 0.000, 0.000<0.05). Conclusion The application of surgical dislocation of hip joint in the hip surgery can improve the postoperative pain and the levels of inflammatory factors, and enhance the hip joint improvement. Thus, it has high clinical value.更多还原