摘要
目的:探究不同入路方式下的全髋关节置换术对老年股骨颈骨折患者术后恢复的影响。方法:回顾性分析2018年9月-2020年9月在四川绵阳四○四医院进行全髋关节置换术的105例老年股骨颈骨折患者临床资料,按手术方法的不同分为两组,Super PATH组(n=48)进行经皮辅助关节囊入路全髋关节置换术(supercapsular percutaneously-assisted total hip,Super PATH)微创入路治疗,常规后外侧组(n=57)进行常规后外侧入路治疗。对比两组手术情况、术后不同时间点Harris髋关节功能评分量表(HHS)评分、起立-行走测试(TUG)结果、视觉模拟评分法(VAS)评分、疼痛介质[5-羟色胺(5-HT)、前列腺E_(2)(PGE_(2))]、术后并发症发生情况。结果:两组手术时间及术中出血量比较,差异无统计学意义(P>0.05);Super PATH组术后下地时间早于常规后外侧组,住院时间短于常规后外侧组(P<0.05)。两组术前及术后6个月HHS评分比较,差异无统计学意义(P>0.05);Super PATH组术后3个月HHS评分高于常规后外侧组(P<0.05)。Super PATH组术后1周、术后1个月、术后6个月TUG时间均短于常规后外侧组(P<0.05)。两组术前及术后1个月VAS评分比较,差异无统计学意义(P>0.05);Super PATH组术后1周VAS评分低于常规后外侧组(P<0.05)。两组术前及术后1个月5-HT、PGE_(2)水平比较,差异无统计学意义(P>0.05);Super PATH组术后1周5-HT、PGE_(2)水平低于常规后外侧组(P<0.05)。Super PATH组并发症发生率为4.17%,低于常规后外侧组的19.30%(P<0.05)。结论:Super PATH入路与常规后外侧入路微创全髋关节置换术相比,前者更有利于老年股骨颈骨折患者早期功能恢复,缓解疼痛,且术后并发症发生风险较低。
Objective:To investigate the effect of total hip arthroplasty under different approaches on postoperative recovery of elderly patients with femoral neck fracture.Method:The clinical data of 105 elderly patients with femoral neck fracture who underwent total hip arthroplasty in Sichuan Mianyang 404 Hospital from September 2018 to September 2020 were retrospectively analyzed.They were divided into two groups according to different surgical methods.Super PATH group(n=48)was treated with supercapsular percutaneously-assisted total hip(Super PATH)minimally invasive approach,and conventional posterolateral group(n=57)was treated with conventional posterolateral approach.The operation conditions,Harris hip function scale(HHS)at different time points after operation,the results of timed up and go test(TUG),visual analogue scale(VAS)score,pain medium[5-hydroxytryptamine(5-HT),prostate E_(2)(PGE_(2))],and postoperative complications were compared between the two groups.Result:There were no significant differences in operation time and intraoperative blood loss between the two groups(P>0.05).The postoperative ambulation time in Super PATH group was earlier than that in conventional posterolateral group,and the hospitalization time in the Super PATH group was shorter than that in the conventional posterolateral group(P<0.05).There were no significant differences in HHS scores between the two groups before and 6 months after operation(P>0.05).The HHS score of the Super PATH group was higher than that of the conventional posterolateral group at 3 months after operation(P<0.05).TUG at 1 week,1 month and 6 months after operation in Super PATH group were shorter than those in conventional posterolateral group(P<0.05).There were no significant differences in VAS scores between the two groups before and 1 month after operation(P>0.05).The VAS score of Super PATH group was lower than that of conventional posterolateral group 1 week after operation(P<0.05).There were no significant differences in the levels of 5-HT and PGE_(2)between the two groups before and 1 month after operation(P>0.05).The levels of 5-HT and PGE_(2)in the Super PATH group were lower than those in the conventional posterolateral group 1 week after operation(P<0.05).The incidence of complications in Super PATH group was 4.17%,which was lower than 19.30%in conventional posterolateral group(P<0.05).Conclusion:Super PATH approach is more conducive to early functional recovery,pain relief and lower risk of postoperative complications in elderly patients with femoral neck fracture than conventional posterolateral approach.
作者
刘伦
吴聪
贾全忠
贾志刚
LIU Lun;WU Cong;JIA Quanzhong;JIA Zhigang(不详;Sichuan Mianyang 404 Hospital,Mianyang 621000,China)
出处
《中外医学研究》
2022年第8期18-22,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
股骨颈骨折
全髋关节置换术
Super
PATH微创入路
后外侧入路
老年患者
术后恢复
Femoral neck fracture
Total hip replacement
Supercapsular percutaneously-assisted total hip minimally invasive approach
Posterolateral approach
Elderly patients
Postoperative recovery
