文章摘要
程蒋琪,邵禹棋,陈哲峰,刘 锋.三种入路行初次人工全髋关节置换术的早期疗效比较[J].南京医科大学学报,2020,(5):702~707
三种入路行初次人工全髋关节置换术的早期疗效比较
Comparing the outcomes of three different approaches for primary total hip arthroplasty
投稿时间:2020-01-03  
DOI:10.7655/NYDXBNS20200516
中文关键词: 人工全髋关节置换术  直接前方入路  疼痛  血清学  预后
英文关键词: total hip arthroplasty  direct anterior approach  pain  serology  outcomes
基金项目:江苏省自然科学基金面上项目(BK20191492)
作者单位
程蒋琪 南京医科大学第一附属医院骨科 江苏 南京 210029 
邵禹棋 南京医科大学第一附属医院骨科 江苏 南京 210029 
陈哲峰 南京医科大学第一附属医院骨科 江苏 南京 210029 
刘 锋 南京医科大学第一附属医院骨科 江苏 南京 210029 
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中文摘要:
      目的:比较应用直接前方入路(direct anterior approach,DAA)与外侧入路(direct lateral approach,DLA)和后侧入路(posterior approach,PA)行人工全髋关节置换术的早期疗效。方法:回顾性分析2018年9月—2019年9月采用DAA行人工全髋关节置换术22例,其中男8例,女14例。在同期采用DLA和PA行全髋置换术的患者中,根据年龄、BMI、病因及严重程度配对22例。统计3组患者手术时间,切口长度,术后连续3 d的疼痛评分,磷酸激酶,C反应蛋白,血红蛋白,失血量,术后1、3个月时的Harris评分,假体位置以及术后并发症情况。结果:DAA组患者术后第1、2天VAS评分均低于DLA组和PA组(P < 0.05),术后1个月DAA组患者Harris评分高于DLA及PA组(P < 0.05)。手术时间DAA组为(90.91±18.55)min,与其余两组相比差异有统计学意义(P < 0.05)。结论:与传统的直接外侧入路和后方入路相比,直接前方入路具有术后疼痛轻,短期康复快等优点。
英文摘要:
      Objective:This study aims to compare the early results of total hip arthroplasty(THA)by direct anterior approach(DAA),lateral approach(DLA) and posterior approach(PA). Methods:A total of 22 patients(8 males and 14 females)who underwent total hip arthroplasty using DAA from September 2018 to September 2019 were retrospectively analyzed. Of the patients who underwent total hip arthroplasty using DLA and PA during the same period,22 were matched according to age,BMI,etiology,and severity. The operation time,incision length,postoperative 3?day continuous pain score(VAS),phosphokinase(CK),C?reactive protein(CRP),hemoglobin,blood loss,postoperative 1?month and 3?month Harris scores,prosthesis position and postoperative complications in the three groups were statistically analyzed. Results:The VAS on the first and second day after operation in DAA group was lower than that in DLA group,and the difference had statistical significance. The Harris score at 1 month after operation in DAA group was higher than that in DLA and PA groups(P < 0.05). The operation time DAA was(90.91 ± 18.55)min,the difference was statistically significant compared with the other two groups(P < 0.05). Conclusion:Compared with the traditional direct lateral approach and posterior approach,the direct anterior approach has the advantages of less postoperative pain and faster short?term rehabilitation.
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