摘要
目的 探讨经梨状肌入路全髋关节置换术(THA)治疗老年股骨颈骨折的疗效.方法 采用经梨状肌入路(观察组,46例)和传统后外侧入路(传统组,51例)THA治疗97例老年股骨颈骨折患者.比较两组切口长度、术中出血量、手术时间、住院时间、术后首次下地时间、疼痛VAS评分、术后并发症发生情况.采用Har-ris评分评价髋关节功能.结果 患者均获得随访,时间6～8个月.切口长度、术中出血量、手术时间、住院时间:观察组均短(少)于传统组(P＜0.01).术后首次下地时间:观察组早于传统组(P＜0.01).疼痛VAS评分:术后第1、3、7天观察组均低于传统组(P＜0.01).Harris评分:术后1周、1个月观察组均高于传统组(P＜0.01);术后3、6个月两组比较差异均无统计学意义(P＞0.05).术后并发症发生率:观察组低于传统组(P＜0.05).结论 经梨状肌入路THA治疗老年股骨颈骨折,能明显缩短住院时间,减轻患者术后疼痛,减少术后并发症的发生,促进患者早日行走,短期疗效较好.
Abstract
Objective To investigate the efficacy of transpiriformis approach total hip arthroplasty(THA)on elderly patients with femoral neck fractures.Methods Ninety-seven elderly patients with femoral neck fractures underwent THA,they were treated with transpiriformis approach(observation group,46 cases)or the conventional posterolateral approach(conventional group,51 cases).Parameters such as incision length,intraoperative blood loss,surgery dura-tion,hospitalization time,time to first weight-bearing,pain VAS and occurrence of complications were compared be-tween the two groups.Hip joint function was evaluated using the Harris score.Results All patients were followed up for 6～8 months.The observation group exhibited shorter incision lengths,less intraoperative blood loss,shorter surgi-cal duration and hospital stay,compared with the conventional group(P＜0.01).The time of first weight-bearing:the observation group was earlier than the conventional group(P＜0.01).Pain VAS:at postoperative 1,3,7 d,the obser-vation group were lower than the conventional group(P＜0.01).Harris scores in the observation group were higher than the conventional group at 1 week and 1 month postoperatively(P＜0.01);however,there was no statistical signif-icance between two groups at 3,6 months postoperatively(P＞0.05).The incidence rate of complications in the obser-vation group was lower than that in the conventional group(P＜0.05).Conclusions For femoral neck fractures in elderly patients,THA with transpiriformis approach can obviously shorten the hospitalization duration,relieve postoper-ative pain,reduces the occurrence of complications,and facilitates walking of patients,with good short-term effect.
基金项目
四川省医学会骨科(尚安通)专项科研基金(2020SAT46)
四川省医学会骨科(尚安通)专项科研基金(2021SAT19)
四川省绵阳市卫生健康委员会科研基金(202007)
维普
万方数据