基于术后VAS评分及并发症发生率探讨小切口后外侧与传统后外侧入路人工股骨
Exploring the efficacy of small incision posterolateral and traditional posterolateral lateral approaches for artificial femoral replacement based on postoperative VAS scores and complication rates
原旭海 1余进伟 2王斌2
作者信息
- 1. 温县人民医院骨科三,河南 温县 454850
- 2. 河南理工大学第一附属医院(焦作市第二人民医院)骨科三区,河南 焦作 454000
- 折叠
摘要
目的:探究不同手术入路行人工股骨头置换术(Artificial femoral head replacement,AFHR)在髋部骨折中的应用价值.方法:选取 2021年4 月至 2023 年4 月温县人民医院 93 例髋部骨折患者临床资料,根据手术入路不同分为两组,小切口组 45 例行小切口后外侧入路行AFHR,传统组 48 例行传统后外侧入路AFHR.观察两组手术相关指标,术前及术后 3 d、5 d,采用视觉模拟量表评估疼痛程度,酶联免疫法检测血清学指标,术后 6 m,采用Harris 髋关节功能量表手术优良率同时记录并发症情况.结果:小切口组切口长度、手术时间及术后下地时间均短于传统组,术中出血量、术后 24h引流量、术后各时间疼痛评分低于传统组(P＜0.05);术后 3 d、5 d小切口组血清 5-羟色胺(5-hydroxytryptamine,5-HT)、P物质(Substance P,SP)神经肽Y(Neuropetide Y,NPY)水平低于传统组(P＜0.05);两组术后 6 m手术优良率、并发症总发生率与比较,差异无统计学意义(P＞0.05).结论:小切口后外侧与传统后外侧入路AFHR治疗髋部骨折均有较好的远期效果及安全性,而前者能优化手术流程,减少术中出血和降低疼痛,可促进术后恢复.
Abstract
Objective:To explore the application value of different surgical approaches for artificial femoral head replacement(AFHR)in hip fractures.Methods:The clinical data of 93 patients with hip fracture in Wenxian People's Hospital from April 2021 to April 2023 were selected and divided into two groups according to the different surgical approaches,45 cases of small incision group performed AFHR with small incision posterior lateral approach,and 48 cases of traditional group performed AFHR with traditional posterior lateral approach.Surgery related indexes were observed in the two groups,and the degree of pain was assessed by visual analog scale and serological indexes were detected by enzyme immunoassay in the preoperative period and in the postoperative period of 3 and 5 days.In the postoperative period of 6 months,the Harris Hip Function Scale was used to assess the degree of pain,and the enzyme immunoassay detected the serological indexes.Harris Hip Function Scale was used for surgical excellence rate and complications were recorded at the same time.Results:The incision length,operation time,and postoperative ambulation time in the small incision group were shorter than those in the traditional group,and the intraoperative blood loss,postoperative 24-hour drainage volume,and postoperative pain scores at various time points were lower than those in the traditional group(P<0.05).The levels of serum 5-hydroxytryptamine(5-HT),Substance P(SP),and Neuropetide Y(NPY)in the small incision group were lower than those in the traditional group at 3 and 5 days after surgery(P<0.05).There was no significant difference in the excellent rate of surgery and the total incidence of complications between the two groups at 6 months after surgery(P>0.05).Conclusion:Both small incision posterior lateral approach and traditional posterior lateral approach AFHR have good long-term efficacy and safety in the treatment of hip fractures,while the former can optimize the surgical process,reduce intraoperative bleeding and pain,and promote postoperative recovery.
关键词
髋部骨折/人工股骨头置换术/后外侧入路/小切口/疼痛程度/并发症Key words
Hip fracture/Artificial femoral head replacement/Posterolateral approach/Small incision/Degree of pain/Complication引用本文复制引用
出版年
2024
NETL
NSTL
万方数据