摘要
目的探究直接前方入路(direct anterior approach,DAA)、后外侧入路(posterolateral approach,PLA)髋关节置换术对患者平衡功能及影像学指标的影响。方法选取2022年1月至2023年1月淄博市中医医院收治的120例髋关节置换术患者作为研究对象,以随机数字表法分为A组与B组,每组60例。A组行PLA髋关节置换术,B组行DAA髋关节置换术。比较两组围手术期指标、并发症发生情况、影像学指标、手术前后髋关节功能。结果B组手术时间长于A组,术中出血量少于A组,术后下床活动时间短于A组,差异有统计学意义(P<0.05)。术后3、7 d,两组视觉模拟评分法评分均低于前一时间点,且B组低于A组,差异有统计学意义(P<0.05)。B组并发症发生率低于A组,差异有统计学意义(P<0.05)。B组髋臼假体前倾角小于A组,正位柄尖端近侧1 cm柄-髓腔比大于A组,差异有统计学意义(P<0.05)。术后3个月,两组Harris髋关节量表、Berg平衡量表评分均高于术前,且B组高于A组,差异有统计学意义(P<0.05)。结论髋关节置换术中,与PLA相比,尽管DAA手术时间延长,但可减少患者手术创伤,降低术后疼痛程度,保持髋臼解剖学结构稳定,改善其髋关节功能,降低并发症发生率。
Objective To explore the effects of direct anterior approach(DAA)and posterolateral approach(PLA)for hip replacement on patients'balance function and imaging indexes.Methods A total of 120 patients who underwent hip replacement surgery admitted to Zibo Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected as the research subjects,and they were divided into the group A and the group B by the random number table method,with 60 cases in each group.The group A underwent PLA hip replacement surgery,and the group B underwent DAA hip replacement surgery.The perioperative indicators,complications,imaging indicators and hip joint functions before and after the surgery were compared between the two groups.Results The surgical time in the group B was longer than that in the group A,the intraoperative blood loss was less than that in the group A,and the postoperative ambulation time was shorter than that in the group A,the differences were statistically significant(P<0.05).At 3 and 7 d after the surgery,the visual analog scale scores of the two groups were lower than those at the previous time points,and the group B was lower than the group A,and the differences were statistically significant(P<0.05).The incidence of complications in the group B was lower than that in the group A,and the difference was statistically significant(P<0.05).The forward inclination angle of the acetabular prosthesis in the group B was smaller than that in the group A,and the ratio of the handle to the medullary cavity 1 cm proximal to the tip of the normal handle was larger than that in the group A,and the differences were statistically significant(P<0.05).At 3 months after the surgery,the scores of the Harris hip scale and the Berg balance scale of the two groups were higher than those before surgery,and the group B was higher than the group A,and the differences were statistically significant(P<0.05).Conclusion In hip replacement surgery,although DAA surgery has a longer surgical time compared to PLA,it can reduce patient surgical trauma and postoperative pain,maintain stable acetabular anatomical structure,improve hip joint function,and reduce the overall incidence of complications.
作者
李大为
崔超
陈燕
LI Dawei;CUI Chao;CHEN Yan(Department of Orthopedics and Traumatology,Zibo Hospital of Traditional Chinese Medicine,Zibo,Shandong,255300,China)
出处
《当代医学》
2025年第4期16-21,共6页
Contemporary Medicine
关键词
髋关节置换术
直接前方入路
后外侧入路
Hip replacement
Direct anterior approach
Postlateral approach
