摘要
目的:比较直接前侧入路(DAA)与后外侧入路(PLA)全髋关节置换术治疗老年股骨颈骨折患者的效果。方法:回顾性分析2021年3月至2024年3月该院收治的102例老年股骨颈骨折患者的临床资料,根据手术入路不同将其分为观察组与对照组各51例。观察组采用DAA全髋关节置换术治疗,对照组采用PLA全髋关节置换术治疗。比较两组围手术期指标(手术时间、术后引流量、术中出血量、切口长度)水平,术后不同时间疼痛[视觉模拟评分法(VAS)]评分、髋关节功能[Harris髋关节评分系统(HHS)]评分、平衡能力[Berg平衡量表(BBS)]评分、本体感觉[髋关节位置觉测试(JPS)]水平,以及并发症发生率。结果:观察组手术时间长于对照组,术后引流量、术中出血量均少于对照组,切口长度短于对照组,差异有统计学意义(P<0.05);术后1 d,观察组VAS评分低于对照组,差异有统计学意义(P<0.05);术后7 d,两组VAS评分比较,差异无统计学意义(P>0.05);术后1、3、6个月,观察组HSS评分均高于对照组,差异有统计学意义(P<0.05);术后3个月,观察组BBS评分高于对照组,JPS水平低于对照组,差异有统计学意义(P<0.05);术后6个月,两组BBS评分、JPS水平比较,差异均无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:DAA全髋关节置换术治疗老年股骨颈骨折患者可改善围手术期指标水平,降低疼痛评分和本体感觉水平,提高髋关节功能、平衡能力评分,效果优于PLA全髋关节置换术治疗,但会延长手术时间。
Objective:To compare effects of direct anterior approach(DAA)and posterolateral approach(PLA)total hip arthroplasty in treatment of elderly patients with femoral neck fractures.Methods:The clinical data of 102 elderly patients with femoral neck fractures admitted to this hospital from March 2021 to March 2024 were retrospectively analyzed.According to the different surgical approaches,they were divided into observation group and control group,51 cases in each group.The observation group was treated with DAA total hip arthroplasty,while the control group was treated with PLA total hip arthroplasty.The levels of perioperative indexes(operation time,postoperative drainage volume,intraoperative blood loss,incision length),the pain[visual analogue scale(VAS)]score,the hip joint function[Harris hip score(HHS)]score,the balance ability[Berg balance scale(BBS)]score,the proprioception[hip joint perception test(JPS)]levels at different time after the surgery,and the incidence of complications were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group,the postoperative drainage volume and intraoperative blood loss were less than those of the control group,the incision length was shorter than that of the control group,and the differences were statistically significant(P<0.05).One day after the surgery,the VAS score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Seven days after the surgery,there was no significant difference in the VAS score between the two groups(P>0.05).At 1,3 and 6 months after the surgery,the HSS scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Three months after the surgery,the BBS score of the observation group was higher than that of the control group,the JPS level was lower than that of the control group,and the differences were statistically significant(P<0.05).Six months after the surgery,there were no significant differences in the BBS score and the JPS level between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:DAA total hip arthroplasty in the treatment of the elderly patients with femoral neck fractures can improve the perioperative index levels,reduce the pain scores and the proprioception levels,and improve the hip function and the balance ability scores.Moreover,it is superior to PLA total hip arthroplasty,but it will prolong the operation time.
作者
张永丰
ZHANG Yongfeng(Department of Orthopaedics of Linying County People’s Hospital,Luohe 462600 Henan,China)
出处
《中国民康医学》
2026年第2期152-155,共4页
Medical Journal of Chinese People’s Health
关键词
全髋关节置换术
老年
直接前侧入路
后外侧入路
股骨颈骨折
髋关节功能
并发症
Total hip arthroplasty
Elderly
Direct anterior approach
Posterolateral approach
Femoral neck fracture
Hip joint function
Complication
