SuperPATH入路半髋关节置换术治疗老年股骨颈骨折临床短期疗效
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(1. 爱德堡医院骨科,廊坊 065000;2. 解放军总医院骨科,北京 100853)

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R68; R592


Short-term efficacy of SuperPATH approach for hip arthroplasty in the elderly with femoral neck fracture
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(1. Department of Orthopedics, Aidebao Hospital, Langfang 065000, China;2. Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China)

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    【摘要】目的 探讨SuperPATH入路髋关节置换术在老年股骨颈骨折患者中的应用及疗效。方法 入选2015年9月至2017年3月期间爱得堡医院骨科收治的老年单侧股骨颈骨折患者39 例,根据手术方法分为2组:SuperPATH入路组(n=14)和后外侧入路组(n=25)。对比2组患者的手术时间、术中出血量、术后引流量、术后24 h内疼痛视觉模拟量表(VAS)评分等围术期参数。随访3个月,对比2组患者的术后独立行走时间、并发症发生情况及Harris髋关节量表(HHS)评分。采用SPSS 17.0 软件进行数据处理,依据数据类型,组间比较分别采用t检验或χ2检验。结果 与后外侧入路组患者相比,SuperPATH入路组患者的术中失血量[(101.4±16.7) vs (135.3±21.6)ml]和术后引流量[(70.4±10.2) vs (85.9±16.4)ml]更少、切口长度更小[(6.8±0.7) vs (10.1±0.9)cm]、VAS评分更低[(3.5±1.0) vs (6.8±1.7)分],差异均具有统计学意义(P<0.05)。截止末次随访时,2组患者均无脱位、感染和松动发生。与后外侧入路组患者相比,SuperPATH入路组患者的术后独立行走时间显著缩短[(2.8±1.2) vs(9.2±2.2)d,P<0.05]。结论 SuperPATH入路是一种可以达到快速康复目的的髋关节置换的微创入路方式,对老年患者这一特殊人群尤为适合。

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    【Abstract】Objective To investigate the application and efficacy of SuperPATH approach for hip arthroplasty in the elderly patients with femoral neck fracture. Methods A total of 39 elderly patients with unilateral femoral neck fracture admitted to the Orthopedic Department of Aidebao Hospital from September 2015 to March 2017 were enrolled in this study. They were divided into SuperPATH approach group (n=14) and posterolateral approach group (n=25) according to the approach they received. The operation time, intraoperative bleeding volume, postoperative drainage volume, and visual analogue scale (VAS) score within 24 h after operation were compared between the 2 groups. After 3 months′ follow-up, the independent walking time, complications and Harris hip joint score were compared between them. SPSS statistics 17.0 was used to perform the statistical analysis. Student′s t test or Chi-square test was employed for intergroup comparison based on different data types. Results Compared with the posterolateral approach group, the patients with SuperPATH approach had less amounts of intraoperative blood loss [(101.4±16.7) vs (135.3±21.6)ml] and post-operative drainage [(70.4±10.2) vs (85.9±16.4)ml], shorter incision length [(6.8±0.7) vs (10.1±0.9)cm] and lower VAS score [(3.5±1.0) vs (6.8±1.7)scores, P<0.05]. At the end of the last follow-up, no dislocation, infection or loosening occurred in both groups. The independent walking time was significantly shorter in the SuperPATH group than in the posterolateral approach group in 3 months after operation [(2.8±1.2) vs (9.2±2.2)d, P<0.05]. Conclusion SuperPATH approach is a minimally invasive approach for hip replacement with the advantage of rapid recovery, especially suitable for the elderly patients.

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吴国华,狄勇,马英华,赵继磊,梁永辉. SuperPATH入路半髋关节置换术治疗老年股骨颈骨折临床短期疗效[J].中华老年多器官疾病杂志,2018,17(7):529-532

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  • 收稿日期:2018-02-05
  • 最后修改日期:2018-04-10
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  • 在线发布日期: 2018-07-29
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