经后外侧入路仅切断股方肌的股骨头置换术疗效分析

doi:10.13418/j.issn.1001-165x.2020.02.021

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (2) : 208-211. DOI: 10.13418/j.issn.1001-165x.2020.02.021

张小路，　方凯彬，　吴世强，　蔡礼权，　柯庆峰

作者信息 +

Analysis of the effect of femoral head replacement with cutting off femoral quadratus muscle by posterior external approach

ZHANG Xiao-lu，FANG Kai-bin， WU Shi-qiang，CAI Li-quan，KE Qing-feng

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文章历史 +

摘要

目的　探讨仅切断股方肌的改良后外侧入路与传统后外侧入路行股骨头置换术的近期临床疗效。方法　选取行单侧人工股骨头置换术的患者60例，其中20例采用仅切断股方肌的改良后外侧入路手术（改良组），40例实施常规后外侧入路手术（传统组）。比较两组患者的手术时间、出血量、手术前后血红蛋白差值、VAS评分及Harris评分、术后并发症及首次下地时间。结果　60例患者均顺利完成手术。与传统组相比，改良组术中出血量较少、术后首次下地时间较早、手术时间较长、手术前后血红蛋白差值较小、术后2周髋关节Harris评分较高、术后24 h VAS评分较低，差异有统计学意义（P<0.05）。两组切口均Ⅰ期愈合，传统组1例患者出现术后假体后脱位，予手法复位外展支具固定1月后未再发生脱位。术后半年随访，两组Harris评分无统计学差异（P>0.05）。末次随访时两组均未发生假体松动、感染等并发症。结论　仅切断股方肌的改良后外侧入路具有围手术期出血少，术后疼痛轻、恢复快等优势，但其远期疗效有待进一步观察。

Abstract

Objective　To explore the short-term clinical effects of femoral head replacement by modified posterolateral approach and traditional posterolateral approach.　Methods　A total of 60 patients who underwent unilateral artificial femoral head replacement were collected, of which 20 underwent a modified posterolateral approach with cutting off the quadratus femoris (improved group) and 40 underwent a conventional posterolateral approach (traditional group).The operation time, the blood loss volume, haemoglobin difference pre- and post-operation VAS scores and Harris scores, postoperative complications and first landing time were compared between the two groups.　Results　All 60 patients successfully completed the operation. Compared with the traditional group, the improved group had less intraoperative blood loss, earlier first landing time after operation, longer operation time, less hemoglobin difference, higher hip Harris scores 2 weeks after operation, lower VAS scores 24 hours after operation. Two groups were Ⅰ-stage healing of incision, 1 patients in the traditional group occurred prosthesis dislocation after operation, no dislocation occurred again after 1 month by manualreduction and immobilization. There were no statistical differences in Harris score between the two groups (P>0.05). There were no complications or prosthesis loosening in both groups during the last follow-up.　Conclusions　The modified posterolateral approach with cutting off the quadratus femoris has the advantages of less perioperative bleeding, less postoperative pain and faster postoperative recovery, but its long-term effect remains to be further observed.

导出引用

张小路, 方凯彬, 吴世强, 蔡礼权, 柯庆峰. 经后外侧入路仅切断股方肌的股骨头置换术疗效分析[J]. 中国临床解剖学杂志. 2020, 38(2): 208-211 https://doi.org/10.13418/j.issn.1001-165x.2020.02.021

ZHANG Xiao-lu, FANG Kai-bin, WU Shi-qiang, CAI Li-quan, KE Qing-feng. Analysis of the effect of femoral head replacement with cutting off femoral quadratus muscle by posterior external approach[J]. Chinese Journal of Clinical Anatomy. 2020, 38(2): 208-211 https://doi.org/10.13418/j.issn.1001-165x.2020.02.021

中图分类号： R658.3

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