摘要
目的比较微创双切口与改良Harding入路全髋关节置换术在高龄患者中的疗效。方法2003年5月～2006年12月,采用微创双切口技术对21例高龄患者(平均82岁)行全髋关节置换术,与同期采用改良Harding入路对39例高龄患者(平均83岁)行全髋关节置换术的疗效进行比较。结果双切口组术中出血量(270±94)ml与改良Harding组(280±107)ml比较差异无显著性(t=-0.360,P=0.720)。术后第2天,双切口组病人能做主动直腿抬高的动作,且术后第10天抬高角度(53±12)°与改良Harding组(32±16)°比较差异有显著性(t=5.262,P=0.000),但双切口组术后6个月的Harris评分(80.6±12.6)与改良Harding组(79.5±13.2)比较并无统计学意义(t=0.313,P=0.756)。双切口组骨科系统并发症发生率(9.5%,2/21)与改良Harding组(8.1%,3/37)比较差异无显著性(χ2=0.000,P=1.000),其他系统并发症发生率(19.0%,4/21)与改良Harding组(37.8%,14/37)比较也无统计学意义(χ2=2.210,P=0.137)。结论在高龄患者中,选择性地采用微创双切口技术能取得相对满意的短期效果,但其远期疗效与改良Harding入路并无显著差异。
Objective To compare the efficacy of two-incision microinvasive and modified Harding approaches for total hip arthroplasty in aged patients.Methods From May 2003 to December 2006,21 old patients（aged 82 on average） received two-incision microinvasive total hip arthroplasty in our hospital.The outcomes of the surgery was compared with those of 39 cases（mean age,83）,who underwent the operation through the modified Harding approach.Results No significant difference was observed in intraoperative blood loss between the two groups [（270±94） ml vs（280±107） ml,t=-0.360,P=0.720].On the 2nd day after the surgery,the patients in the two-incision group could raise their legs straight upward without needing help.At day 10,they could raise the legs straight up to a mean of（53±12）°,which was significantly higher than that in the Harding group [（32±16）°,t=5.262,P=0.000].However,the Harris scores were similar in both the groups in 6 months after the operation（80.6±12.6 vs 79.5±13.2,t=0.313,P=0.756）.The incidence rates of orthopedics and systemic complications in the two-incision group was not significantly different from those in the Harding group [9.5%（2/21） vs 8.1%（3/37）,χ^2=0.000,P=1.000;19.0%（4/21） vs 37.8%（14/37）,χ^2=2.210,P=0.137].Conclusions The short-term outcomes of microinvasive two-incision total hip arthroplasty is better than that of modified Harding approach in aged patients.However,the long-term results of the two procedures are similar.
出处
《中国微创外科杂志》
CSCD
2008年第8期691-693,共3页
Chinese Journal of Minimally Invasive Surgery
