| 孙明辉,王渭君,闵令田,陈 铖,翁文杰.直接前方入路与直接外侧入路人工全髋关节置换术的临床效果比较研究[J].,2020,(15):2952-2956 |
| 直接前方入路与直接外侧入路人工全髋关节置换术的临床效果比较研究 |
| A Comparative Study on the Clinical Effects of Total Hip Arthroplasty through Direct Anterior Approach and Direct Lateral Approach |
| 投稿时间：2020-03-26 修订日期：2020-04-21 |
| DOI：10.13241/j.cnki.pmb.2020.15.031 |
| 中文关键词: 直接前方入路 直接外侧入路 初次全髋关节置换术 髋关节功能 平衡功能 步态参数 |
| 英文关键词: Direct anterior approach Direct lateral approach Primary total hip arthroplasty Hip function Balance function |
| 基金项目:江苏省"六大人才高峰"第十批高层次人才项目（WSW-002）；南京市医学科技发展资金资助项目（YKK17062） |
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| 中文摘要: |
| 摘要 目的：探讨平卧位直接前方入路 (DAA) 与侧卧位直接外侧入路 ( DLA) 对行初次全髋关节置换术(THA)患者髋关节功能、平衡功能和步态参数的影响。方法：选取2018年2月~2019年10月期间我院收治的初次THA患者97例，根据入路方式的不同随机分为A组 (n=47) 和B组 (n=50) ，A组行侧卧位DLA，B组行平卧位DAA，比较两组髋关节功能、影像学参数、平衡功能和步态参数，记录两组术后并发症发生率。结果：术后1周、1个月、3个月及6个月两组髋关节Harris评分(HHS) 、Berg平衡量表评分(BBS)依次升高，且B组高于A组 (P<0.05) 。B组手术时间长于A组，术中出血量少于A组，切口长度、初次下床行走时间短于A组 (P<0.05) 。术后3个月、6个月两组步频、步速、步长依次升高，且B组高于A组 (P<0.05) 。两组并发症发生率对比，组间比较未见统计学差异(P>0.05) 。两组术后6个月髋臼假体外展角、前倾角对比，组间比较无显著差异(P>0.05) 。结论：与侧卧位DLA相比，初次THA患者行平卧位DAA可获得与其相当的手术效果，同时能更好地改善患者髋关节功能、平衡功能和步态，且安全性有保障。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of supine position direct anterior approach (DAA) and lateral position direct lateral approach (DLA) on hip function, balance function and gait parameters in patients undergoing primary total hip arthroplasty (THA). Methods: 97 patients with primary THA admitted to our hospital from February 2018 to October 2019 selected, and were divided into group A (n=47) and group B (n=50) according to the different ways of approach, group A was given lateral position DLA, group B was given supine position DAA. The hip function, imaging parameters, balance function and gait parameters were compared between the two groups, and the incidence of postoperative complications was recorded. Results: 1 week, 1 month, 3 months and 6 months after operation, Harris score (HHS) and Berg Balance Scale score (BBS) of hip joint of the two groups showed an increasing trend, and group B was higher than group A (P<0.05). The operation time of group B was longer than that of group A, the intraoperative hemorrhage was less than that of group A, the incision length and time of first walking out of bed were shorter than those of group A (P<0.05). 3 months and 6 months after operation, the step frequency, step speed and step length of the two groups were increased in turn, and group B was higher than group A (P<0.05). There was no difference in the incidence of complications between the two groups (P>0.05). Comparison of acetabular abduction angle and anteversion angle between the two groups 6 months after operation showed no differences (P>0.05). Conclusion: Compared with lateral position DLA, the patients with primary THA are given supine position DAA, it can obtain the same surgical effect, and can improve the hip joint function, balance function and gait parameters, and the safety is guaranteed. |
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