| 摘要: |
| 目的：观察经微创 SuperPath 入路行全髋关节置换术后患者的关节功能及生命质量，并与传统后外侧入路做随机对照研究。方法：选取拟行全髋关节置换术的患者 54 例，按数字随机表法分为观察组和对照组各 27 例，分别行 SuperPath 和传统后外侧入路全髋关节置换术，记录两组手术前后的 Harris 髋关节功能评分、计时“起立 - 行走”测试时间、单腿站立测试时间、6 min 步行测试距离、术后下地负重行走时间、住院时间、健康调查简表 SF-36 评分及并发症，并进行对比。结果：观察组术后 1 周及 3 个月的 Harris 评分（70.5±5.6，83.1±5.5）分别高于对照组（63.8±6.1，78.0±5.6）（P<0.05），6 个月及 12 个月两组间差异无统计学意义（P>0.05）。相较于对照组，观察组术后 1 个月及 3 个月的计时“起立 - 行走”时间 [(36.5±7.3) s，(24.4±4.9) s] 更短，术后 1 个月的单腿站立时间 [(14.4±3.6) s] 更长，术后 3 个月的 6 min 步行距离 [(395.1±27.7) m] 更远（P<0.05）。观察组术后下地时间及住院时间 [(20.0±3.6) h，(9.7±2.8) d] 分别短于对照组[(33.2±5.4) h，(13.2±3.7) d]（P<0.05）。SF-36 评分，术后 12 个月观察组心理健康及总体健康两个维度评分（78.1±9.3，82.0±8.8）分别高于对照组（73.1±8.7，76.3±10.2）（P<0.05）；躯体疼痛及社会功能两个维度评分无统计学差异（P>0.05）。对照组 2 例出现无症状下肢深静脉血栓。结论：相比较于传统后外侧入路，微创 SuperPath 入路的全髋关节置换术能更快、更有效地恢复髋关节功能，提高患者术后的生命质量，符合现代快速康复理念。 |
| 关键词: SuperPath 入路 关节成形术 髋关节置换术 髋关节功能 |
| DOI：10.3969/j.issn.1007-6948.2019.05.012 |
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| 基金项目: |
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| Clinical Research on Joint Function and Life Quality through SuperPath Approach in Total Hip Arthroplasty |
| ZHANG Zhong-liang,LIN Jun-hong,XIA Bing |
| Department of Joint Surgery, Traditional Chinese Medical Hospital of Jinhua, Jinhua (321017), China |
| Abstract: |
| Objective To observe the joint function and life quality in total hip arthroplasty (THA) through SuperPath approach, and compare randomly to traditional posterolateral approach in THA. Methods According to random number table, 54 patients who needed THA were randomly divided into observation group (SuperPath approach) and control group (traditional posterolateral approach), each group included 27 cases. Preoperative and postoperative Harris hip score, time of timed-up-and-go, time of single-limb stance, distance of 6 -minute walk test, ambulation time, length of stay, SF- 36 score and complications in two groups were recorded and compared. Results The Harris hip scores of 1 week and 3 months after operation in observation group (70.5±5.6 and 83.1±5.5) were signi?cantly higher than those in control group (63.8±6.1 and 78.0±5.6) (P<0.05), but had no statistical sense in 6 months and 12 months after operation (P>0.05). Compared to control group, the time of timed-up-and-go of 1 month and 3 months after operation [(36.5±7.3) s and (24.4±4.9) s] were shorter, the time of single-limb stance of 1 months after operation [(14.4 ±3.6) s] was longer, and the distance of 6 -min walk test of 3 months after operation [(395. 1± 27. 7 ) m] was farther, the differences were statistically signi?cant (P <0.05). Ambulation time and length of stay in observation group[(20.0±3.6) h and (9.7± 2. 8) d] were signi?cantly shoter than control group [(33.2±5.4) h and (13.2±3.7) d] (P<0.05).After 12 months of operation, the scores of mental health and general health in observation group (78.1±9.3 and 82.0±8.8) were signi?cantly higher than control group (73.1±8.7 and 76.3±10.2) (P<0.05), but had no statistical sense on the scores of body pain and social function between the two groups (P>0.05). Two cases of asymptomatic deep venous thrombosis were observed in the control group. Conclusion Compared to traditional posterolateral approach, the THA through SuperPath approach can improve the joint function and life quality more effectively, and conform to the idea of fast track surgery. |
| Key words: SuperPath approach arthroplasty replacement hip hip joint function |
