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中国临床研究:2019,32(12):1663-1666
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小切口后外侧入路全髋关节置换术治疗股骨颈骨折
(1.延安大学附属医院关节外科,陕西 延安 716000;2.中航工业西安医院骨科 陕西 西安 710077)
Posterolateral mini-incision total hip arthroplasty for femoral neck fracture
摘要
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投稿时间:2019-02-27   网络发布日期:2019-12-23
中文摘要: 目的 探究小切口后外侧入路全髋关节置换术在股骨颈骨折患者中的应用效果。方法 选取2015年7月至2018年7月收治的120例股骨颈骨折患者,依据治疗方案不同分组,各60例。试验组行小切口后外侧入路全髋关节置换术,对照组行常规切口后外侧入路全髋关节置换术。比较两组手术相关指标及术后并发症发生率,并观察两组术前及术后1 d、14 d血清炎性因子[白介素-6(IL-6)、C反应蛋白(CRP)]、术前及术后1个月骨代谢指标[I型前胶原氨基端前肽(PINP)、抗酒石酸酸性磷酸酶5b(TRACP-5b)]、术前及术后6个月髋关节功能。结果 两组手术时间相比,差异无统计学意义(P>0.05);试验组术中出血量及术后引流量均较对照组少,住院时间较对照组短(P<0.05);术后1 d,两组血清IL-6、CRP水平均较术前明显升高,且试验组低于对照组(P<0.05);术后14 d,两组血清IL-6、CRP水平均较术前、术后1 d明显下降(P<0.05),但组间相比,差异无统计学意义(P>0.05);试验组术后1个月血清PINP水平较对照组高,TRACP-5b水平较对照组低(P<0.05);试验组术后并发症发生率8.33%与对照组15.00%相比,差异无统计学意义(P>0.05);试验组术后6个月髋关节功能评分高于对照组(P<0.05)。结论 对股骨颈骨折患者行小切口后外侧入路全髋关节置换术,可显著减少术中出血量及术后引流量,降低患者血清炎症因子水平,促进骨折愈合及髋关节功能恢复。
Abstract:Objective To investigate the effect of total hip arthroplasty(THA) via small incision posterolateral approach on the patients with femoral neck fracture. Methods A total of 120 patients with femoral neck fractures from July 2015 to July 2018 were enrolled and divided into experimental group and control group according to different treatment method(n=60,each).The small incision posterolateral approach for total hip arthroplasty was performed in experimental group,and the conventional incision posterior approach for total hip arthroplasty was conducted in control group.The operation-related indexes and the incidence of postoperative complications were compared between two groups.Serum inflammatory factors [interleukin-6 (IL-6),C-reactive protein (CRP)] before and 1-,14- day after operation,bone metabolic indexes [amino-terminal propeptide of type I procollagen (PINP),tartrate-resistant acid phosphatase 5b (TRACP-5b)] before and one month after operation and hip joint function before and 6 months after operation were observed and compared between two groups. Results There was no significant difference in operation time between two groups (P>0.05).Compared with control group,the intraoperative blood loss,the postoperative drainage and the hospital stay statistically decreased in experimental group (all P<0.05).At 1 day after operation,the levels of serum IL-6 and CRP in two groups were significantly higher than those before operation and were statistically lower in experimental group than those in control group (P<0.05);at 14 days after operation,the levels of IL-6 and CRP in two groups were significantly lower than those before operation and 1 day after operation (P<0.05),but there was no significant difference between two groups (P>0.05).The levels of serum PINP and TRACP-5b in experimental group were significantly improved 1 month after operation,and PNP level increased,and TRACP-5b level decreased significantly compared with control group (P<0.05).There was no significant difference in the postoperative complication rate between experimental group and control group (8.33% vs 15.00%,P>0.05).At 6 months after operation,the scores of hip joint function were significantly higher than those before operation in experimental group and were significantly higher than those in control group (P<0.05). ConclusionFor the patients with femoral neck fracture,posterolateralmini-incisiontotalhiparthroplastycan significantly reduce intraoperative blood loss,postoperative drainage volume and serum inflammatory factor levels,promote fracture healing and hip function recovery and improve the quality of life of patients.
文章编号:     中图分类号:R 687.4    文献标志码:A
基金项目:陕西省自然科学基金(2013CM2025)
引用文本:
路浩东,孙剑波.小切口后外侧入路全髋关节置换术治疗股骨颈骨折[J].中国临床研究,2019,32(12):1663-1666.

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