SuperPATH入路与MDAA入路在老年患者髋关节置换术中的应用价值<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2024.10.001

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摘要【目的】探讨改良直接前方入路(MDAA)与SuperPATH入路在老年患者髋关节置换术中的应用价值。【方法】选取2020年7月至2023年7月在河南省洛阳正骨医院(河南省骨科医院)行髋关节置换术的104例老年患者,根据治疗方法不同分为观察组(采用SuperPATH入路髋关节置换术,n=54)和对照组(采用MDAA入路髋关节置换术,n=50)。比较两组手术相关指标、Harris髋关节功能评分、患侧髋臼杯前倾角和外展角、疼痛程度评分、并发症发生率及白细胞介素-6(IL-6)、去甲肾上腺素(NE)、醛固酮(ALD)水平。【结果】观察组患者手术时间及术后首次下床活动时间均短于对照组(P<0.05),术中切口长度短于对照组(P<0.05)。术后1周、术后1个月,观察组髋关节功能评分高于对照组(P<0.05)。术后1个月,观察组患侧髋臼杯外展角小于对照组(P<0.05)。术后1周,观察组疼痛程度评分低于对照组(P<0.05)。术后24 h,两组IL-6、NE、ALD均升高,但观察组低于对照组(P<0.05)。两组股外侧皮神经损伤发生率比较,差异无统计学意义(P>0.05)。【结论】MDAA入路与SuperPATH入路应用于老年患者髋关节置换术中,可促进患者髋关节功能恢复,安全性均良好,但SuperPATH入路术式,可缩短术中切口长度,缩小术后患侧髋臼外展角,提升术后髋关节功能,减轻患者术后疼痛。

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关键词 ：关节成形术,置换,髋, 髋关节/外科学

Abstract：【Objective】To evaluate the value of modified direct anterior approach (MDAA) and SuperPATH approach in elderly patients undergoing hip replacement. 【Methods】A total of 104 elderly patients undergoing hip arthroplasty in Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital) from July 2020 to July 2023 were selected and divided into the observation group (SuperPATH hip arthroplasty, n=54) and the control group (MDAA hip arthroplasty, n=50) according to different treatment methods. The postoperative indexes, Harris hip function score, anterior inclination and abduction Angle of the affected acetabular cup, pain degree score, complication rate and the levels of interleukin-6(IL-6), norepinephrine (NE) and aldosterone (ALD) were compared between the two groups. 【Results】The operation time and the first time of getting out of bed in the observation group were shorter than those in the control group (P<0.05), and the length of incision in the observation group was shorter than that in the control group (P<0.05). One week and one month after surgery, the hip function scores of the observation group were higher than those of the control group (P<0.05). One month after operation, the abduction Angle of the affected acetabular cup in the observation group was lower than that in the control group (P<0.05). One week after surgery, the pain degree score of the observation group was lower than that of the control group (P<0.05). 24 h after operation, IL-6, NE and ALD were increased in both groups, but the observation group was lower than the control group (P<0.05). There was no significant difference in the incidence of lateral femoral cutaneous nerve injury between the two groups (P>0.05). 【Conclusion】 MDAA and SuperPATH can promote the recovery of hip function in elderly patients with good safety, but SuperPATH can shorten the length of the intraoperative incision, reduce the postoperative acetabular epitaxy Angle, improve the postoperative hip function and reduce postoperative pain.

Key words： Arthroplasty, Replacement, Hip Hip Joint/SU

收稿日期: 2024-05-11

中图分类号:

R684.75

基金资助:^*河南省中医药科学研究专项课题(编号:2017ZYZ1007)

通讯作者: **E-mail:404185214@qq.com

引用本文:

陈晓波, 李帅垒, 刘爱斌, 柴昊, 童培建. SuperPATH入路与MDAA入路在老年患者髋关节置换术中的应用价值^*[J]. 医学临床研究, 2024, 41(10): 1457-1460.
CHEN Xiaobo, LI Shuailei, LIU Aibin, et al. Application Value of SuperPATH and MDAA in Hip Replacement in Elderly Patients. JOURNAL OF CLINICAL RESEARCH, 2024, 41(10): 1457-1460.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.10.001 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I10/1457

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