小切口全髋关节置换近期临床应用

目的 观察前外侧入路小切口全髋关节置换术近期临床疗效。方法 36例行全髋置换术,记 录切口长度、手术时间、术中出血量、术后引流量,并观察术后全身和局部并发症。结果 手术切口平 均长度约9cm(7～10cm)。手术时间平均90min(70～110min),术中出血量平均400ml(300～500ml), 术后24h引流量平均250ml(100～350ml),术中术后平均输血量300ml。切口平均12d一期愈合。术后 未发现心肺疾病或髋关节脱位等全身、局部并发症。术后患肢在3～10d后均可部分负重行走,步态正 常,Harris评分平均95分,功能优良率96％。结论 临床观察证明:只要严格掌握手术适应征,术者 有良好的手术技巧,小切口微创全髋置换术是一种安全有效的手术。

Small incision in hip replacement

Objective To observe the short term clinic effect of minimally invasion total hip arthroplasty through small incision. Methods 36 cases were performed minimally invasion total hip arthroplasty through anterolateral small incision. The length of the incision, operation time, intraoperative blood loss and postoperative drainage were recorded and systemic or local complication were observed. Results The length of incision ranged from 7 to 10 cm (mean 9cm). The operation time was 70-110min (mean 90 min). The interoperation blood loss were 300-500ml (mean 300ml). The drainage of 24 hours after operation was 100-350ml (mean 250ml). The mean blood transfusion were 400ml in operation and post operation and the mean healing time of incision were 12 days. No heart and lung systemic complication or local complication such as dislocation of hip joint occurred. All patients were followed up and the patients could walk in 3-10 days with incompletely weight bearings. The Harris scores were 95 on average , and the excellent and good rate in function was 96%. Conclusion Minimally invasion total hip arthroplasty by amterolateral small incision is a safe and effective operation as long as the operates could strictly control indication and grasp the operative technique well.