外侧小切口和普通切口高龄全髋置换术的疗效对比

目的 比较小切口和常规切口直接外侧入路在高龄患者人工髋关节置换术中的临床疗效。方法 回顾性分析2012年1月至2014年6月收治的118例老年髋部疾病患者资料，男48例，女70例；年龄65~91岁，平均（74.05±6.05）岁；小切口组61例，男27例，女34例，平均年龄（73.48±6.05）岁；常规切口组57例，男21例，女36例，平均年龄（74.67±6.12）岁；记录两组患者切口长度、手术时间、术中出血量、术后12h引流量、输血人数、住院时间及术后3个月、6个月和末次Harris评分等。结果 所有患者术后获1~3年（平均2.6年）随访。两组的切口长度、术中出血量、术后12h引流量、输血人数、住院时间及术后3个月Harris评分进行比较，小切口组均显著优于常规切口组，差异有统计学意义（P<0.05）。两组的手术时间、术后6个月及末次Harris评分的差异无统计学意义（P>0.05）。小切口组术后并发症发生率3.28%(2/61)]；常规切口组术后并发症发生率15.79%(9/57)]，两组差异有统计学意义（P<0.05）。结论 与常规切口相比，小切口直接外侧入路髋关节置换术治疗高龄髋关节疾病具有手术创伤小，住院时间断，术后并发症少，关节功能恢复快等优点，疗效满意。

Comparison of primary total hip arthroplasty in elderly patients performed with a minimally invasive direct lateral approach versus the standard lateral approach

Objective To compare the curative effects between minimally invasive and standard direct approach of pri⁃ mary total hip arthroplasty (THA) in elderly patients. Methods One hundred and eighteen geratic patients with hip disease were divided into minimally invasive group (n=61) and standard group (n=57). All the patients were followed up from 15 months to 3 years. The length of incision, surgical duration, intraoperative blood loss, postoperative drainage, number of blood transfusion, hospitalization time and the Harris hip scores were compared between two groups. Results The length of incision, intraoperative blood loss, postoperative drainage, number of blood transfusion and hospitalization time were signifi⁃ cantly lower in minimally invasive group than those in standard group, but the Harris hip scores were significantly higher 3 months after the operation in minimally invasive group than those in standard group (P < 0.05). First intention wound healing was found in all patients in two groups. The postoperative complications were significantly lower in minimally invasive group than those in standard group (3.28% vs 15.79%, P < 0.05). Conclusion Compared with standard incision of primary total hip arthroplasty , minimally invasive direct lateral approach has its advantages, including small surgical trauma, less hospitaliza⁃ tion time, fewer complications, and which can help restore joint function quickly, making the curative effect satisfied in elderly patients.