后外侧入路小切口微创人工全髋关节置换术初步报告

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1、后外侧入路小切口微创人工全髋关节置换术初步报告作者：黄相杰高广凌谭远超周志高刘德忠焦明航【关键词】髋关节摘要：［目的］探讨后外侧入路小切口微创(minimallyinvasivesurgery，MIS)人工全髋关节置换的手术方法和初期临床治疗效果。［方法］采用后外侧入路MIS技术为68例72髋实施人工全髋关节置换术。股骨头坏死34例，其中双侧3例；股骨颈骨折25例；髋关节骨性关节炎9例，其中双侧1例。［结果］手术切口长75~11cm，平均928cm；术中出血量200~480ml，平均280ml；术后3个月时Harris评分平均为93分。在以往采用传统后外侧入路行人工

2、全髋关节置换的病例中，选择病种、性别、年龄、术前Harris评分相近的患者68例72髋做为对照组，对两组进行对比：（1）切口MIS组明显短于传统组；（2）术中出血量少于传统组；（3）3个月时的Harris评分高于传统组(P＜0001)。［结论］采用MIS人工全髋关节置换技术，手术切口短，创伤小，出血少，术后功能恢复快，较传统的全髋置换术有明显的优势，但应有严格的手术指征和熟练的操作技术。　　关键词：微创外科；髋关节；关节置换；小切口11　　Preliminaryreportofminimallyinvasivesurgeryfortotalhiparthroplas

3、ty　　Abstract：［Objective］Toreportthesurgicaltechniqueandpreliminarytherapeuticresultofminimallyinvasivesurgery(MIS）fortotalhiparthroplasty(THA）throughaposterolateralapproach［Method］Seventytwocasesof68patientsoftotalhiparthroplastywereperformedthroughposterolateralminiincisionTherewere34

4、casesoffemoralheadnecroses,25casesoffemoralneckfracturesand9casesofosteoarthritis［Result］Theaveragelengthoftheincisionwas928cm(ranged,75~11cm);Theaverageintraoperativebloodlosswas280ml(ranged,200~480ml)Accordingtothe3monthpostoperativefollowup,allcaseshadanaverageHarrisHipScoreof93Ther

5、esultwascomparedwithanother68caseswiththesimilargender,similaraverageage,andsimilarpreoperativeHarrisHipScorewhichacceptedtraditionaltreatingmethodThepatientsinMISgrouphadshorterskinincision,lessbloodlossandsignificantimprovementofHarrisHipScoreafterthe3monthfollowup(P＜0001)［Conclusion

6、］MISforTHAtreatmentthroughposterolateralapproachhastheadvantagesofshorterskinincision,lesstissuedamage,lessbloodlossandquicker11postoperativerecoveryItbringsobviousbetterresultcomparedwithcasesusingconventionalincision,butithastofollowstrictindicationsandhighdemandingforoperativetechni

7、que　　Keywords：Minimallyinvasivesurgery(MIS);Hipjoint;Arthroplasty;Miniincision人工全髋关节置换(totalhiparthroplasty,THA)已经成为一种成熟的外科技术，是治疗髋关节疾病有效的治疗手段。随着临床应用越来越广泛。对其要求也在不断增加。除要提高植入物的使用寿命外，还要求减少手术的创伤性，缩短康复时间。本世纪初，许多学者开始将微创技术应用于THA手术。目前，小切口微创THA(miniincisionsurgeryorminiinvasivesurgeryTHA，MISTH