髋关节外科脱位技术在髋关节手术的临床应用效果及对髋关节功能、预后的影响
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摘要
目的探讨髋关节外科脱位技术在髋关节手术中的临床应用效果及对患者髋关节功能、预后的影响。方法 118例行髋关节手术治疗的股骨头坏死患者,按照随机数字表法分为对照组和观察组,每组59例。两组患者均实施死骨清理打压植骨治疗,对照组选择直前入路,观察组应用髋关节外科脱位技术,比较两组的术后并发症发生情况、术后疼痛评分、血清炎症因子指标水平、髋关节功能评分、髋关节活动度、髋关节改善效果。结果观察组术后并发症发生率为1.69%,低于对照组的11.86%,差异具有统计学意义(P<0.05)。观察组术后8、12、24、48 h时疼痛评分均低于对照组,差异具有统计学意义(P<0.05)。手术后,两组患者C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)水平均低于本组手术前,且观察组CRP、IL-6、PCT水平均低于对照组,差异具有统计学意义(P<0.05)。手术后,两组患者髋关节功能评分、髋关节活动度均高于本组手术前,且观察组的髋关节功能评分、髋关节活动度均高于对照组,差异具有统计学意义(P<0.05)。观察组患者髋关节改善优良率为96.61%,高于对照组的84.75%,差异具有统计学意义(P<0.05)。结论髋关节外科脱位技术应用于股骨头坏死患者的髋关节手术中,可有效减少术后并发症,促进髋关节功能恢复,改善预后。
Objective To discuss the effect of hip surgical dislocation in hip surgery and its influence on hip function and prognosis. Methods A total of 118 femoral head necrosis patients treated by hip joint surgery were divided by random number table into control group and observation group, with 59 cases in each group. Both groups were treated with bone clearance and compression and bone grafting. The control group was treated with direct anterior approach, while the observation group was treated with hip joint surgical dislocation technology. Comparison were made on occurrence of postoperative complications, postoperative pain score, serum inflammatory factor index, hip function score, hip joint activity, hip joint improvement between the two groups. Results The observation group had lower incidence of postoperative complications as 1.69% than 11.86% in the control group, and the difference was statistically significant(P<0.05). The observation group had lower pain score in postoperative 8, 12, 24 and 48 h than the control group, and the difference was statistically significant(P<0.05). After operation, both groups had lower C-reactive protein(CRP), interleukin-6(IL-6), procalcitonin(PCT) levels than those before operation, and the observation group had lower CRP, IL-6, PCT levels than the control group. Their difference was statistically significant(P<0.05). After operation, both groups had higher hip function score, hip joint activity than those before operation, and the observation group had higher hip function score, hip joint activity than the control group. Their difference was statistically significant(P<0.05). The observation group had higher excellent rate of hip joint improvement as 96.61% than 84.75% in the control group, and the difference was statistically significant(P<0.05). Conclusion Application of hip joint surgical dislocation technology in hip joint surgery of patients with femoral head necrosis, can effectively reduce postoperative complications, promote recovery of hip joint function and improve prognosis.
Objective To discuss the effect of hip surgical dislocation in hip surgery and its influence on hip function and prognosis. Methods A total of 118 femoral head necrosis patients treated by hip joint surgery were divided by random number table into control group and observation group, with 59 cases in each group. Both groups were treated with bone clearance and compression and bone grafting. The control group was treated with direct anterior approach, while the observation group was treated with hip joint surgical dislocation technology. Comparison were made on occurrence of postoperative complications, postoperative pain score, serum inflammatory factor index, hip function score, hip joint activity, hip joint improvement between the two groups. Results The observation group had lower incidence of postoperative complications as 1.69% than 11.86% in the control group, and the difference was statistically significant(P<0.05). The observation group had lower pain score in postoperative 8, 12, 24 and 48 h than the control group, and the difference was statistically significant(P<0.05). After operation, both groups had lower C-reactive protein(CRP), interleukin-6(IL-6), procalcitonin(PCT) levels than those before operation, and the observation group had lower CRP, IL-6, PCT levels than the control group. Their difference was statistically significant(P<0.05). After operation, both groups had higher hip function score, hip joint activity than those before operation, and the observation group had higher hip function score, hip joint activity than the control group. Their difference was statistically significant(P<0.05). The observation group had higher excellent rate of hip joint improvement as 96.61% than 84.75% in the control group, and the difference was statistically significant(P<0.05). Conclusion Application of hip joint surgical dislocation technology in hip joint surgery of patients with femoral head necrosis, can effectively reduce postoperative complications, promote recovery of hip joint function and improve prognosis.
引文
[1]张建,刘建,李庭,等.髋关节外科脱位联合死骨刮除植骨治疗股骨头坏死的临床疗效观察.重庆医学, 2017, 46(36):5149-5152.
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[5]李业清.髋关节外科脱位死骨清理打压植骨联合补肾活血汤治疗股骨头坏死ARCOⅢA~ⅢB期临床研究.南京中医药大学,2017.
[6]姚晨,沈计荣,杜斌,等.髋关节外科脱位死骨清理打压植骨治疗ⅢA、ⅢB期股骨头无菌性坏死.中华解剖与临床杂志,2016, 21(2):133-136.
[7]冯晓飞,张建军,张小栋,等.两种人工髋关节置入治疗缺血性股骨头坏死的效果比较.西南国防医药, 2016, 26(7):723-725.
[8]李军,梅玉峰,王海鹏,等.髋关节外科脱位技术在髋关节手术中的应用.中国骨与关节杂志, 2016, 31(2):91-96.
[9]李长民,丁继龙,王文正,等.加长柄全髋关节置换治疗双侧股骨头坏死并双侧转子间骨折.创伤外科杂志, 2016, 18(3):176-177.
[10]万彦林,姜文学,王鹏飞,等.髋臼发育不良和股骨头坏死患者行髋关节表面置换术后血清金属离子水平比较.中国矫形外科杂志, 2016, 24(5):439-443.
[11]冯宾,钱文伟,翁习生,等.髓芯减压+同种异体骨打压植骨治疗早期股骨头坏死的疗效观察.中国医学科学院学报, 2015,37(2):133-139.
[12]肖凯,罗殿中,程徽,等.股骨颈基底部旋转截骨术治疗早期股骨头坏死的临床疗效.中华骨科杂志, 2018, 38(7):425-432.
[13]姚平.髋关节外科脱位入路治疗PipkinⅣ型骨折的临床疗效观察.医学理论与实践, 2018, 31(4):532-534.
[14]吴奇.髋关节外科脱位治疗髋关节撞击征的解剖和临床研究.第四军医大学, 2015.
[15]李振伟,黄德刚.外科脱位技术在髋关节相关疾病中的应用进展.中国矫形外科杂志, 2018, 26(11):1022-1025.
[2]李建设.髋关节外科脱位入路手术治疗股骨头骨折的效果分析.河南医学研究, 2016, 25(6):1078.
[3]朱威宏,毛新展,王万春,等.髋关节外科脱位入路在髋关节良性疾病的应用.中国现代医学杂志, 2016, 26(16):76-80.
[4]龚景海,顾国明,鲍欣彪,等.髋关节外科脱位入路手术治疗股骨头骨折的应用体会.中国骨与关节损伤杂志, 2015, 30(6):622-623.
[5]李业清.髋关节外科脱位死骨清理打压植骨联合补肾活血汤治疗股骨头坏死ARCOⅢA~ⅢB期临床研究.南京中医药大学,2017.
[6]姚晨,沈计荣,杜斌,等.髋关节外科脱位死骨清理打压植骨治疗ⅢA、ⅢB期股骨头无菌性坏死.中华解剖与临床杂志,2016, 21(2):133-136.
[7]冯晓飞,张建军,张小栋,等.两种人工髋关节置入治疗缺血性股骨头坏死的效果比较.西南国防医药, 2016, 26(7):723-725.
[8]李军,梅玉峰,王海鹏,等.髋关节外科脱位技术在髋关节手术中的应用.中国骨与关节杂志, 2016, 31(2):91-96.
[9]李长民,丁继龙,王文正,等.加长柄全髋关节置换治疗双侧股骨头坏死并双侧转子间骨折.创伤外科杂志, 2016, 18(3):176-177.
[10]万彦林,姜文学,王鹏飞,等.髋臼发育不良和股骨头坏死患者行髋关节表面置换术后血清金属离子水平比较.中国矫形外科杂志, 2016, 24(5):439-443.
[11]冯宾,钱文伟,翁习生,等.髓芯减压+同种异体骨打压植骨治疗早期股骨头坏死的疗效观察.中国医学科学院学报, 2015,37(2):133-139.
[12]肖凯,罗殿中,程徽,等.股骨颈基底部旋转截骨术治疗早期股骨头坏死的临床疗效.中华骨科杂志, 2018, 38(7):425-432.
[13]姚平.髋关节外科脱位入路治疗PipkinⅣ型骨折的临床疗效观察.医学理论与实践, 2018, 31(4):532-534.
[14]吴奇.髋关节外科脱位治疗髋关节撞击征的解剖和临床研究.第四军医大学, 2015.
[15]李振伟,黄德刚.外科脱位技术在髋关节相关疾病中的应用进展.中国矫形外科杂志, 2018, 26(11):1022-1025.