标题：SuperPATH微创入路人工股骨头置换术治疗老年股骨颈骨折的短期随访研究

      作者：徐果飞 1，胡力 1，杨书华 2    (1.崇州市人民医院骨科，四川 成都 611230；2.四川省骨科医院，四川 成都 610000)

      卷次： 2018年29卷17期

      【摘要】 目的 探讨SuperPATH微创入路人工股骨头置换术治疗老年股骨颈骨折患者的临床效果。方法 选取崇州市人民医院骨科 2016年 2月至 2017年 10月收治的老年股骨颈骨折患者 92例，按随机数表法分为对照组和观察组，每组46例。对照组采取常规入路人工股骨头置换术，观察组采取SuperPATH微创入路人工股骨头置换术。统计两组患者的手术情况(切口长度、手术时间、术中失血量、术后引流量)、术后恢复情况(下床活动时间、完全负重时间、住院时间)、术前及术后6个月髋关节功能(Harris)评分、术前及术后3个月生活质量(SF-36)分值和并发症发生率。结果 观察组患者的手术时间为(118.76±14.33) min，明显长于对照组的(69.54±11.08) min，但切口长度为(7.09±1.10) cm，明显短于对照组的(9.07±1.05) cm，差异均有统计学意义(P<0.05)；观察组患者的术中失血量为(190.29±21.51) mL，术后引流量为(116.84±18.35) mL，少于对照组的(387.41±49.52) mL、(292.03±17.41) mL，差异均有统计学意义(P<0.05)；观察组患者的下床活动时间(2.66±0.62) d、完全负重时间(11.27±2.76) d、住院时间(9.34±1.06) d，明显短于对照组的(8.51±4.57) d、(31.53±6.40) d、(14.44±2.12) d，差异均有统计学意义(P<0.05)；术后6个月，两组患者的关节活动度、功能、行走、疼痛分值较术前增高，且观察组关节活动度(4.91±0.03)分、功能(16.52±0.97)分、行走(31.02±1.78)分、疼痛(42.97±2.96)分，明显高于对照组的(4.04±0.10)分、(13.07±1.02)分、(27.20±1.56)分、(37.86±2.51)分，差异均有统计学意义(P<0.05)；术后3个月，两组患者的SF-36分值较术前增高，且观察组患者的SF-36分值为(86.66±8.57)分，明显高于对照组的(78.78±9.11)分，差异有统计学意义(P<0.05)；观察组患者的并发症发生率为6.52%，明显低于对照组的21.74%，差异有统计学意义(P<0.05)。结论 采取SuperPATH微创入路人工股骨头置换术治疗老年股骨颈骨折可减少手术创伤，改善患者髋关节功能，缩短机体功能恢复时间，且利于提高患者术后生活质量，并降低并发症发生率。
      【关键词】 SuperPATH微创入路；人工股骨头置换术；股骨颈骨折；并发症；髋关节功能；预后
      【中图分类号】 R683.42 【文献标识码】 A 【文章编号】 1003—6350（2018）17—2400—05

Short-term follow-up study of superpath minimally invasive approach in artificial femoral head replacement forsenile femoral neck fractures.
XU Guo-fei 1, HU Li 1, YANG Shu-hua 2. 1. Department of Orthopedics, Chongzhou People'sHospital, Chengdu 611230, Sichuan, CHINA; 2. Department of Orthopedics, Orthopedics Hospital of Sichuan Province,Chengdu 610000, Sichuan, CHINA
【Abstract】 Objective To explore the clinical effect of artificial femoral head replacement by SuperPATH mini-mally invasive approach for elderly patients with femoral neck fractures. Methods A total of 92 patients with femoralneck fractures treated Chongzhou People's Hospital were selected from February 2016 to October 2017. According to therandom number table, they were randomly divided into control group and observation group, with 46 patients in eachgroup. The control group received conventional femoral head replacement, and the observation group received artificialfemoral head replacement by SuperPATH minimally invasive approach. The operative condition (length of incision, dura-tion of operation, blood loss during operation, postoperative drainage), postoperative recovery (bed-off activity time, fullweight bearing time, length of hospital stay), hip function (Harris) score before and 6 months after operation, quality oflife (SF-36) score before and 3 months after operation, and incidence of complications between the two groups werecompared. Results The duration of operation in the observation group was (118.76±14.33) min, which was significant-ly longer than (69.54±11.08) min of the control group, but the length of the incision was (7.09±1.10) cm, which was sig-nificantly shorter than (9.07±1.05) cm of the control group (P<0.05). The intraoperative blood loss and postoperativedrainage of the patients in the observation group was (190.29 ± 21.51) mL, (116.84 ± 18.35) mL, which was less than(387.41±49.52) mL, (292.03±17.41) mL of the control group (P<0.05). The bed-off activity time, full weight-bearing time,and length of hospital stay was (2.66±0.62) d, (11.27±2.76) d, (9.34+1.06) d in the observation group, which were signifi-cantly shorter than (8.51±4.57) d, (31.53±6.40) d, (14.44±2.12) d in the control group (P<0.05). Six months after opera-·论 著·doi:10.3969/j.issn.1003-6350.2018.17.010基金项目：四川省卫生和计划生育委员会科研项目(编号：20150129)