外侧微创切口全髋关节置换术_临床医学论文.docVIP

外侧微创切口全髋关节置换术_临床医学论文 外侧微创切口全髋关节置换术_临床医学论文 摘要:目的 探讨微创全髋关节置换的可能性和优缺点。 方法 2004年1月至2004年12月，对22例（26髋）采用侧卧位，大转子前1/3略弧顶向后的纵切口，完成全髋关节置换。记录术前、术后切口长度、术中出血量、手术时间、假体位置、伤口愈合情况和直腿抬起时间。 结果 所有患者的假体位置良好，4例伤口愈合不良，换药后治愈。手术开始时平均切口长度8.3cm，手术结束时平均切口长度9.0cm。平均手术时间87min。平均术中出血量145mL，术后出血量139mL。直腿抬起时间3.7d。无假体脱位及骨折等并发症。 结论 微创全髋关节置换术具有创伤小、出血少、恢复快等优点。7～9cm伤口足可以顺利完成全髋关节，刻意追求过小切口会导致皮肤及软组织损伤，甚至假体位置异常。 关键词: 关节成形术;置换;髋;微创;手术 （Department of Orthopaedics，Xuzhou Hospital Affiliated to Southeast University，Jiangsu Xuzhou221009，China）Abstract:Objective To explore the possibility，advantage and disadvantage of minimally invasive total hip arthroplasty.Methods From Jan2004to Dec2004，26hips in22cases were performed with minimally invasive total hip arthroplasty，position the patient on the side，with the affected hip uppermost.Make a curved longitudinal inci-sion along the anterior third of the greater trochanter，slightly convex posteriorly.The length of incision preoperative and postoperative was observed.The blood loss，operation time，prosthetic position，the healing of wound and func-tional recovery were also recorded.Results The position of component was good in all cases.The average length of the incision was8.3cm preoperative，9.0cm postoperative.The average operation time was87minutes.The aver-age blood loss was145mL intraoperative，139mL postoperative.Patient can lift his or her leg in3.7days.No dislo-cation and fracture occurred.Conclusion The advantages of minimally invasive total hip arthroplasty are less trau-matic，less blood loss and rapid recovery of function.7～9cm is enough to complete THA.Restricting the length of skin incision for THA may have adverse effects，such as injury of skin and soft tissue and malposition of component.Key words:arthroplasty;replacement;hip;minimally invasive;surgical 全髋关节置换治疗髋关节疾病己有40多年历史，是目前最为成功运用的假体置换手术［1］ 。随着手术技巧和器械的改进，在不影响手术质量的情况下，如何以最小的创伤完成手术，让病人早期康复己成为目前研究重点。我院自2004年1月至2004年12月共采用外侧入路完成微创全髓关节置换22例26髋，效果满意。现汇报如下。 　　1 一般资料 共有22人（26髋）实施微创全髋关节置换术，男9例，女13例。年龄56～82