观察老年股骨颈骨折DAA 入路髋关节置换术疗效追踪分析。 方法:研究选择2019 年9 月-2021年6月髋关节置换术的老年股骨颈骨折患者100例,并均接受人工髋关节置换术治疗。根据数字随机分组法随机分为观察组和对照组。观察组采用DAA入路,对照组采用后外侧入路。对比手术指标(手术时间、切口长度、术中骨折、术中出血量、术后伤口引流量、术后首次下地的时间)以及并发症(肺部感染、尿路感染、血栓、假体失败、异位骨化、髋关节脱位)、疼痛( VAS评分)、髋关节功能( Harris)评分,评价治疗后1周及治疗后3个月时的生活质量评分。结果:观察组手术时间、切口长度、术后首次下地时间明显短于对照组;而术中骨折率低于对照组;术中出血量、术后伤口引流量明显少于对照组( P<0. 05 );观察组术后并发症率少于对照组( P<0. 05 );术后3个月时Harris评分较前升高,且观察组高于对照组;而疼痛评分较前下降,观察组均低于对照组( P<0. 05 );治疗后1周2组患者的生活质量评分相比,差异无统计学意义( P>0. 05 )。治疗后3个月时的生活质量评分较治疗后1周评分升高,且观察组高于对照组,差异有统计学意义( P<0. 05 )。结论:在老年股骨颈骨折并接受髋关节置换术治疗中,开展DAA入路,可明显缩短手术时间、术后首次下地时间与切口长度,减少术中骨折、术中出血量、术后伤口引流量,降低术后并发症与疼痛感,提升术后的髋关节功能的恢复,改善生活质量,效果较为理想。

Aim To compare the effects of direct anterior and posterolateral total hip arthroplasty on elderly pa-tients with femoral neck fractures.Methods The clinical data of 90 elderly patients with femoral neck fracture under-going total hip arthroplasty were retrospectively analyzed.According to the approach method,they were divided into ante-rior approach group(46 cases)and posterolateral approach group(44 cases).Perioperative indexes,early postoperative X-ray prosthesis position information,hip function,balance function,levels of inflammatory factors,bone metabolism inde-xes and complications were compared between the two groups.Results Compared with the anterolateral approach group,the operative time of the anterolateral approach group was increased(P<0.05).Intraoperative blood loss and postoperative hospital stay were decreased(P<0.05).One month after surgery,the levels of osteocalcin,hip joint and balance function scores were increased,and tartrate-resistant acid phosphatase 5b and C-terminal peptide of type I collagen were decreased after operation(P<0.05).The levels of postoperative inflammatory factor in the anterior approach group were lower than those in the posterolateral approach group(P<0.05).There were no significant differences in the postop-erative X-ray prosthesis position information and incidence of complications between the two groups(P>0.05).Con-clusion Both approaches can effectively improve hip joint function in elderly patients with femoral neck fractures,but di-rect anterior approach has less damage and faster short-term recovery compared to the posterior lateral approach.

目的:对比分析微创SuperPath入路与传统后路人工股骨头置换治疗老年股骨颈骨折的近期临床疗效.方法:选取我院2016年8月～2019年7月收治的100例老年股骨颈骨折患者为研究对象,随机将其分为A、B两组,每组各50例,其中,A组为对照组,采用传统后路人工股骨头置换术,B组为观察组,采用微创SuperPath入路置换术,对比两组患者的治疗效果与手术情况.结果:相对于A组,B组患者治疗效果更佳.结论:对老年股骨颈骨折患者进行治疗时,采用微创SuperPath入路置换术,患者出血量更少,恢复时间更快,切口更短,具有较高的临床应用价值.