唐立群

【摘要】 目的 探討髖關(guān)節(jié)外科脫位技術(shù)在髖關(guān)節(jié)手術(shù)中的臨床應(yīng)用效果及對患者髖關(guān)節(jié)功能、預(yù)后的影響。方法 118例行髖關(guān)節(jié)手術(shù)治療的股骨頭壞死患者， 按照隨機(jī)數(shù)字表法分為對照組和觀察組， 每組59例。兩組患者均實(shí)施死骨清理打壓植骨治療， 對照組選擇直前入路， 觀察組應(yīng)用髖關(guān)節(jié)外科脫位技術(shù)， 比較兩組的術(shù)后并發(fā)癥發(fā)生情況、術(shù)后疼痛評分、血清炎癥因子指標(biāo)水平、髖關(guān)節(jié)功能評分、髖關(guān)節(jié)活動(dòng)度、髖關(guān)節(jié)改善效果。結(jié)果 觀察組術(shù)后并發(fā)癥發(fā)生率為1.69%， 低于對照組的11.86%， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組術(shù)后8、12、24、48 h時(shí)疼痛評分均低于對照組， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。手術(shù)后， 兩組患者C反應(yīng)蛋白（CRP）、白細(xì)胞介素-6（IL-6）、降鈣素原（PCT）水平均低于本組手術(shù)前， 且觀察組CRP、IL-6、PCT水平均低于對照組， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。手術(shù)后， 兩組患者髖關(guān)節(jié)功能評分、髖關(guān)節(jié)活動(dòng)度均高于本組手術(shù)前， 且觀察組的髖關(guān)節(jié)功能評分、髖關(guān)節(jié)活動(dòng)度均高于對照組， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組患者髖關(guān)節(jié)改善優(yōu)良率為96.61%， 高于對照組的84.75%， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 髖關(guān)節(jié)外科脫位技術(shù)應(yīng)用于股骨頭壞死患者的髖關(guān)節(jié)手術(shù)中， 可有效減少術(shù)后并發(fā)癥， 促進(jìn)髖關(guān)節(jié)功能恢復(fù)， 改善預(yù)后。

【關(guān)鍵詞】 髖關(guān)節(jié)手術(shù);股骨頭壞死;髖關(guān)節(jié)外科脫位技術(shù);創(chuàng)傷骨科;髖關(guān)節(jié)功能;打壓植骨

DOI：10.14163/j.cnki.11-5547/r.2019.01.006

【Abstract】 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.