广西医学

目的比较微创前侧比基尼入路与外侧入路行人工全髋关节置换术的效果。方法回顾性分析80例行人工全髋关节置换术治疗的患者的临床资料，将其按照手术方式分为观察组与对照组，每组40例，观察组实施微创前侧比基尼入路人工全髋关节置换术，对照组采用外侧入路的人工全髋关节置换术治疗。比较两组患者的手术时间、切口长度、术中出血量、术后住院时间、术后下地负重时间、术后并发症发生情况及对疗效的满意度，以及术前与术后6个月的Harris髋关节评分。结果与对照组相比，观察组患者切口长度更短，术中出血量更少，术后住院时间更短，术后下地负重时间更早（P<0.05）。术后6个月，两组患者的Harris髋关节评分均较术前升高，且观察组患者的Harris髋关节评分高于对照组（P<0.05）。观察组患者的疗效满意度评分高于对照组（P<0.05）。两组患者术后并发症总发生率差异无统计学意义（P>0.05）。结论经微创前侧比基尼入路和外侧入路行人工全髋关节置换术均可提高患者的髋关节功能，但前者可缩短手术切口长度及术后住院时间，减少术中出血量，更有利于术后尽早下地负重，患者对疗效的满意度更高，术后髋关节功能恢复更好。

Objective To compare the effect of minimally invasive anterior bikini approach and lateral approach in artificial total hip arthroplasty. Methods Clinical data of 80 patients undergoing artificial total hip arthroplasty were retrospectively analyzed, and patients were randomly divided into observation group or control group according to their surgical methods, with 40 cases in each group. The observation group underwent artificial total hip arthroplasty via the minimally invasive anterior bikini approach, while the control group underwent artificial total hip arthroplasty via the lateral approach. The operation duration, incision length, intraoperative bleeding volume, postoperative length of hospital stay, postoperative time to out⁃of⁃bed and weight⁃bearing, occurrence of postoperative complications, satisfaction with efficacy, and Harris hip scores before and 6 months after surgery were compared between the two groups. Results Compared with the control group, the observation group had a shorter incision length, less intraoperative bleeding volume, a shorter postoperative length of hospital stay, and an earlier time to postoperative out⁃of⁃bed and weight⁃bearing (P<0.05). At 6 months postoperatively, the Harris hip scores of both groups elevated as compared with before operation, and the Harris hip score of the observation group was higher than that of the control group (P<0.05). The satisfaction score regarding efficacy in the observation group was higher than that in the control group (P<0.05). There was no statistically significant difference in the overall incidence rate of postoperative complications between the two groups (P>0.05). Conclusion Both the minimally invasive anterior bikini approach and the lateral approach can improve hip function in patients undergoing artificial total hip arthroplasty. However, the former approach can shorten incision length and postoperative length of hospital stay, reduce intraoperative bleeding volume, facilitate earlier postoperative out⁃of⁃bed and weight⁃bearing, result in higher patients' satisfaction with efficacy, and lead to superior recovery of hip joint function postoperatively.