黄济嘉 卢晓燕 陈楚茗 陈歌海 陈晓生

【摘要】 目的：探討微创SuperPATH入路髋关节置换术对老年股骨颈骨折患者术后快速康复的作用。方法：选取2018年4月-2019年12月本院收治的老年股骨颈骨折患者70例。按照随机数字表法分为观察组（n=35）和对照组（n=35）。两组患者均行髋关节置换术治疗，对照组采用传统外侧入路手术方法，观察组采用微创SuperPATH入路方法。比较两组患者手术情况、术后恢复情况、术后疼痛程度、术后3个月髋关节恢复情况以及并发症发生率。结果：观察组切口长度、下地活动时间、住院时间均短于对照组，术中失血量低于对照组，手术时间长于对照组，差异均有统计学意义（P<0.05）。术后1周，观察组VAS评分低于对照组，差异有统计学意义（P<0.05）。观察组髋关节恢复优良率为80.0%，高于对照组的51.4%，差异有统计学意义（P<0.05）。观察组术后并发症发生率为5.7%，低于对照组的25.7%，差异有统计学意义（P<0.05）。结论：微创SuperPATH入路髋关节置换术治疗老年股骨颈骨折效果显著，有利于减少手术创伤、降低术后疼痛和并发症的发生，可有效改善患者髋关节功能，促进患者快速康复。

【关键词】 微创SuperPATH入路 髋关节置换术 老年 股骨颈骨折 快速康复

Study on the Rapid Rehabilitation of Elderly Patients with Femoral Neck Fracture after Hip Replacement Via Minimally Invasive SuperPATH Approach/HUANG Jijia， LU Xiaoyan， CHEN Chuming， CHEN Gehai， CHEN Xiaosheng. //Medical Innovation of China， 2021， 18（07）： 00-005

[Abstract] Objective： To explore the effect of minimally invasive SuperPATH approach for hip replacement on the rapid rehabilitation of elderly patients with femoral neck fracture. Method： A total of 70 elderly patients with femoral neck fracture admitted to our hospital from April 2018 to December 2019 were selected. According to random number table method， they were divided into observation group （n=35） and control group （n=35）. Both groups were treated with hip arthroplasty， the conventional lateral approach was used in the control group， the observation group was treated with minimally invasive SuperPATH approach. The surgical situation， postoperative recovery， postoperative pain， hip recovery at 3 months after surgery and the incidence of complications were compared between the two groups. Result： The incision length， ambulation time and hospitalization time of the observation group were shorter than those of the control group， the intraoperative blood loss was lower than that of the control group， the operation time of the observation group was longer than that of the control group， the differences were statistically significant （P<0.05）. One week after operation， the VAS score of the observation group was lower than that of the control group， the difference was statistically significant （P<0.05）. The excellent and good rate of hip joint recovery in the observation group was 80.0%， which was higher than 51.4% in the control group， the difference was statistically significant （P<0.05）. The incidence of postoperative complications in the observation group was 5.7%， which was lower than 25.7% in the control group， the difference was statistically significant （P<0.05）. Conclusion： Minimally invasive SuperPATH approach for hip replacement has a significant effect in the treatment of femoral neck fracture in the elderly， which is conducive to reducing surgical trauma， postoperative pain and complications. It can effectively improve the function of hip joint and promote the rapid recovery of patients.

[Key words] Minimally invasive SuperPATH approach Hip replacement Elderly Femoral neck fracture

Rapid rehabilitation

First-authors address： Puning Peoples Hospital， Puning 515300， China

doi：10.3969/j.issn.1674-4985.2021.07.001

股骨颈骨折是骨科临床常见的疾病之一，随着我国老龄化社会的加剧，该病的发病率一直居高不下，给患者身心健康、生活质量、家庭负担带来了严重的影响[1]。人工髋关节置换术是目前治疗股骨颈骨折的首选方式，对缓解患者症状、降低并发症、早期负重行走、改善患者预后具有理想的效果。既往髋关节置换术一般采用后外侧入路，术中需要切断外旋肌群，对患者创伤较大[2]。近年来，伴随着微创技术、精准外科、快速康复理念的深入研究，微创SuperPATH入路髋关节置换术成为临床骨科医生关注的热点，其临床应用优势的凸显也逐渐得到了广泛的认可[3-4]。微创SuperPATH入路髋关节置换术不仅保留了后侧入路术式的优点，且不会导致血管神经的损伤，同时利于减少术中失血量、保留关节囊及肌群，降低了术后髋关节脱位的风险[5]。……