小切口全髋关节置换的手术体会【摘要】探讨小切口人工全髋关节置换手术的优缺点。［方法］比较32例37髋小切口人工全髋关节置换术与普通切口人工全髋关节置换术在切口长度、手术时间、术中出血量、术后引流量、住院时间及并发症等方面的异同。［结果］小切口组平均切口长度为77cm，普通切口组为115cm（P《005）；小切口组平均手术时间为95min，普通切口组为51min(P《005)；小切口组术中平均出血量为380ml，普通切口组为299ml（P《005）；小切口组及普通切口组在术后引流量及住院时间方面无显著性差异（P》005）；小切口组1例术中出现大转子尖骨折、股骨颈截骨过多、髋臼内凸，1例因髋臼安放角度异常于术后第3d出现髋关节脱位，行扩大切口调整髋臼假体角度后恢复正常；普通切口组术中、术后无1例出现并发症。［结论］与普通长度切口全髋关节置换手术相比，小切口手术在出血量、组织损伤程度、手术时间方面并无明显优势；由于切口小，术野受限，手术操作比较困难，易出现假体安装位置异常等问题。在熟练做好普通切口全髋置换手术、不增加手术损伤的前提下，可尽量减小手术切口长度，没有必要刻意追求小切口全髋置换手术。【关键词】小切口关节成形术髋置换人工关节---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---Abstract［Objective］Toexploretheadvantagesanddisadvantagesofminimalincisionsurgery(MIS)fortotalhipreplacement［Methods］Thirty-twopatients(37hips)whohadundergoneaMISwerecomparedwith32patients(37hips)whohadundergoneconventionalincisionsurgerywithsimilarcondictionsThelengthofincision,operationtime,intraoperativebloodloss,postoperativedrainage,hospitalizeddaysandcomplicationswereobserved［Results］Theaverageincisionlengthwas77cmforMISgroupand115cmforconventionalincisiongroup(P《005)Theaveragesurgicaltimewas95minutesforMISgroupand51minutesforconventionalincisiongroup(P《005)Theaverageintraoperativebloodlosswas380mlforMISgroupand299mlforconventionalincisiongroup(P《005)Therewasnosignificantdifferenceinpostoperativedrainage,hospitalizeddaysbetweenthesetwogroups(P》005)InMISgroup,greatertrochanterfractureoccuredin1patientduringoperationDislocationoccurredinanotherpatientwithanterolateralapproach3dayspostoperativelybecauseofmalpositionofthecup,thecupwasthenadjustedtoproperpositionbyreoperationwith---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---extendedincisionlengthInconventionalincisiongroup,nocomplicationoccuredduringorafteroperations［Conclusion］Totalhipreplacementwiththeincisionlengthof6~85cmisaverydemandingtechniqueTherewerenomuchadvantagesofMISfortotalhipreplacementconcerningsurgicaltime,bloodlossortraumacomparewithaconventionalincisionsurgeryTheincisionlengthfortotalhipreplacementshouldnotbestressedThemostimportantthingfortotalhipreplacementisnotthelengthoftheincisionandthelengthofincisionshouldnotbereducedatthepriceofmoresofttissueinjuryKeywords：minimalincision;athroplasty；hipreplacement;hipprosthesis目前，小切口或微创全髋关节置换手术在全国各地大小医院遍地开花。截至2007年8月31日，输入“关节置换小切口髋关节”三个关键词可在互联网简体中文和繁体中文网页中搜索到约21800项查询结果，输入“关节置换微创髋关节”可搜索到约32800项相符合的查询结果；在中国期刊网全文数据库中输入“小切口”和“髋关节置换”可以查到89篇相关文章，输入“微创”和“髋关节置换”可以查阅到77篇相关文章。可见小切口全髋关节置换术在现---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---阶段备受推崇。对于小切口或微创人工关节置换手术，不同的作者有不同的体会，但多数作者认为...