刘洪文;陈锦成;朱国涛;徐杰;

• 1:福建中医药大学中医骨伤及运动康复教育部重点实验室
• 2:福建医科大学省立临床医学院福建省立医院骨科

摘要(Abstract)：

[目的]比较股内侧肌下入路(subvastus approach, SVA)与内侧髌旁入路(medial parapatellar approach,MPA)对人工全膝关节置换(TKA)术后快速康复的影响。[方法]前瞻性连续纳入拟行初次、单侧TKA手术的原发性膝骨关节炎患者80例,采用随机数字表法分为两组,40例患者采用SVA入路TKA,40例采用MPA入路TKA。比较两组患者切口长度、手术时间、术后引流量、依托考昔片追加量、直腿抬高时间、起始下地时间、运动和静息状态下疼痛视觉模拟评分(VAS评分)、膝关节活动度(ROM)和美国特种外科医院评分(HSS评分)。[结果] SVA组手术时间显著长于MPA组(P<0.05),但SVA组在切口长度、依托考昔追加量、直腿抬高、下地行走时间等方面均显著优于MPA组(P<0.05)。两组术前运动状态下VAS评分、膝ROM和HSS评分差异均无统计学意义(P>0.05)。在疼痛方面,术后6 h、术后1 d、术后3 d静息状态下SVA组VAS评分均低于MPA组(P<0.05),术后6 h、术后1 d、术后3 d、术后1周、术后1个月运动状态下SAV组VAS评分显著低于MPA组(P<0.05),术后1周静息状态下和术后3个月运动状态下VAS评分两组间差异无统计学意义(P>0.05)。在功能方面,术后3 d、术后1周、术后1个月SVA组膝ROM和HSS评分均高于MPA组(P<0.05),而术后3个月两组间膝ROM及HSS评分差异无统计学意义(P>0.05)。[结论]与MPA入路相比,SVA入路行TKA手术更有利于患者术后快速康复。

关键词(KeyWords)： 全膝关节置换术;股内侧肌下入路;内侧髌旁入路;快速康复

Abstract:

Keywords:

基金项目(Foundation): 福建省卫生厅中青年骨干人才项目(编号:2013-ZQNZD-1)

作者(Author): 刘洪文;陈锦成;朱国涛;徐杰;

Email:

DOI:

参考文献(References)：

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