| Objective:Hip joint disease is one of the most common disease in the clinical stage. Among them, hip joint inflammation and avascular necrosis of the femoral head with a poor prognosis, with the progression of the disease, loss of hip function in patients with all, a severe pain in the hip joint, a serious impact on the patient’s daily life. In recent years, the clinical incidence of hip joint disease has increased year by year, and the clinical treatment of hip joint disease is very much. The minimally invasive total hip arthroplasty is the perfect way to treat the diseases of hip joint, it is the innovation of minimally invasive treatment of community, this treatment can not only maximize the reduce of patients with soft tissue injury in surgery and reduce the amount of bleeding in patients, and can reduce postoperative pain, shorter postoperative recovery time after is improved after operation of patients with hip joint disease quality of life an important guarantee 。 Minimally invasive surgery in the early stage of hip replacement can be combined with the concept of rapid rehabilitation. The concept of rapid rehabilitation surgery in a very innovative idea, it is surgery, anesthesiology and nursing of the perfect combination, the basic purpose of rapid recovery for the use of optimization methods, as much as possible to reduce patient trauma stress, promote their speedy recovery. Applying the concept of rapid rehabilitation to minimally invasive total hip arthroplasty can reduce the trauma stress response, reduce postoperative pain and shorten the recovery time, which has good application value. Methods:In 88 cases of hip joint disease patients admitted to our hospital from June 2012-2015 year in June as the research object, randomly divided 22 patients who underwent conventional incision total hip arthroplasty, the A group, 22 patients underwent minimally invasive incision hip replacement treatment, the group B, 22 patients accept the traditional incision hip replacement therapy + rapid rehabilitation treatment, the C group, 22 patients underwent minimally invasive incision total hip arthroplasty and quick rehabilitation treatment, the D group, compared the clinical efficacy of four groups of patients, including patients incision length, operation time, perioperative bleeding the incidence of patients, and the position of the prosthesis and Harris score of postoperative complications. Results:1、Operation conditionA group of patients with the average incision length was 14.5 + 1.9cm, the average operation time was 98.35 + 15.65 m, perioperative period the average amount of bleeding was 315.6 + 213.5ml; B group of patients with the average incision length was 7.6 + 0.5cm, the average operation time was 90.38 + 15.65 h, perioperative period the average amount of bleeding was 232.1 + 203.2ml; C group average the length of incision was 14.9 + 2.0cm, the average operation time was 98.44 + 16.11 m, perioperative period the average amount of bleeding was 317.7 + 230.7ml; D group of patients with the average incision length was 7.5 + 0.7cm, the average operative time was 90.21 13.52 m during operation period, the average amount of bleeding was 230.9 + 205.4ml; B, D group of patients with obvious therapeutic effect better than A and C group, between the two groups, the difference was significant(P<0.05).2.、The position of the hip jointPostoperative X-ray showed that patients of A group the acetabular cup abduction angle is 38.2 + 6.1 degrees and the acetabular cup dip angle is 11.5 9.2 + degree, patients in group B cup abduction angle was 40.5 + 5.5 degrees and acetabular cup dip angle is 13.2 + 8.84 degree, patients in group C cup abduction angle was 36.2 + /- 7.1 degrees and acetabular cup dip angle is 12.5 + 9.5 degrees, patients in group D cup abduction angle was 40.8 + 5.4 degrees and acetabular cup dip angle is 13.2 + 9.0 degrees. There was no significant difference between the four groups(P>0.05).3、The complications after operationFour groups of patients with stable disease after surgery, did not appear hip dislocation, postoperative infection and deep vein thrombosis and other complications.4、Harris score after operation Patients were followed up for 6 months, the control group, the postoperativePatients were followed up for 6 months, A group of postoperative average Harris score for 90.6 + 2.8 points, after operation in group B average Harris score for 92.6 + 3.1 points, after operation in group C average Harris score is 92.3 + 2.5 points, after the operation of group D average Harris score for 95.5 + 2.7 points, between the four groups, group A and group B compared, the difference is significant(P < 0.05). Compared with group A, the difference of C group was significant(P<0.05). There was significant difference between the B group and the D group(P<0.05). Group; group C and group D the difference is significant(P < 0.05); a group of patients with postoperative Harris grade showed excellent in 5 cases, good in 5 cases, 8 cases and poor in 4 cases, excellent rate was 45%; B group of patients with postoperative Harris grade showed excellent in 7 cases, good in 6 cases, in 5 cases and poor in 4 cases, the excellent and good rate was 60%, C group patients postoperative Harris grade showed excellent in 5 cases, good in 7 cases, 4 cases, poor in 6 cases, the excellent and good rate was 55% d in patients with postoperative Harris grade, excellent in 8 cases, good in 7 cases, 4 cases, poor in 3 cases, the excellent and good rate was 68%, contrast group, a group and B group comparison, the difference is significant(P < 0.05). Compared with group A, the difference of C group was significant(P<0.05). There was significant difference between the B group and the D group(P<0.05). There was significant difference between the C group and the D group(P<0.05). Conclusion:Minimally invasive total hip replacement with a small incision, short operation time, less intraoperative blood loss, fast postoperative recovery of patients with clinical advantages, the rapid rehabilitation has let after surgery to make a fast recovery effect, is worth popularizing widely. |
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