| 微创前外侧入路下全髋置换术对股骨颈骨折患者骨代谢指标及髋关节功能的影响 |
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投稿时间：2019-06-14
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| 期刊信息：《中国骨伤》2019年，第32卷，第12期，第1117-1122页 |
| DOI：10.3969/j.issn.1003-0034.2019.12.010 |
| 基金项目: |
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中文摘要:
目的：分析股骨颈骨折应用微创前外侧入路下全髋置换术对血清Ⅰ型胶原氨基端前肽（N-terminal propeptide of typeⅠprecollagen，PINP），抗酒石酸酸性磷酸酶-5b（tartrate resistant acid phosphatase-5b，TRACP-5b）水平及髋关节功能的影响。
方法：选取2016年9月至2017年5月收治的98例股骨颈骨折患者，分为对照组和观察组，各49例。对照组男30例，女19例，年龄63~72岁，予以微创前外侧入路下半髋置换术治疗；观察组男29例，女20例，年龄62~73岁，予以微创前外侧入路下全髋置换术治疗。比较两组围手术期情况（手术时间、出血量、切口长度、住院时间），骨代谢指标，包括PINP，TRACP-5b，成纤维细胞因子（fibroblast growth factor，FGF），骨钙素（bone gla-protein，BGP），Ⅰ型胶原羧基端前肽（propeptide carboxy-terminal procollagen，PICP），骨特异性碱性磷酸酶（bone-specific alkaline phosphatase，BAP），以及疼痛介质指标，如前列腺素E2（prostaglandin E2，PGE2），5-羟色胺（5-hydroxytryptamine，5-HT）水平，评价髋关节功能及并发症发生情况。
结果：观察组手术时间长于对照组（P<0.05）；两组出血量、切口长度、住院时间比较差异无统计学意义（P>0.05）。观察组术后1个月PINP、FGF、BGP、PICP、BAP高于对照组，TRACP-5b低于对照组（P<0.05）；观察组术后1个月PGE2、5-HT低于术前，且低于对照组（P<0.05）。观察组髋关节功能优良率高于对照组（P<0.05），并发症发生率与对照组比较差异无统计学意义（P>0.05）。
结论：微创前外侧入路下全髋关节置换术能提高股骨颈骨折患者髋关节功能，改善骨代谢状态，促进骨折愈合，缓解患者疼痛程度，安全可靠，值得推广。 |
| 【关键词】关节成形术,置换,髋 股骨颈骨折 最小侵入性外科手术 骨折愈合 |
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| Effect of minimally invasive anterior lateral approach for total hip arthroplasty on serum typeⅠcollagen propeptide,tartrate-resistant acid phosphatase 5b and hip joint function in patients with femoral neck fracture |
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ABSTRACT
Objective: To analyze the level of serum N-terminal propeptide of typeⅠprecollagen (PINP) and tartrate resistant acid phosphatase 5b(TRACP-5b) in patients with femoral neck fracture(FNF) after minimally invasive anterior lateral approach with total hip arthroplasty and the effects of hip function.
Methods: From September 2016 to May 2017,98 cases of femoral neck fracture were divided into control group and observation group,49 cases in each group. There were 49 patients in control group,including 30 males and 19 females,ranging in age from 63 to 72 years old,who underwent minimally invasive anterolateral total hip arthroplasty. There were 49 patients in observation group,including 29 males and 20 females,ranging in age from 62 to 73 years old,who underwent minimally invasive anterolateral total hip arthroplasty. The perioperative conditions(operation time,bleeding volume,incision length,hospitalization time),bone metabolism indexes including PINP,TRACP-5b,fibroblast growth factor(FGF),bone gla-protein(BGP),propetide carboxy-terminal procollagen (PICP),bone-specific alkaline phosphatase(BAP),and pain mediators such as prostaglandin E2 (PGE2) and 5-hydroxytrytamine (5-HT) levels were compared between the two groups. The hip joint function and complications were evaluated.
Results: The operation time of the observation group was longer than that of the control group(P<0.05);there was no significant difference in bleeding volume,incision length and hospitalization time between two groups(P>0.05). PINP,fibroblast growth factor,BGP,PICP and BAP in observation group were higher than those in control group 1 month after operation,and TRACP-5b was lower than those in control group(P<0.05);PGE2 and 5-HT in observation group 1 month after operation were lower than those before operation,and lower than those in control group(P<0.05). The excellent and good rate of hip function in observation group was higher than that in control group (P<0.05),and the incidence of complications was not significantly different from that in the control group (P>0.05).
Conclusion: Minimally invasive anterolateral approach total hip arthroplasty is safe and reliable,and can improve hip function,improve bone metabolism,promote fracture healing,alleviate pain in patients with femoral neck fracture,which is worthy of promotion. |
| KEY WORDS Arthroplasty,replacement,hip Femoral neck fractures Minimally invasive surgical procedures Fracture healing |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 郭瑞峰,郑稼.微创前外侧入路下全髋置换术对股骨颈骨折患者骨代谢指标及髋关节功能的影响[J].中国骨伤,2019,32(12):1117~1122 |
| 英文格式: | GUO Rui-feng,ZHENG Jia.Effect of minimally invasive anterior lateral approach for total hip arthroplasty on serum typeⅠcollagen propeptide,tartrate-resistant acid phosphatase 5b and hip joint function in patients with femoral neck fracture[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(12):1117~1122 |
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