前侧入路与传统后外侧入路人工全髋关节置换术的血清学层面对比研究

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Abstract Objective To investigate the changes and clinical significance of serum levels in patients between direct anterior approach (DAA) and posterolateral (PLA) in total tip arthroplasty(THA).Methods 60 cases of total hip arthroplasty were collected from October 2015 to March 2017 inWeifang medical university affiliated hospital，26 cases underwent THA throughdirect anteroposterior approach，34 cases underwentTHA through posterior lateral approach.All patients were primary unilateral total hip arthroplasty.The general clinical data and incision length，operation time and intraoperative blood loss were collected from the two groups and fasting venous blood was collected in the morning.The contents of CRP，IL-1，TNF-α，CK in blood serum were detected on the day before operation and 1，3，5 days on the first day and the first day after operation.Results The operative time，intraoperative blood loss，incision length，and acetabular prosthesis aberrations were significantly different between the DAA group and the PLA group (P＜0.05)，the rest of the general data showed no significant difference (P＞0.05).The levels of CRP，IL-1 and TNF-α in the serum of the two groups were higher than those before the first day，and reached the peak at 3 days after operation.The difference was statistically significant (P＜0.05).The changes of serum levels of CPR，IL-1，TNF-α，CK in the group DAA and group PLA were similar over time，but the levels of IL-1，TNF-α and CK in the DAA group were significantly lower than those in the group PLA.Conclusion The levels of CRP，IL-1，TNF-α and CK in the serum of patientsachieved the highest on the third day after operation，which suggests that 3daysafter operation is the critical period for anti-inflammatory treatment after total hip replacement.The levels of IL-1，TNF- and CK in DAA group were lower，suggesting that DAA has less soft tissue injury than PLA，and the rate of acute aseptic inflammation is lower.Moreover，DAA incisionhas shorter length，shorter operation time and less bleeding during operation.DAA treatment is superior to PLA.

Key words： arthroplasty replacement hip surgical approach direct anterior approach serology creatine kinase

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［1］Repantis T，Bouras T，Korovessis P.Comparison of minimally invasive approach versus conventional anterolateral approach for total hip arthroplasty：arandomized controlled trial［J］.Eur J Orthop Surg Traumatol，2015，25(1)：111-116.
［2］Zawadsky MW，Paulus MC，Murray PJ，et al.Early outcome comparison between the direct anterior approach and the mini-incision posterior approach forprimary total hip arthroplasty：150 consecutive cases［J］.J Arthroplasty，29(6)：1256-1260.
［3］陈戎波，王仁，李小建，等.改良前外侧入路对老年股骨颈骨折行髋关节置换术的安全性分析［J］.中国骨与关节损伤杂志，2014，29 (4)：376-377.
［4］桑伟林，朱力波，陆海明，等.直接前入路与后外侧入路全髋关节置换术的对比研究［J］.中华关节外科杂志(电子版)，2015，9(5)：584-588.
［5］Barrett WP，Turner SE，Leopold JP.Prospective randomized study of directanteriorvspostero-lateral approach for total hip arthroplasty［J］.J Arthroplasty，2013，28(9)：1634-1648.
［6］Wagner F，Wagner K，Weber S，et al.Inflammatory effects of hypothermia and inhaled H2S during resuscitated，hyperdynamic murine septic shock［J］.Shock (Augusta，Ga.)，2011，35(4)：396-402.
［7］王飞，刘克敏.膝关节创伤后炎性细胞因子变化的研究现状［J］.中国康复理论与实践，2013，19(6)：501-504.
［8］梅晓亮，郭亭，赵建宁.全髋关节置换术后血清炎性因子表达特点及临床意义［J］.中国骨伤，2011，24(6)：463-465.
［9］Ng LG，Sutherland AP，Newton R，et al.B cellactivating factor belonging to the TNF family (BAFF)-R is theprincipal BAFF receptor facilitating BAFF costimulation of circulating T and Bcells［J］.J Immunol，2004，173(2)：807-817.
［10］Kaye AD，Hoover JM，Baluch AR.A contemporary review of multiple organfailure［J］.Middle East J Anaesthesiol，2005，18(2)：273-292.
［11］Bergin PF，Doppelt JD，Kephart CJ，et al.Comparison of minimally invasive directanterior versus posterior total hip arthroplasty based on inflammation and muscledamage markers［J］.J Bone Joint Surg (Am)，2011，93(15)：1392-1398.
［12］董群，董杰，王海诚.剧烈运动后血清肌酸激酶及其同功酶的变化［J］.中国临床康复，2005，9(48)：173.
［13］Kopp J，LoosB，SpilkerG.Correlation between serum creatinine kinase levels and extent of muscle damage in electrical burns［J］.Burns：Journal of the International Society for Burn Injuries，2004，30(7)：680-683.
［14］Strecker W，Gebhard F，Perl M，et al.Biochemical characterization of individual injury pattern and injury severity［J］.Injury，2003，34(12)：879-887.
［15］Smith-Petersen MN.Evolution of mouldarthroplasty of the hip joint by M.N.Smith-Petersen［J］.Clin Orthop Relat Res，1978 (134)：5-11.