目的 对比侧卧位直接前入路（DAA）与平卧位改良前外侧入路（MAASP）在单侧全髋关节 置换术中的效果。方法 选取 76 例拟行单侧全髋关节置换术的患者，采用随机数字表分为 A 组和 B 组 （各 38 例）。A 组采用侧卧位 DAA 实施全髋关节置换术，B 组采用 MAASP 实施全髋关节置换术。对比手术指标（手术时间、术中出血量、切口长度、术后首次下床活动时间、术后住院时间），术后 1、3、7 d 疼痛程度，术后髋臼前倾角、双下肢长度差异，术后 3、6 个月、1 年髋关节功能评分和术后 1 年内并发症。 结果 B 组手术时间、切口长度、术后首次下床活动时间、术后住院时间均短于 A 组（P < 0.05），术中出血 量少于 A 组（P < 0.05）；两组术后 3、7 d 疼痛评分均低于术后 1 d（P < 0.05），术后 7 d 疼痛评分均低于术后 3 d（P < 0.05），B 组术后 1、3、7 d 疼痛评分均低于 A 组（P < 0.05）；术后 3、6 个月、1 年两组间髋关节功能评 分和术后 1 年内并发症差异均无统计学意义（P > 0.05）。结论 侧卧位 DAA 与 MAASP 在单侧全髋关节置 换术中应用均可促进髋关节功能恢复，但后者创伤小、术后恢复快、疼痛轻。 

Objective To compare the clinical outcomes of direct anterior approach（DAA）in lateral position and modified anterolateral approach in supine position （MAASP）in unilateral total hip replacement. Methods 76 patients who were to undergo unilateral total hip replacement were enrolled，and they were randomly divided into group A and group B（38 cases each）. Total hip replacement with DAA in lateral position was performed in group A，while total hip replacement with MAASP was performed in group B. The operative indexes（operation time，intraoperative hemorrhage，incision length，first time out of bed activity time，postoperative hospital stay time），postoperative pain levels at 1，3 d and 7 d after operation，acetabular anteversion and lower limb length difference after operation，hip function scores at 3，6 months and 1 year after operation and complications with in 1 year were compared between the two groups. Results The operation time，incision length，the first time of getting out of bed after operation and the time of hospitalization in group B were shorter than those in group A（P < 0.05）， and the amount of intraoperative bleeding was less than that in group A（P < 0.05）. The pain scores at 3 d and 7 d after operation were lower than those at 1 d after operation in both groups（P < 0.05），and the pain scores at 7 d after surgery were lower than those at 3 d after operation（P < 0.05），and the pain scores at 1，3 d and 7 d after operation in group B were lower than those in group A（P < 0.05）. There were no statistical differences in hip joint function scores at 3 months，6 months and 1 year after operation and complications within 1 year between the two groups （P > 0.05）. Conclusion DAA in lateral position and MAASP can both increase hip joint function recovery，but the latter is less traumatic，recovers faster，and has less postoperative pain.