本文選題：3D打印技術(shù) + 膝骨關(guān)節(jié)炎　； 參考：《遼寧中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:觀察、分析、研究對嚴重膝骨關(guān)節(jié)炎患者應(yīng)用3D打印截骨導(dǎo)板技術(shù)輔助進行人工全膝關(guān)節(jié)置換術(shù)的臨床應(yīng)用效果與價值及對3D打印技術(shù)輔助人工全膝關(guān)節(jié)置換術(shù)的應(yīng)用前景進行簡單評價。術(shù)后使用艾葉散熏洗配合功能練習(xí),探究艾葉散是否有助于患者的功能康復(fù)。方法:于2013年11月至2015年12月在我院初次行單側(cè)人工全膝關(guān)節(jié)置換術(shù)的膝骨關(guān)節(jié)炎患者中隨機抽取60例進行觀察、分析、研究。其中,男21例,女39例;年齡在55-80歲,平均(68.83±7.16)歲。于應(yīng)用3D打印截骨導(dǎo)板輔助人工全膝關(guān)節(jié)置換術(shù)的患者中隨機抽取30例,再從常規(guī)行人工全膝關(guān)節(jié)置換術(shù)的患者中隨機抽取30例,構(gòu)成兩組進行對照研究。一組為應(yīng)用3D打印截骨導(dǎo)板進行人工全膝關(guān)節(jié)置換術(shù),另一組為對照組,采用常規(guī)手術(shù)操作進行人工全膝關(guān)節(jié)置換術(shù)。分別記錄兩組的手術(shù)時間、術(shù)中及術(shù)后的總出血量(總出血量為術(shù)中出血量與術(shù)后為引流量的總和)、術(shù)后膝關(guān)節(jié)功能改善情況,進行分析、比較,并且評估兩組的手術(shù)并發(fā)癥發(fā)生概率。兩組術(shù)后均在醫(yī)生指導(dǎo)下按康復(fù)計劃配合艾葉散熏洗進行功能康復(fù)練習(xí)。從60例在沈陽市骨科醫(yī)院由同一術(shù)者及團隊進行初次單側(cè)人工全膝關(guān)節(jié)置換術(shù)的樣本中隨機抽取10例行艾葉散熏洗配合功能練習(xí)的患者進組,為實驗組,抽取10例未行艾葉散熏洗配合功能練習(xí)的患者進組,為對照組,進行隨機對照實驗,評估配合艾葉散熏洗進行功能康復(fù)練習(xí)的效果。此次研究采用美國膝關(guān)節(jié)協(xié)會評分(American the knee society knee score,KSS)KSS評分方法對全膝關(guān)節(jié)置換術(shù)后膝關(guān)節(jié)及功能進行評分。采用SPSS統(tǒng)計學(xué)軟件進行統(tǒng)計學(xué)的分析和處理,通過t檢驗、x2檢驗統(tǒng)計學(xué)分析來統(tǒng)計相關(guān)數(shù)據(jù),以P0.05表示差異有統(tǒng)計學(xué)意義。結(jié)果:兩組術(shù)后的膝關(guān)節(jié)KSS評分比兩組術(shù)前的膝關(guān)節(jié)KSS評分及功能評分均有所提高,均為P0.05,其差異有統(tǒng)計學(xué)意義。對兩組之間術(shù)后膝關(guān)節(jié)KSS評分及功能評分的得分進行比較,并無明顯區(qū)別,P0.05,其差異無統(tǒng)計學(xué)意義。兩組均未出現(xiàn)手術(shù)并發(fā)癥。3D組的手術(shù)耗費時間小于常規(guī)組的手術(shù)耗費時間,運用統(tǒng)計學(xué)t檢驗方式得出,P0.05,其差異有統(tǒng)計學(xué)意義。3D組手術(shù)的總出血量少于常規(guī)組,通過統(tǒng)計學(xué)t檢驗方式得出,P0.05,其差異有統(tǒng)計學(xué)意義。術(shù)后使用艾葉散熏洗配合功能練習(xí),經(jīng)患者自訴,痛楚感減輕,肌肉緊張感減輕,可使患者更加主動進行功能練習(xí),但其無差異無統(tǒng)計學(xué)意義,P0.05。結(jié)論:人工全膝關(guān)節(jié)置換術(shù)可有效改善嚴重膝骨關(guān)節(jié)炎患者的膝關(guān)節(jié)功能,免除難以忍受的疼痛,提高患者生活質(zhì)量。3D打印截骨導(dǎo)板輔助進行人工全膝關(guān)節(jié)置換術(shù)與常規(guī)人工全膝關(guān)節(jié)置換術(shù)術(shù)后患者膝關(guān)節(jié)功能恢復(fù)情況并無明顯區(qū)別,兩者都是安全有效的嚴重膝骨關(guān)節(jié)的治療方式。但應(yīng)用3D打印截骨導(dǎo)板輔助進行人工全膝關(guān)節(jié)置換術(shù)比常規(guī)人工全膝關(guān)節(jié)置換術(shù)的手術(shù)時間耗時更少,出血總量更少,并且操作更加簡潔,相應(yīng)的使手術(shù)并發(fā)癥發(fā)生概率更小。經(jīng)患者自訴艾葉散可以減輕患者疼痛感、僵硬感,使患者可以更加主動功能練習(xí)。
[Abstract]:Objective: To observe, analyze and study the clinical effect and value of the application of 3D print osteotomy guide for total knee arthroplasty in patients with severe knee osteoarthritis, and to evaluate the application prospect of 3D printing assisted total knee arthroplasty. Methods: from November 2013 to December 2015, 60 cases of knee osteoarthritis were randomly selected from the first unilateral total knee arthroplasty in our hospital for observation, analysis and study. Among them, 21 males and 39 females, aged 55-80 years, average (68.83 + 7.16) years of age, were used in 3D printing osteotomy guide. 30 cases were randomly selected from the patients with plate assisted total knee replacement, and 30 cases were randomly selected from the conventional total knee arthroplasty, and two groups were studied. One group was used 3D print osteotomy guide for total knee replacement, and the other group was a control group. The operation time of the two groups was recorded, the total bleeding amount during and after the operation (the total amount of bleeding was the total amount of bleeding and the flow rate after the operation). After the operation, the improvement of the knee joint function was analyzed and compared, and the incidence of complications in the two groups was evaluated. The two groups were under the guidance of the rehabilitation plan under the guidance of the doctor. 60 cases were randomly selected from the sample of the same operator and team for the first unilateral total knee arthroplasty in the hospital of Shenyang Department of orthopedics. 10 cases were randomly selected from the sample of the first unilateral total knee replacement in the hospital of Shenyang Department of orthopedics. In the control group, a randomized controlled trial was conducted to evaluate the effect of functional rehabilitation exercises with the folium Artemisia. The American the Knee Society knee score, KSS KSS score was used to score the knee joint and function after total knee arthroplasty. Statistical analysis and treatment, by t test, x2 test statistical analysis to statistical data, P0.05 showed statistical significance. Results: the two groups of postoperative knee joint KSS score was higher than the two groups before the operation of the knee joint KSS score and functional scores were all P0.05, the difference was statistically significant. Between the two groups after the operation between the two groups There was no significant difference between the score of KSS and function score of the knee joint, and there was no significant difference between the two groups. The difference between the two groups was less than that of the conventional group, and the difference was statistically significant in the group.3D. The difference was statistically significant in the group.3D. The difference was statistically significant in the group.3D. The amount is less than that of the routine group, and the difference has statistical significance by the t test of statistics. The difference has statistical significance. After the operation, the use of leaf free smoking and washing with function exercises, the patient complained, the pain relief, the muscle tension lightened, can make the patient more active in functional exercise, but there is no difference in statistical significance, P0.05. conclusion: artificial total knee joint placement. It is effective to improve the knee joint function of patients with severe knee osteoarthritis, to relieve the unbearable pain, and to improve the quality of life of the patients with.3D print osteotomy guide for the rehabilitation of knee joint function after total knee replacement and conventional total knee replacement. Both are safe and effective. The treatment of severe knee osteoarthroplasty. But the use of 3D print osteotomy to assist in artificial total knee arthroplasty is less time consuming, less bleeding, more concise operation, and less probability of operation complications. The pain and stiffness make the patient more active.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R687.4;TP391.73
，

本文編號：2052560