本文關(guān)鍵詞： 全膝關(guān)節(jié)置換 個(gè)性化 截骨模板 下肢力線 髖-膝-踝角　出處：《貴州醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:1、探討個(gè)性化截骨導(dǎo)航模板輔助膝關(guān)節(jié)置換手術(shù)與傳統(tǒng)置換手術(shù)的臨床療效;2、尋找一種標(biāo)準(zhǔn)化、適宜推廣普及的TKA手術(shù)方式。方法:選擇貴州省骨科醫(yī)院2015年6月一2016年12月行全膝關(guān)節(jié)置換術(shù)(TKA)21例21膝重度骨性關(guān)節(jié)炎患者,采用定制3D個(gè)性化截骨模板輔助TKA(3D組),同期隨機(jī)選擇22例22膝患者采用傳統(tǒng)手術(shù)方式行TKA(傳統(tǒng)組)。兩組患者的年齡、性別、術(shù)前站立負(fù)重位影像學(xué)(X線)冠狀位股骨和脛骨機(jī)械軸的夾角(髖-膝-踝角)、術(shù)前HSS評(píng)分上無(wú)統(tǒng)計(jì)學(xué)意義;記錄兩組患者手術(shù)時(shí)間、顯性出血量(術(shù)中出血量+術(shù)后傷口引流量)、術(shù)后髖-膝·踝角、術(shù)后脛骨后傾角和術(shù)后3月HSS評(píng)分。結(jié)果:顯性出血量3D組為(259.5±40.4)ml,傳統(tǒng)組(396.8±50.8)ml,差異比較具有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后下肢力線髖-膝-踝角3D組為(1.01±0.33)°,傳統(tǒng)組為(2.32±0.47)°,術(shù)后脛骨后傾角 3D 組為(2.93±0.08)°,傳統(tǒng)組為(4.02±0.41)°,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后3月HSS評(píng)分3D組為(92.7±0.2),傳統(tǒng)組為(91.0±0.5),兩組差異比較具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:3D打印個(gè)性化截骨導(dǎo)航模板輔助TKA手術(shù)操作簡(jiǎn)便,具有能提高下肢力線的精確性,縮短手術(shù)時(shí)間,減少出血、良好功能等優(yōu)勢(shì),適宜推廣普及。
[Abstract]:Objective: to explore the clinical effect of individualized osteotomy and navigation template for knee arthroplasty and to find out a kind of standardization. Methods: 21 cases of 21 patients with severe osteoarthritis of knee were treated with total knee arthroplasty in Guizhou Orthopaedic Hospital on June 1st 2015 and December 2016. A customized 3D osteotomy template was used to assist the TKA(3D group. 22 patients with 22 knees were randomly selected to perform TKA with traditional surgical methods at the same time. The age and sex of the patients in the two groups were compared. The angle of the mechanical axis of femur and tibia in coronal position (hip knee ankle angle) had no statistical significance in preoperative HSS score. Dominant bleeding volume (intraoperative bleeding volume, postoperative wound drainage volume, postoperative hip, knee and ankle angle, Postoperative tibial posterior inclination and HSS score on March. Results: the dominant bleeding volume was 259.5 鹵40.4ml in 3D group, 396.8 鹵50.8ml in traditional group, the difference was statistically significant (P 0.05), the force line of lower extremity was 1.01 鹵0.33 擄in 3D group, 2.32 鹵0.47 擄in traditional group, and 2.32 鹵0.47 擄in traditional group. The obliquity of 3D group was 2.93 鹵0.08 擄, and that of traditional group was 4.02 鹵0.41 擄, the difference was statistically significant (P 0.05), the HSS score of 3D group was 92.7 鹵0.2% on March, and that of traditional group was 91.0 鹵0.5 擄. The difference between the two groups was statistically significant (P 0.05). It has the advantages of improving the accuracy of the force line of the lower limb, shortening the operation time, reducing the bleeding, good function and so on, so it is suitable for popularization.
【學(xué)位授予單位】：貴州醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.4

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