發(fā)布時間：2018-04-11 11:29

  本文選題：發(fā)育性髖關(guān)節(jié)發(fā)育不良 + 直接前入路人工髖關(guān)節(jié)置換��； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探討直接前入路全髖關(guān)節(jié)置換術(shù)(DAA)及常規(guī)后外側(cè)入路全髖關(guān)節(jié)置換術(shù)(PLA)兩種術(shù)式治療成人髖關(guān)節(jié)發(fā)育不良繼發(fā)骨性關(guān)節(jié)炎(Crowe分型I-II型)的近期臨床療效及其臨床差異性。方法:對本研究中因患先天性髖臼發(fā)育不良繼發(fā)骨性關(guān)節(jié)炎在江蘇省中醫(yī)院接受直接前入路全髖關(guān)節(jié)置換術(shù)和常規(guī)后外側(cè)入路全髖關(guān)節(jié)置換術(shù)的患者各10例(DAA組10例,PLA組10例)進行完整的術(shù)后隨訪。所有手術(shù)均由同一手術(shù)者完成。PLA組平均隨訪時間為9.3個月,DAA組平均隨訪時間8.6個月,均獲得了較為完整的術(shù)后隨訪。應(yīng)用SPSS16.0統(tǒng)計軟件進行統(tǒng)計分析并比較兩組患者手術(shù)前后Harris評分、失血量、術(shù)后血紅蛋白下降水平及脫位率等數(shù)據(jù)。結(jié)果:DAA組和PLA組療效均令人滿意,至末次隨訪時所有患者均未出現(xiàn)感染、假體松動等術(shù)后并發(fā)癥。兩組患者術(shù)前Harris評分并無明顯差異(PLA組:55.7±2.75,DAA組:56.1 土2.81,Z=-0.306,P0.05)。隨訪結(jié)果表明,兩組患者術(shù)后Harris評分均較術(shù)前明顯改善(PLA組:術(shù)前 55.7±2.75,術(shù)后 74.2±4.71,P0.05;DAA組:術(shù)前 56.1±2.81,術(shù)后83.2土4.29,P0.05)。與PLA組相比,DAA組術(shù)后隨訪結(jié)果Harris評分較高(PLA組:74.2±4.71,DAA 組:83.2±4.29,P0.05),出血量較少(PLA 組:256.00±74.72,DAA 組:167.50±32.25,P0.05),術(shù)后血紅蛋白下降較少(PLA 組:29.30±12.88,DAA組:15.90±8.53,P0.05),術(shù)后脫位率低(PLA組:脫位1人;DAA組:無脫位)。DAA組患者術(shù)后髖關(guān)節(jié)Harris評分、脫位率、出血量、血紅蛋白下降量均優(yōu)于PLA組。結(jié)論:對于髖關(guān)節(jié)發(fā)育不良繼發(fā)骨性關(guān)節(jié)炎(Crowe分型I-II型)患者來說,DAA具有創(chuàng)傷小、出血少、脫位率低、功能恢復(fù)快、早期關(guān)節(jié)活動度更優(yōu)等優(yōu)點。
[Abstract]:Objective: to investigate the clinical efficacy and clinical difference of direct anterior approach total hip replacement (DAA) and conventional posterolateral approach total hip replacement (I-II) in the treatment of adult hip dysplasia secondary osteoarthritis (Osteoarthritis).Methods: ten patients with osteoarthritis secondary to congenital acetabular dysplasia received direct anterior approach total hip replacement and routine posterolateral approach total hip replacement in Jiangsu Provincial Hospital of traditional Chinese Medicine (Jiangsu Provincial Hospital of traditional Chinese Medicine).10 cases of PLA group (n = 10) were followed up completely.All the operations were performed by the same person. The average follow-up time of PLA group was 9.3 months and the average follow-up time of DAA group was 8.6 months.The data of Harris score, blood loss, hemoglobin level and dislocation rate before and after operation were analyzed by SPSS16.0 software and compared between the two groups.Results the curative effect of the two groups was satisfactory. No infection, loosening of prosthesis and other postoperative complications were found in all the patients at the last follow-up.There was no significant difference in preoperative Harris score between the two groups.The follow-up results showed that the postoperative Harris scores in both groups were significantly improved compared with those before operation: 55.7 鹵2.75 preoperatively, 74.2 鹵4.71 P0.05A, 56.1 鹵2.81 preoperatively and 83.2 鹵4.29p 0.05m postoperatively.Harris score of hip joint after operation,The rate of dislocation, the amount of bleeding and the decrease of hemoglobin were better than those of PLA group.Conclusion: for the patients with secondary osteoarthritis with dysplasia of hip (I-II type), it has the advantages of less trauma, less bleeding, lower dislocation rate, faster functional recovery and better early joint motion.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4

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本文編號：1735845