發(fā)布時(shí)間：2018-09-05 09:57

【摘要】：目的系統(tǒng)評(píng)價(jià)骨盆截骨術(shù)治療Perthes病,揭示預(yù)后特征,為科學(xué)評(píng)價(jià)骨盆截骨術(shù)提供依據(jù)。方法檢索Pubmed、Embase、Cochrane library、Web of science、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)、中國知網(wǎng)(CNKI)、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫,收集國內(nèi)外骨盆截骨術(shù)治療Perthes病的相關(guān)研究,依據(jù)美國醫(yī)療保健研究與質(zhì)量局(Agency for Healthcare Research and Quality,AHRQ)對(duì)橫斷面研究的評(píng)價(jià)標(biāo)準(zhǔn)進(jìn)行質(zhì)量評(píng)價(jià),整理提取數(shù)據(jù),采用Meta-analyst軟件進(jìn)行meta分析。結(jié)果1.根據(jù)Stulberg分級(jí)評(píng)價(jià)標(biāo)準(zhǔn),結(jié)果分析表明2-16歲的Perthes病患者行骨盆截骨術(shù)后隨訪2.6-15.2年,Stulberg I級(jí)的患者為19.2%,II級(jí)的患者為38.0%,III級(jí)的患者為27.5%,IV級(jí)的患者為17.2%,V級(jí)的患者為4.0%;根據(jù)Mose分級(jí)評(píng)價(jià)標(biāo)準(zhǔn),結(jié)果分析表明2-14歲的Perthes病患者行骨盆截骨術(shù)后隨訪1.5-9.0年,Mose分級(jí)為“優(yōu)”的患者為52.4%,“良”的患者為25.0%,“差”的患者為20.3%。2.根據(jù)Mckay髖關(guān)節(jié)功能分級(jí)評(píng)價(jià)標(biāo)準(zhǔn),分析結(jié)果表明3-14歲的Perthes病患者行骨盆截骨術(shù)后隨訪1.0-6.5年,Mckay髖關(guān)節(jié)功能分級(jí)“優(yōu)”的患者為88.5%,“良”的患者為9.9%,“可”的患者為3.3%,“差”的患者為0.8%。3.Meta分析不良癥狀(雙下肢不等長、跛行、Trendelenburg征)結(jié)果表明:2-17歲的Perthes病患者行骨盆截骨術(shù)后隨訪2.8-15.2年,殘留雙下肢不等長的患者為24.1%;2-17歲行骨盆截骨術(shù)后隨訪2.8-6.9年殘留Trendelenburg征(+)的患者為19.6%;2-17歲行骨盆截骨術(shù)后隨訪3.0-6.5年殘留跛行的患者為40.3%。結(jié)論1.按Stulberg分級(jí)、Mose分級(jí)評(píng)價(jià)標(biāo)準(zhǔn),骨盆截骨術(shù)后可有效緩解患者臨床癥狀,并延遲或降低遠(yuǎn)期骨關(guān)節(jié)炎的發(fā)生率。2.按Mckay髖關(guān)節(jié)分級(jí)評(píng)價(jià)標(biāo)準(zhǔn),骨盆截骨術(shù)對(duì)緩解髖關(guān)節(jié)疼痛、改善髖關(guān)節(jié)功能效果較好。3.Meta分析表明骨盆截骨術(shù)后殘留較多的不良癥狀有跛行、Trendelenburg征(+)及雙下肢不等長。
[Abstract]:Objective to evaluate the effect of pelvic osteotomy in the treatment of Perthes's disease, and to reveal the prognostic features, and to provide scientific basis for the evaluation of pelvic osteotomy. Methods Pubmed,Embase,Cochrane library,Web of science, Chinese biomedical literature database (CBM), (CNKI), Wanfang database and Weip database were searched to collect the relevant research of pelvic osteotomy for Perthes disease at home and abroad. According to the (Agency for Healthcare Research and Quality,AHRQ of the United States Medical Care Research and quality Bureau, the evaluation standard of cross-sectional research was evaluated, the data was collected and the meta was analyzed by Meta-analyst software. Result 1. According to the Stulberg grading criteria, the results showed that the follow-up period of 2.6-15.2 years after pelvic osteotomy in patients with Perthes's disease aged 2-16 years was 19.2g / II, 38.0g / III and 17.2g / V respectively, according to the evaluation criteria of Mose grade. The results showed that the patients with Perthes's disease aged 2 to 14 were followed up for 1.5 to 9.0 years after pelvic osteotomy. The number of patients with "excellent", "good" and "poor" patients were 52.4, 25.0 and 20.33. 2 respectively. According to Mckay hip function grading criteria, The results showed that the patients with Perthes's disease aged 3-14 were followed up 1.0-6.5 years after pelvic osteotomy for a period of 1.0-6.5 years. The scores of "excellent", "good", "can" and "poor" patients were 88.5, 9.9, 3.3 and 3.33, respectively, and those with "poor" and "poor" were analyzed for adverse symptoms by 0.8%.3.Meta. (lower limbs are unequal in length, The results of Trendelenburg's sign showed that patients with Perthes's disease aged 2 to 17 were followed up for 2.8-15.2 years after pelvic osteotomy. Patients with residual lower extremities of varying lengths were followed up for 2.8-6.9 years with residual Trendelenburg sign (2.8-6.9 years) in patients aged from 2 to 17 years. The patients with residual claudication of 3.0-6.5 years after pelvic osteotomy at the age of 19.6 and 17 years were followed up by pelvic osteotomy for 3.0-6.5 years and 40.3% of the patients were followed up after pelvic osteotomy. Conclusion 1. According to the criteria of Stulberg grade and Mose grade, pelvic osteotomy can effectively relieve the clinical symptoms and delay or reduce the incidence of long-term osteoarthritis. According to Mckay hip grading evaluation criteria, pelvic osteotomy was effective in relieving hip pain and improving hip joint function. 3. Meta-analysis showed that the most residual adverse symptoms after pelvic osteotomy were limping Trendelenburg sign and lower extremity.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R726.8

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