本文選題：股骨頭缺血性壞死 + 亨格福德和倫諾克斯分期法�。� 參考：《廣州中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：目的： 采用MRI掃描圖像,探討股骨頭缺血性壞死在磁共振上的分期與壞死指數(shù)之間的相關(guān)性,并尋找股骨頭塌陷的臨界點(diǎn),以期為臨床利用MRI圖像預(yù)測(cè)股骨頭塌陷提供更全面的參考標(biāo)準(zhǔn)。 方法： 回顧分析2012年7月至2014年1月69例(共100髖)在我科經(jīng)磁共振檢查可確診為股骨頭缺血性壞死而且圖像可以顯示明確分期的病患,對(duì)每一個(gè)缺血性壞死股骨頭的MRI圖像依照Hungerford和Lennox制定的五期分法進(jìn)行分期,另采用Koo等提出的壞死指數(shù)法計(jì)算公式算出每一個(gè)股骨頭的壞死指數(shù),將分期與壞死指數(shù)對(duì)應(yīng)起來(lái),運(yùn)用統(tǒng)計(jì)學(xué)的方法對(duì)二者進(jìn)行分析,探討二者間存在的關(guān)系,并確定股骨頭塌陷的臨界點(diǎn)。 結(jié)果： Ⅰ期股骨頭缺血性壞死34髖,壞死指數(shù)為0.32±0.20(95%CI：0.25～0.39),Ⅱ期股骨頭缺血性壞死32髖,壞死指數(shù)均值為0.49±0.17(95%CI：0.43～0.55),Ⅲ期股骨頭缺血性壞死18髖,壞死指數(shù)均值為0.62±0.18(95%CI：0.53～0.71),Ⅳ期股骨頭缺血性壞死16髖,壞死指數(shù)均值為0.83±0.23(95%CI：0.70～0.95),各期股骨頭壞死指數(shù)經(jīng)顯著性檢驗(yàn),差異有統(tǒng)計(jì)學(xué)意義(P0.05),snk法對(duì)任意兩期壞死指數(shù)均值差的統(tǒng)計(jì)學(xué)分析結(jié)果顯示工期與Ⅱ期壞死指數(shù)均值差為-0.17,Ⅰ期與Ⅲ期壞死指數(shù)均值差為-0.30,Ⅰ期與Ⅳ期壞死指數(shù)均值差為-0.51,Ⅱ期與Ⅲ期壞死指數(shù)均值差為-0.13,Ⅱ期與Ⅳ期壞死指數(shù)均值差為-0.33,Ⅲ期與Ⅳ期壞死指數(shù)均值差為-0.21,利用SNK法對(duì)以上任意兩期均值差進(jìn)行分析,結(jié)果顯示任意兩組差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。Ⅱ期(無(wú)塌陷)僅3髖壞死指數(shù)0.53,Ⅲ期(開(kāi)始塌陷)各髖壞死指數(shù)均0.53。 結(jié)論： 在MRI圖像上,股骨頭缺血性壞死的壞死指數(shù)隨著分期推進(jìn)而增大；壞死指數(shù)0.53可作為股骨頭塌陷的參考臨界值,在MRI分期不明確的情況下,結(jié)合壞死指數(shù)可以為臨床預(yù)測(cè)股骨頭塌陷提供更全面的信息。
[Abstract]:Objective: The correlation between MRI staging and necrosis index of avascular necrosis of femoral head was studied by using MRI scanning image, and the critical point of collapse of femoral head was found. In order to provide a more comprehensive reference standard for clinical prediction of femoral head collapse using MRI images. Methods: From July 2012 to January 2014, 69 cases (100 hips) with avascular necrosis of the femoral head diagnosed by MRI in our department were analyzed retrospectively. The MRI images of each avascular necrosis of femoral head were divided into five stages according to Hungerford and Lennox. The necrosis index of each femoral head was calculated by using the formula of necrosis index proposed by Koo et al. The statistical method was used to analyze the relationship between them and to determine the critical point of the collapse of the femoral head. Results: There were 34 hips with avascular necrosis of femoral head in stage 鈪，

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