發(fā)布時(shí)間：2018-03-19 00:25

  本文選題：肩鎖關(guān)節(jié)脫位　切入點(diǎn)：鎖骨鉤板　出處：《新鄉(xiāng)醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：背景肩鎖關(guān)節(jié)脫位是骨科各種創(chuàng)傷疾病中較為常見的疾病類型之一,其臨床發(fā)病率呈現(xiàn)出逐年升高的趨勢,故對于肩鎖關(guān)節(jié)脫位的相關(guān)臨床研究具有重要的現(xiàn)實(shí)意義和研究價(jià)值。目前重度肩鎖關(guān)節(jié)脫位(Rockwood III型及以上),常規(guī)保守治療效果不佳,首選的治療方法以手術(shù)治療為主。近年來,應(yīng)用鎖骨鉤板治療急性肩鎖關(guān)節(jié)脫位逐漸成為一種成熟、標(biāo)準(zhǔn)的治療方案,主要包括傳統(tǒng)切口植入鎖骨鉤板和經(jīng)皮植入鎖骨鉤板。但是傳統(tǒng)手術(shù)切口放置鎖骨鉤板的創(chuàng)傷較大,術(shù)后恢復(fù)周期較長,為優(yōu)化手術(shù)操作,加快術(shù)后康復(fù),本研究總結(jié)臨床實(shí)踐經(jīng)驗(yàn),采用兩種手術(shù)方法治療急性肩鎖關(guān)節(jié)脫位并進(jìn)行比較分析。目的通過經(jīng)皮植入鎖骨鉤板與傳統(tǒng)切口植入鎖骨鉤板治療急性肩鎖關(guān)節(jié)脫位的臨床療效差異比較,優(yōu)化鎖骨鉤板治療急性肩鎖關(guān)節(jié)脫位的手術(shù)操作,以期達(dá)成急性肩鎖關(guān)節(jié)脫位患者的術(shù)后快速康復(fù)。為急性肩鎖關(guān)節(jié)脫位患者提供療效更佳的治療方法,同時(shí)也為急性肩鎖關(guān)節(jié)脫位臨床研究提供可靠依據(jù)。方法選取我院2013年12月至2015年12月期間收治的急性肩鎖關(guān)節(jié)脫位患者124例為本次研究的調(diào)查對象,按照患者給予手術(shù)治療方法的不同將患者分成了研究組(68例)和對照組(56例)。研究組68例患者給予經(jīng)皮植入鎖骨鉤板的方式進(jìn)行治療,對照組56例患者給予傳統(tǒng)切口植入鎖骨鉤板的方式進(jìn)行治療。觀察和比較兩組患者實(shí)施不同手術(shù)方式治療后的手術(shù)切口長度(cm)、手術(shù)時(shí)間(min)、術(shù)中出血量(ml)以及臨床綜合療效。結(jié)果(1)比較兩組患者實(shí)施不同手術(shù)治療方法后的切口長度、手術(shù)時(shí)間和術(shù)中出血量三項(xiàng)指標(biāo)。研究組患者的切口長度為(3.48±0.33)cm,對照組患者的切口長度為(7.41±0.86)cm;研究組患者的手術(shù)時(shí)間為(50.34±7.43)min,對照組患者的手術(shù)時(shí)間為(57.86±10.34)min;研究組患者的術(shù)中出血量為(60.34±9.23)ml,對照組患者術(shù)中出血量為(69.36±9.46)ml,兩組進(jìn)行比較,差異均具有明顯的統(tǒng)計(jì)學(xué)意義(P均0.05);(2)研究組患者實(shí)施手術(shù)治療后的臨床整體優(yōu)良率為94.12%;對照組患者實(shí)施手術(shù)治療后的臨床整體優(yōu)良率為82.14%。兩組患者實(shí)施不同手術(shù)治療后的臨床整體優(yōu)良率組間比較,研究組患者的臨床整體優(yōu)良率水平顯著高于對照組患者。組間數(shù)據(jù)比較差異具有顯著統(tǒng)計(jì)學(xué)意義(χ2=4.3968,P=0.0360)。結(jié)論與傳統(tǒng)手術(shù)切口植入鎖骨鉤鋼板相比,經(jīng)皮植入鎖骨鉤板治療急性肩鎖關(guān)節(jié)脫位具有良好的臨床療效,手術(shù)操作簡便、手術(shù)時(shí)間短、手術(shù)出血量少、術(shù)后切口美觀度高、并發(fā)癥少,具有良好的臨床應(yīng)用價(jià)值和推廣價(jià)值。
[Abstract]:Background dislocation of acromioclavicular joint is one of the most common types of trauma diseases in orthopedic department, and its clinical incidence is increasing year by year. Therefore, it has important practical significance and research value for the clinical study of acromioclavicular joint dislocation. At present, Rockwood III type and above type of severe acromioclavicular dislocation, routine conservative treatment is not good. In recent years, the treatment of acute acromioclavicular dislocation with clavicular hook plate has gradually become a mature and standard treatment. The traditional incision was mainly used to implant clavicle hook plate and percutaneous clavicle hook plate, but the wound of clavicular hook plate placement in traditional surgical incision was larger and the recovery period was longer. In order to optimize the operation and accelerate the postoperative recovery, This study summarizes the clinical experience, Two kinds of surgical methods were used to treat acute acromioclavicular dislocation. Objective to compare the clinical effects of percutaneous clavicular hook plate implantation and traditional incision clavicular hook plate implantation in the treatment of acute acromioclavicular dislocation. To optimize the operative procedures of clavicular hook plate for the treatment of acute acromioclavicular dislocation, in order to achieve a rapid recovery after operation, and to provide a better therapeutic method for the patients with acute acromioclavicular dislocation. Methods 124 patients with acute acromioclavicular dislocation admitted from December 2013 to December 2015 were selected as the subjects of this study. The patients were divided into study group (n = 68) and control group (n = 56) according to the different methods of surgical treatment. In study group, 68 patients were treated by percutaneous implantation of clavicle hook plate. 56 patients in the control group were treated with traditional incision implantation of clavicle hook plate. The length of incision, the time of operation and the volume of blood loss during operation were observed and compared between the two groups. Results 1) the incision length of the two groups after different surgical treatment was compared. The length of incision was 3.48 鹵0.33 cm in the study group, 7.41 鹵0.86 cm in the control group, 50.34 鹵7.43 min in the study group and 57.86 鹵10.34 min in the control group. The volume of middle bleeding was 60.34 鹵9.23 ml, while that of control group was 69.36 鹵9.46 ml. The overall excellent and good rate was 94.12 in the study group and 82.14 in the control group. Comparison of the overall clinical excellent and good rates after treatment, The overall excellent and good rate of the patients in the study group was significantly higher than that in the control group. There was a significant difference between the two groups (蠂 2 4.3968 P < 0.03600.Conclusion compared with the traditional surgical incision, the clavicle hook plate was implanted into the clavicle hook plate. Percutaneous clavicular hook plate implantation in the treatment of acute acromioclavicular joint dislocation has a good clinical effect, the operation is simple, the operation time is short, the amount of operative bleeding is less, the postoperative incision aesthetic degree is high, the complication is less. It has good clinical application value and popularizing value.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4

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