發(fā)布時間：2018-03-21 22:21

  本文選題：去神經(jīng)化治療　切入點(diǎn)：髕股　出處：《南昌大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討關(guān)節(jié)鏡下髕股關(guān)節(jié)去神經(jīng)化治療重度髕股關(guān)節(jié)炎的效果,以此來促進(jìn)臨床治療。方法:回顧我們對2012年1月至2016年1月在我院就診的44例以膝前痛為主訴,上下樓梯和蹲起時疼痛更為明顯的患者,男性患者18例,女性患者26例,年齡49-68歲,平均年齡58.7歲,平均病程2.8年,在獲得患者同意情況下對患者進(jìn)行髕股關(guān)節(jié)下清理+微骨折+髕骨成形+外側(cè)支持帶松解+髕股關(guān)節(jié)周圍去神經(jīng)化手術(shù)及術(shù)后隨訪分析,術(shù)前、術(shù)后6個月分別行FELLER髕骨評分、Lysholm評分、Kujala膝關(guān)節(jié)評分標(biāo)準(zhǔn),行股骨肌肉群肌電圖檢查并拍攝髕骨軸位片,與術(shù)前進(jìn)行比較,評估髕骨軌跡糾正情況。觀察有無髕骨內(nèi)側(cè)脫位及反射性神經(jīng)營養(yǎng)不良和缺血壞死等并發(fā)癥發(fā)生,并統(tǒng)計(jì)患者的臨床療效和股骨肌肉群活動時表面肌電測試。計(jì)量資料組間比較采用t檢驗(yàn),組內(nèi)比較采用配對t檢驗(yàn),計(jì)數(shù)資料采用2?檢驗(yàn),P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:術(shù)后平均隨訪16.5個月,術(shù)后無感染或神經(jīng)、血管損傷、髕骨內(nèi)側(cè)脫位等并發(fā)癥發(fā)生。術(shù)前、術(shù)后均采用FELLER髕骨評分、Lysholm評分、Kujala膝關(guān)節(jié)評分標(biāo)準(zhǔn),手術(shù)前后評分差異有統(tǒng)計(jì)學(xué)意義P≤0.05。在研究組股骨肌肉群活動時表面肌電測試中有43例患者都取得了效果,擁有97.73%的總有效率,與術(shù)前比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:我們通過關(guān)節(jié)鏡下髕股關(guān)節(jié)去神經(jīng)化治療,髕骨成形和外側(cè)支持帶松解,能明顯緩解并改善患者癥狀,達(dá)到治療目的。
[Abstract]:Objective: to investigate the effect of arthroscopic denervation of patellofemoral joint in the treatment of severe patellofemoral arthritis. Methods: from January 2012 to January 2016, 44 patients with anterior knee pain were reviewed. There were 18 male patients and 26 female patients, aged 49-68 years, with an average age of 58.7 years and an average duration of 2.8 years. The patients were treated with subpatellofemoral debridement with the consent of the patients. The lateral retinaculum of patelloplasty was loosened around patellofemoral joint and followed up before operation. Six months after operation, FELLER patella score and Lysholm score and Kujala knee joint scoring standard were performed respectively. The femur muscle group electromyography was performed and patellar axial radiographs were taken, and the results were compared with those before operation. To evaluate the correction of patellar locus and to observe the occurrence of complications such as medial dislocation of patella, reflex neurodystrophy and ischemic necrosis. The clinical efficacy and surface electromyography of femur muscle group were measured. T test was used to compare measurement data, matched t test was used for intragroup comparison, and 2? Results: there was no infection, nerve, vascular injury, medial dislocation of patella and other complications after operation for an average of 16.5 months. FELLER patella score and Lysholm score and Kujala knee scoring standard were used after operation. There was a significant difference before and after operation (P 鈮，

本文編號：1645828