本文選題：退變性腰椎側(cè)凸　切入點(diǎn)：矢狀面平衡　出處：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:分析退變性腰椎側(cè)凸矢狀位整體、局部影像學(xué)參數(shù)的特征及各參數(shù)之間的聯(lián)系;探討影響患者健康生存質(zhì)量的相關(guān)參數(shù)。方法:選取74例退變性腰椎側(cè)凸患者,年齡50歲,性別不限。以Lenke-Silva分型為分組依據(jù),分為輕度側(cè)凸組和重度側(cè)凸組,選取40例同年齡階段的健康體檢者作為對(duì)照組。在PACS圖像系統(tǒng)中測(cè)量三組的脊柱-骨盆矢狀位整體、局部影像學(xué)參數(shù),采用SNK檢驗(yàn)比較三組的年齡及影像學(xué)測(cè)量結(jié)果,并用Pearson相關(guān)性檢驗(yàn)分析各參數(shù)間的相關(guān)性;對(duì)所有退變性腰椎側(cè)凸患者進(jìn)行ODI及生存質(zhì)量量表SF-12問(wèn)卷自評(píng)調(diào)查,采用Pearson相關(guān)性檢驗(yàn)分析各量表評(píng)分結(jié)果與退變性腰椎側(cè)凸患者矢狀面參數(shù)的相關(guān)性。結(jié)果:多重比較檢驗(yàn)結(jié)果顯示:(1)PR-T12:對(duì)照組、輕度側(cè)凸組與重度側(cè)凸組之間PR-T12差異最為明顯,F=11.383 P=0.0000.05,差異具有統(tǒng)計(jì)學(xué)意義;(2)SVA:脊柱矢狀位失衡的發(fā)生率分別為:對(duì)照組2.0%,輕度側(cè)凸組36.0%,重度側(cè)凸組44.1%;對(duì)照組、輕度側(cè)凸組及重度側(cè)凸組的SVA差異具有統(tǒng)計(jì)學(xué)意義;(3)TK、PT、TPA:側(cè)凸組的TK值均較對(duì)照組減小,而側(cè)凸組的PT與TPA均較對(duì)照組顯著增大,且差異均具有統(tǒng)計(jì)學(xué)意義。相關(guān)性分析結(jié)果顯示:(1)PI與PT、SS的相關(guān)性依然存在,兩套骨盆參數(shù)緊密相關(guān);(2)LL與多個(gè)參數(shù)密切相關(guān)(相關(guān)系數(shù)r0.5)包括TK、SSA、SS、PR-T12、PR-S1,其中SSA與LL關(guān)系最為緊密,r=0.737。(3)SSA與TPA與各影像學(xué)參數(shù)的相關(guān)性明顯優(yōu)于SVA。HRQOL評(píng)分相關(guān)性研究顯示:SVA與HRQL的相關(guān)性強(qiáng)于PT,同時(shí)SVA還與SF-12MCS具有較弱的相關(guān)性,r=0.192,p=0.0450.05。LL在與ODI的相關(guān)性最強(qiáng),r=-0.648,p=0.0160.05。結(jié)論:1、評(píng)價(jià)退行性腰椎側(cè)凸患者脊柱-骨盆矢狀面平衡時(shí)應(yīng)重視參數(shù)TPA與PR-T12。2、SVA的平衡與合理的PT值對(duì)與退變性腰椎側(cè)凸患者的健康生存質(zhì)量具有明確意義。
[Abstract]:Objective: to analyze the sagittal position of degenerative lumbar scoliosis, the characteristics of local imaging parameters and the relationship between these parameters, and to explore the relevant parameters affecting the quality of life of the patients. Methods: 74 patients with degenerative lumbar scoliosis were selected. The age of 50 years was not limited to sex. According to Lenke-Silva classification, they were divided into mild scoliosis group and severe scoliosis group. Forty healthy persons of the same age were selected as control group. The whole spine and pelvis sagittal position and local imaging parameters were measured in the PACS imaging system. The age and imaging results of the three groups were compared by SNK test. All patients with degenerative lumbar scoliosis were investigated with ODI and quality of life (QOL) SF-12 questionnaire. Pearson correlation test was used to analyze the correlation between the scores of each scale and the sagittal parameters of patients with degenerative lumbar scoliosis. The difference of PR-T12 between mild scoliosis group and severe scoliosis group was the most obvious. The difference was statistically significant (P < 0.05). The incidence of sagittal position imbalance was: control group 2.0, mild scoliosis group 36.0, severe scoliosis group 44.1. The difference of SVA between mild and severe scoliosis group was statistically significant. The TK value of scoliosis group was lower than that of control group, while PT and TPA of scoliosis group were significantly higher than that of control group. The results of correlation analysis showed that there was still a correlation between Pi and PTSS. Two sets of pelvis parameters are closely correlated with several parameters (correlation coefficient r0.5), including TKS SSASSN PR-T12PR-S1, in which SSA and LL are most closely related to each imaging parameter. The correlation between SSA and TPA is significantly better than that of SVA.HRQOL score. The correlation between HRQL and SF-12MCS is stronger than that of PT.The correlation between SVA and SF-12MCS is weaker than that between SVA and SF-12MCS. The correlation between SVA and ODI is the strongest. Conclusion: 1, in evaluating the sagittal balance of spine and pelvis in patients with degenerative lumbar scoliosis, attention should be paid to the balance of TPA and PR-T12.2 SVA in patients with degenerative lumbar scoliosis. A reasonable PT value is significant for the healthy quality of life in patients with degenerative lumbar scoliosis.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R681.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 邱勇;;脊柱側(cè)凸矯治中的平衡原則與美學(xué)理念[J];中國(guó)脊柱脊髓雜志;2008年09期

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本文編號(hào)：1682002