本文選題：股骨近端　切入點(diǎn)：纖維結(jié)構(gòu)不良　出處：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:分析股骨近端纖維結(jié)構(gòu)不良(fibrous dysplasia of bone,FD)治療后的臨床效果,明確合理的手術(shù)方式是否可以降低纖維結(jié)構(gòu)不良患者術(shù)后的并發(fā)癥及復(fù)發(fā)。方法:回顧性選取2005年1月到2015年1月于山西醫(yī)科大學(xué)第二醫(yī)院就診治療并符合病理學(xué)診斷的股骨近端纖維結(jié)構(gòu)不良患者40例,男18例,女22例,年齡14~49歲;單側(cè)病變患者36例,雙側(cè)病變患者4例;病程1個(gè)月~8年,平均14個(gè)月,其中伴髖內(nèi)翻畸形患者3例。40例患者中,10例患者采取靜脈輸注雙磷酸鹽藥物治療(藥物組),30例患者采取外科手術(shù)治療,其中采用病灶刮除滅活植骨術(shù)9例(第1組),采用病灶刮除滅活植骨內(nèi)固定術(shù)18例(第2組),3例髖內(nèi)翻畸形患者采用病灶刮除滅活植骨、截骨矯形術(shù)(第3組)。結(jié)果:40例病人均得到隨訪,時(shí)間12~134個(gè)月,平均隨訪時(shí)間24個(gè)月。隨訪期間4例(40%)服用藥物患者及2例(6.67%)手術(shù)患者的治療效果不佳,其他患者術(shù)后1年時(shí)髖關(guān)節(jié)功能均恢復(fù)良好,步態(tài)正常。所有患者無內(nèi)固定物松動(dòng),行病灶刮除滅活植骨、截骨矯形術(shù)的患者,髖內(nèi)翻畸形均得到矯正,12個(gè)月后Harris髖關(guān)節(jié)功能評(píng)分為83分、87分和94分。統(tǒng)計(jì)學(xué)方法比較后發(fā)現(xiàn),藥物組與手術(shù)組治療處理后的復(fù)發(fā)率有顯著差異(P0.05),患者的年齡、性別、及手術(shù)方式均對(duì)術(shù)后12個(gè)月時(shí)的Harris髖關(guān)節(jié)功能評(píng)分沒有顯著差異(P0.05)。結(jié)論:手術(shù)是治療股骨近端纖維結(jié)構(gòu)不良的一種確切有效方式,術(shù)后髖關(guān)節(jié)功能得到較好恢復(fù),截骨矯形可治療伴有髖內(nèi)翻畸形的股骨近端纖維結(jié)構(gòu)不良。
[Abstract]:Objective: to analyze the clinical effect of fibrous dysplasia of bonefinder (FDD) in the treatment of proximal femoral fibrous dysplasia. To determine whether a reasonable surgical procedure can reduce the postoperative complications and recurrence in patients with fibrous dysplasia. Methods: retrospective study was conducted in the second Hospital of Shanxi Medical University from January 2005 to January 2015. Forty patients with proximal femoral fibrous dysplasia were diagnosed. 18 males and 22 females aged 1449 years, 36 patients with unilateral lesions and 4 patients with bilateral lesions, the course of disease ranged from 1 month to 8 years (mean 14 months). Among them, 10 patients with hip varus deformity were treated by intravenous bisphosphate therapy (30 patients in the drug group were treated by surgical treatment). Among them, 9 cases were treated by focal curettage and inactivated bone grafting (group 1), 18 cases by focal curettage and inactivation of bone graft (group 2), 3 cases of hip varus deformity were treated by focal curettage and inactivation of bone graft. Results all 40 patients were followed up for 12 ~ 134 months, with an average follow-up time of 24 months. During the follow-up period, 4 patients took drugs and 2 patients took 6.67. The other patients had good hip function and normal gait one year after operation. All the patients had no loosening of internal fixation, and all patients underwent focal curettage and bone grafting, osteotomy and orthopedics. After 12 months Harris hip joint function score was 83 points 87 points and 94 points. Statistical analysis showed that there was significant difference in the recurrence rate between the drug group and the operation group after treatment (P0.05%, age, sex). There was no significant difference in Harris hip function score at 12 months after operation (P 0.05). Conclusion: operation is an effective method for the treatment of proximal femoral fibrous dysplasia, and the function of hip joint is better recovered after operation. Osteotomy can be used to treat proximal fibrous dysplasia of femur with hip varus deformity.
【學(xué)位授予單位】：山西醫(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)】：R687.3

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