本文選題：前交叉韌帶重建(ACLR)　切入點(diǎn)：磁共振成像(MRI)　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：背景:前交叉韌帶斷裂是一種常見的損傷,在美國每年大約有250000人發(fā)病。ACL損傷導(dǎo)致嚴(yán)重功能障礙[1]。在這個運(yùn)動醫(yī)學(xué)時代,ACL重建對病人生活質(zhì)量起著至關(guān)重要的作用。事實(shí)證明,ACL撕裂不能采取保守治療讓它自己修復(fù)。而ACL重建被認(rèn)為是治療ACL撕裂的標(biāo)準(zhǔn)手術(shù)方式。在評價ACL移植物完整性和診斷ACL撕裂的并發(fā)癥上MRI起著重要作用。首次ACL重建后的復(fù)發(fā)性不穩(wěn)發(fā)病率為3%到10%。移植物失敗是復(fù)發(fā)性不穩(wěn)最重要的原因[27]。由于乆繩肌自身的生物力學(xué)特性,它被用于移植物的首選,而乆繩肌自體移植較自身的ACL有更強(qiáng)大的抗拉載荷、剛度和橫截面積。目的:評估4束和5束半腱肌、股薄肌自體移植物行膝關(guān)節(jié)前交叉韌帶重建術(shù)后的MRI表現(xiàn),比較兩者之間的不同。方法:回顧從2015年1月至2016年12月之間ACL重建術(shù)后的40例患者的MRI。將ACL重建患者分為兩組:A組和B組.A組20例用5束自體半腱肌、股薄肌移植,B組20例用4束自體半腱肌、股薄肌移植。進(jìn)行MRI評價,包括移植物撕裂、移植物強(qiáng)度、移植物信號、移植物粗細(xì)、移植物不連續(xù)、骨道位置和后交叉韌帶的過度屈曲。術(shù)后隨訪1個月,3個月和6個月時行MRI檢查。結(jié)果:對40例病人進(jìn)行的研究。在這項研究中,我們分為兩組:20例用5束自體半腱肌、股薄肌移植,20例用4束自體半腱肌、股薄肌移植。A組和B組的平均年齡是29.85歲和31.3歲,不分性別。兩組比較點(diǎn)為術(shù)后6個月移植物信號、移植物強(qiáng)度。A組和B組患者的移植物強(qiáng)度、信號在MRI評估上的差異有統(tǒng)計學(xué)意義,但其他觀察指標(biāo)在1月、3月、6月的MRI評估上都一致而移植物纖維連續(xù)性和完整的移植物厚度是診斷移植物完好的最有價值的征象義。完全不連續(xù)的移植物在診斷完全撕裂上非常有價值而移植物局部薄弱正像在診斷部分撕裂上有價值。結(jié)論:4束和5束半腱肌、股薄肌自體移植物行膝關(guān)節(jié)前交叉韌帶重建術(shù)后的兩組病人,MRI評估兩者的差異沒有統(tǒng)計學(xué)意義。4束和5束半腱肌、股薄肌自體移植物完全可以滿足ACL重建的需求。
[Abstract]:Background: anterior cruciate ligament rupture (ACL) is a common injury. In the United States, about 250000 people suffer from ACL injury every year, which results in severe dysfunction [1].In this era of sports medicine, ACL reconstruction plays a vital role in the quality of life of patients.It turns out that ACL tears cannot be treated conservatively to repair them themselves.ACL reconstruction is considered to be the standard procedure for the treatment of ACL tears.MRI plays an important role in evaluating the integrity of ACL grafts and in diagnosing the complications of ACL laceration.The incidence of recurrent instability after first ACL reconstruction ranged from 3% to 10%.Graft failure is the most important cause of recurrent instability [27].Because of the biomechanical characteristics of the human chorda muscle, it is the first choice for grafts, while the human chorda autograft has a stronger tensile load, stiffness and cross-sectional area than its own ACL.Aim: to evaluate the MRI findings of 4 and 5 semitendinosus and thin femoral muscle autografts after anterior cruciate ligament reconstruction (ACL) reconstruction.Methods: 40 patients after ACL reconstruction from January 2015 to December 2016 were reviewed.The patients with ACL reconstruction were divided into two groups: group A (n = 20) and group B. Group A (n = 20) were treated with autologous semitendinosus (group A) and group B (group B) were transplanted with autogenous semitendinosus (group B).MRI evaluation was performed, including graft tear, graft intensity, graft signal, graft thickness, graft discontinuity, osseous location and overflexion of posterior cruciate ligament.All patients were followed up for 1 month, 3 months and 6 months for MRI examination.Results: 40 patients were studied.In this study, we were divided into two groups: 20 cases were treated with 5 bands of autogenous semitendinosus, 20 cases with thin femoral muscle were transplanted with 4 bundle of autologous semitendinosus, the average age of group A and group B were 29.85 years and 31.3 years, regardless of sex.The graft intensity of patients in group A and group B was significantly different from that in group A and group B, and the difference in MRI evaluation between the two groups was statistically significant.But other observational indicators were consistent in MRI evaluation in January, March and June. The continuity of plant fibers and the complete thickness of the graft were the most valuable signs for the diagnosis of graft integrity.Completely discontinuous grafts are of great value in the diagnosis of complete laceration and weak grafts are just as valuable in diagnosing partial laceration.Conclusion there was no significant difference in MRI evaluation between the two groups after anterior cruciate ligament reconstruction (ACL) reconstruction. There was no significant difference between the two groups in assessing the semitendinosus muscle by MRI. There was no significant difference between the two groups in the evaluation of the semitendinosus muscle in the 4th bundle and the 5th bundle.The thin femoral muscle autograft can completely meet the need of ACL reconstruction.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 高大柱,秦慈南,陳峰,胡大勇,孫成祥;先天性左半腱肌止點(diǎn)異位一例報告[J];中華骨科雜志;2002年12期

2 李德東;;自體半腱肌移植重建膝關(guān)節(jié)外側(cè)副韌帶的治療體會[J];中國療養(yǎng)醫(yī)學(xué);2010年04期

3 張鵬;黃貴喜;;半腱肌解剖重建治療膝關(guān)節(jié)內(nèi)側(cè)副韌帶Ⅲ度損傷[J];創(chuàng)傷外科雜志;2011年02期

4 王啟華;肖尚英;林正琰;劉慶麟;;半腱肌的應(yīng)用解剖學(xué)研究[J];廣東解剖學(xué)通報;1982年02期

5 張生貴,丁永善,熊樹明,劉龍平;半腱肌的血管和神經(jīng)供給[J];臨床應(yīng)用解剖學(xué)雜志;1984年02期

6 朱伯偉;姜琪;匡忠良;;半腱肌——二頭肌袢治療下肢深靜脈瓣膜功能不全12例[J];浙江醫(yī)學(xué);1988年05期

7 陳恒;林金土;沈國星;陳春鵬;;半腱肌的應(yīng)用解剖學(xué)觀察[J];福建醫(yī)學(xué)院學(xué)報;1989年02期

8 夏亞一;吳萌;;應(yīng)用自體半腱肌重建膝關(guān)節(jié)內(nèi)側(cè)副韌帶損傷12例[J];中國微創(chuàng)外科雜志;2007年11期

9 馮香芹;張鵬;黃貴喜;楊希娥;張靜;張立;;半腱肌解剖重建膝關(guān)節(jié)內(nèi)側(cè)副韌帶損傷療效分析[J];河北醫(yī)藥;2011年02期

10 陶永松,鐘世鎮(zhèn),劉牧之,陳子華,徐達(dá)傳;半腱肌的顯微外科解剖學(xué)[J];廣東解剖學(xué)通報;1981年01期

相關(guān)會議論文 前5條

1 陳平泉;王勝;;半腱肌重建膝關(guān)節(jié)陳舊性內(nèi)側(cè)副韌帶損傷[A];2008年浙江省骨科學(xué)學(xué)術(shù)年會論文匯編[C];2008年

2 劉如月;徐長科;王躍錦;吳智輝;郝玉敏;;半腱肌重建后交叉韌帶的療效分析[A];跨世紀(jì)骨傷杰出人才科技成果薈萃[C];2004年

3 壽志強(qiáng);管國華;謝文龍;;關(guān)節(jié)鏡下四股半腱肌重建前交叉韌帶療效觀察[A];浙江省醫(yī)學(xué)會骨科學(xué)分會30年慶典暨2011年浙江省骨科學(xué)學(xué)術(shù)年會論文匯編[C];2011年

4 壽志強(qiáng);管國華;李雄峰;;關(guān)節(jié)鏡下四股半腱肌重建前交叉韌帶療效觀察[A];2013中國工程院科技論壇暨浙江省骨科學(xué)學(xué)術(shù)年會論文摘要集[C];2013年

5 劉江華;楊峻;楊曉勇;李曉松;;關(guān)節(jié)鏡下采用四股半腱肌及股薄肌重建前交叉韌帶[A];玉溪市第三屆二次骨科學(xué)術(shù)研討會論文匯編[C];2009年

相關(guān)碩士學(xué)位論文 前2條

1 薩倪（SUNNY THAPA）;自體四股與五股半腱肌肌腱和股薄肌肌腱重建前交叉韌帶的術(shù)后MRI信號改變的對比研究[D];廣西醫(yī)科大學(xué);2017年

2 劉東帥;前叉韌帶重建中雙層骨腱骨與四股半腱肌的兔實(shí)驗(yàn)對比研究[D];河北醫(yī)科大學(xué);2014年

，

本文編號：1705825