本文選題：全髖關(guān)節(jié)置換術(shù)　切入點(diǎn)：關(guān)節(jié)遺忘評(píng)分　出處：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]驗(yàn)證關(guān)節(jié)遺忘評(píng)分(FJS評(píng)分)的效度,比較它與傳統(tǒng)關(guān)節(jié)評(píng)分天花板效應(yīng),反應(yīng)度的區(qū)別。研究FJS評(píng)分在中國人全髖關(guān)節(jié)置換術(shù)后隨訪的應(yīng)用。從而推廣FJS評(píng)分在中國全髖關(guān)節(jié)置換術(shù)術(shù)后隨訪的應(yīng)用。[方法]收集昆明醫(yī)科大學(xué)第二附屬醫(yī)院骨科從2014年6月到2015年12月行一期單側(cè)全髖關(guān)節(jié)置換術(shù)的患者共51人。平均年齡61. 4歲,其中男性患者29名,平均年齡為61. 2歲;女性患者22名,平均年齡為61. 7歲。左側(cè)18例,右側(cè)33例。股骨頭壞死或髖關(guān)節(jié)骨關(guān)節(jié)炎41例,股骨頸骨折9例,類風(fēng)濕關(guān)節(jié)炎1例。所有患者均在在術(shù)后6個(gè)月和12個(gè)月行Harris髖關(guān)節(jié)評(píng)分(HHS評(píng)分)、牛津髖關(guān)節(jié)評(píng)分(OHS評(píng)分)、關(guān)節(jié)遺忘評(píng)分(FJS評(píng)分)。采用統(tǒng)計(jì)軟件SPSS18.0進(jìn)行統(tǒng)計(jì)分析,通過比較FJS評(píng)分、HHS評(píng)分、OHS評(píng)分的相關(guān)性來驗(yàn)證FJS的效度,比較FJS評(píng)分、HHS評(píng)分、OHS評(píng)分在術(shù)后6個(gè)月、12個(gè)月得分的天花板效應(yīng),比較三者得分從6個(gè)月到12個(gè)月變化的反應(yīng)度,驗(yàn)證性別,年齡,疾病譜對(duì)FJS評(píng)分的影響。[結(jié)果]FJS評(píng)分與HHS評(píng)分和OHS評(píng)分有著高的相關(guān)性,結(jié)果分別是r= 0.839和r=0. 835。術(shù)后6個(gè)月的時(shí)候,FJS評(píng)分的天花板效應(yīng)是0, HHS評(píng)分是19. 60 %,OHS評(píng)分是15. 68%,術(shù)后12個(gè)月的時(shí)候,FJS評(píng)分的天花板效應(yīng)是13. 72%,HHS評(píng)分是29.41%,OHS評(píng)分是25.49%。術(shù)后12個(gè)月的時(shí)候,FJS評(píng)分的天花板效應(yīng)分別是HHS評(píng)分、OHS評(píng)分的一半左右�；颊咝g(shù)后6個(gè)月到術(shù)后12個(gè)月FJS評(píng)分變化的反應(yīng)度ES值為0. 71,HHS評(píng)分變化的反應(yīng)度ES值為0. 35, OHS評(píng)分變化的反應(yīng)度ES值為0.39。男性患者和女性患者術(shù)后6個(gè)月、術(shù)后12個(gè)月時(shí)FJS、HHS、OHS評(píng)分結(jié)果無顯著差異,70歲以上患者和70歲以下患者術(shù)后6個(gè)月、術(shù)后12個(gè)月時(shí)FJS、HHS、OHS評(píng)分結(jié)果無顯著差異,而股骨頸骨折病人和非股骨頸骨折病人術(shù)后6個(gè)月、術(shù)后12個(gè)月時(shí)FJS評(píng)分結(jié)果無顯著差異,HHS評(píng)分和OHS評(píng)分卻有差異。[結(jié)論]FJS評(píng)分是一類評(píng)價(jià)關(guān)節(jié)置換術(shù)后關(guān)節(jié)狀況的病人自評(píng)估評(píng)分系統(tǒng)(PROs),它已經(jīng)被多位專家、多個(gè)國家驗(yàn)證了其良好的信度、效度、條目的內(nèi)部一致性。它的潛在減分設(shè)置涵蓋了以往評(píng)分的患者抱怨內(nèi)容,如:疼痛、僵硬、功能差、活動(dòng)范圍低,而且包含患者心理學(xué)測評(píng),它更加注重患者自身的感受,更加以患者為中心。體現(xiàn)現(xiàn)代醫(yī)療“患者說好才是真的好”的理念。條目簡單便于患者作答和醫(yī)生隨訪。與傳統(tǒng)的關(guān)節(jié)評(píng)分工具相比它的主要優(yōu)勢在于它有低的天花板效應(yīng)和高的反應(yīng)度,使得我們能夠觀察傳統(tǒng)關(guān)節(jié)評(píng)分高分人群的區(qū)別,使得我們能夠觀察患者遠(yuǎn)期關(guān)節(jié)的繼續(xù)變化,便于現(xiàn)代關(guān)節(jié)置換術(shù)的研究,更適合當(dāng)今醫(yī)療水平高、病人要求高的關(guān)節(jié)置換雙高時(shí)代。
[Abstract]:[objective] to verify the validity of joint amnesia score (FJS) and compare it with the ceiling effect and response of traditional joint score.To study the application of FJS score in follow-up of total hip arthroplasty in Chinese.Therefore, the application of FJS score in the follow-up of total hip arthroplasty in China was extended.[methods] A total of 51 patients underwent one-stage total hip replacement from June 2014 to December 2015 in Department of Orthopaedics, second affiliated Hospital of Kunming Medical University.The average age is 61.Four years old, including 29 male patients, the average age is 61.Two years old; 22 women with an average age of 61. 1%.Seven years old.Left 18 cases, right 33 cases.Femoral head necrosis or hip osteoarthritis in 41 cases, femoral neck fracture in 9 cases, rheumatoid arthritis in 1 case.All patients were given Harris hip score, Oxford hip score and joint amnesia score at 6 and 12 months postoperatively.Statistical software SPSS18.0 was used for statistical analysis. The validity of FJS was verified by comparing the correlation between FJS score and FJS score. The ceiling effect of FJS score was compared with that of FJS score at 6 and 12 months after operation.The responses of the three groups from 6 months to 12 months were compared to verify the influence of gender, age and disease spectrum on the FJS score.[results] there was a high correlation between FJS score and HHS score and OHS score, the results were r = 0.839 and r = 0 respectively.835.At 6 months after operation, the ceiling effect of FJS score was 0 and the HHS score was 19. 5%.The OHS score is 15.At 12 months after operation, the ceiling effect of FJS score was 13. 5%.The HHS score is 29.41 and the OHS score is 25.49.At 12 months after operation, the ceiling effect of FJS score was about half that of HHS score.The es value of response to the change of FJS score from 6 months to 12 months after operation was 0. 5%.The reactivity of HHS score was 0. 0.The es value of the change of OHS score was 0.39.There was no significant difference in OHS scores between male and female patients 6 months after operation and 12 months after operation. There was no significant difference in the scores of FJS and HHSH OHS in patients over 70 years of age and patients under 70 years of age 6 months after operation, and 12 months after operation.However, there was no significant difference in FJS scores between patients with femoral neck fracture and those with non-femoral neck fracture at 6 months and 12 months after operation. However, there was no significant difference in FJS score and OHS score between patients with femoral neck fracture and those with non-femoral neck fracture.[conclusion] FJS score is a self-assessment system for evaluating joint status after arthroplasty. It has been verified by a number of experts and countries for its good reliability, validity, and internal consistency of items.Its potential score reduction set covers the past scores of patients' complaints, such as: pain, stiffness, poor function, low range of activities, and includes psychological assessment of patients, it pays more attention to patients' own feelings, more patient-centered.Embodies the modern medical treatment, "the patient says good is really good" the idea.The entry is simple and easy for patients to answer and doctors to follow up.Its main advantage over traditional joint scoring tools is that it has a low ceiling effect and a high level of responsiveness, enabling us to observe the differences between traditional joint scoring groups.So that we can observe the long-term joint changes, facilitate the study of modern arthroplasty, more suitable for the current high level of medical treatment, patients with high demand for joint replacement dual high age.
【學(xué)位授予單位】：昆明醫(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)】：R687.4

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本文編號(hào)：1729488