本文選題：骨關(guān)節(jié)炎 + 腓骨��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:以人工單髁關(guān)節(jié)置換術(shù)(unieom partmental knee arthroplasty,UKA)為對照,研究腓骨近端截骨術(shù)(fibular osteotomy,FO)治療膝關(guān)節(jié)骨關(guān)節(jié)炎的早期療效和機(jī)制。方法:根據(jù)此次試驗的納入及排除標(biāo)準(zhǔn),連續(xù)隨訪2014年7月至2016年3月山西省人民醫(yī)院關(guān)節(jié)外科組收治的患者65人,全部隨訪成功。根據(jù)其采取的手術(shù)方式,將行腓骨截骨的患者分為觀察組(n=31),將行UKA的患者分為對照組(n=34)。比較觀察組和對照組患者的數(shù)據(jù),包括:(1)年齡;(2)術(shù)程用時;(3)術(shù)程出血;(4)在院時間;(5)醫(yī)院扣費;(6)術(shù)前、術(shù)后3個月和12個月的西安大略和麥克馬斯特大學(xué)骨關(guān)節(jié)炎指數(shù)(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)、美國膝關(guān)節(jié)協(xié)會評分(knee society score,KSS)和美國特種外科醫(yī)院(hospital for special surgery knee score,HSS)膝關(guān)節(jié)評分情況。結(jié)果:對所有65例患者進(jìn)行12個月隨訪,全部獲得隨訪成功。組內(nèi)比較:與術(shù)前相比,對照組患者術(shù)后6個月、12個月的HSS評分、WOMAC評分和KSS評分都取得了明顯的改善,差異有統(tǒng)計學(xué)意義(P0.05);在觀察組,與術(shù)前相比,對照組患者術(shù)后6個月、12個月的HSS評分、WOMAC評分和KSS評分也都取得了明顯的改善,差異有統(tǒng)計學(xué)意義(P0.05)。組間比較:在以下4項數(shù)據(jù):a.術(shù)程用時;b.術(shù)程出血;c.醫(yī)院扣費;d.在院時間:,觀察組表現(xiàn)均比對照組更好,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:在治療內(nèi)側(cè)間室型KOA上,腓骨近端截骨術(shù)(fibular osteotomy,FO)取得了與人工單髁關(guān)節(jié)置換術(shù)(unieom partmental knee arthroplasty,UKA)相當(dāng)?shù)呐R床效果,但前者治療費用相對更低,手術(shù)創(chuàng)傷更小,術(shù)后下地更快,是一種很有前景、很值得推廣的手術(shù)方式。
[Abstract]:Objective: to study the early curative effect and mechanism of fibulular osteotomygotomy in the treatment of knee osteoarthritis with artificial monodondylar arthroplasty (UKAA). Methods: according to the criteria of inclusion and exclusion of the trial, 65 patients in the joint surgery group of Shanxi Provincial people's Hospital from July 2014 to March 2016 were followed up successfully. Patients undergoing fibula osteotomy were divided into observation group (n = 31) and control group (n = 34). The data of patients in the observation group and the control group were compared, including the age of 1: 1) the age of 2) the duration of the operation, the bleeding during the operation and the 4) in hospital time, 5) the hospital withheld fees and 6) before operation. 3 and 12 months after operation, the osteoarthritis index of Western Ontario and the University of McMaster was evaluated by Western Ontario and McMaster Universities osteoarthritis and WOMA. The knee society score was evaluated by the American knee Association (AJA) and the for special surgery knee Scoreen HSS at the American Special surgery Hospital. Results: all 65 patients were followed up for 12 months. Intra-group comparison: compared with pre-operation, the HSS scores and KSS scores of the control group were significantly improved at 6 months and 12 months after operation, and the difference was statistically significant (P 0.05); in the observation group, there was no significant difference between before and after operation. In the control group, the HSS score, WOMAC score and KSS score were significantly improved at 6 months and 12 months after operation, and the difference was statistically significant (P 0.05). Group comparison: in the following 4 data: a. The procedure takes a long time. Bleeding during operation. The hospital withheld fees. At 1: 00, the performance of the observation group was better than that of the control group, and the difference was statistically significant (P 0.05). Conclusion: in the treatment of medial interventricular KOA, fibulular osteotomy FOO (fibular osteotomy) has achieved the same clinical effect as artificial monodondylar arthroplasty (UKAA), but the cost of the former is relatively low, the surgical trauma is smaller, and the operation is faster after operation. Is a very promising, very worthy of promotion of the operation.
【學(xué)位授予單位】：山西醫(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

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