本文選題：膝骨性關(guān)節(jié)炎 + 內(nèi)側(cè)間室��； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過(guò)前瞻性隨機(jī)分組試驗(yàn)研究,探討腓骨近端截骨術(shù)對(duì)比膝關(guān)節(jié)鏡有限清理術(shù)在治療早中期內(nèi)側(cè)間室受累型膝骨性關(guān)節(jié)炎的短期臨床療效差異。方法:納入自2015年1月至2016年12月在廣西骨傷醫(yī)院骨關(guān)節(jié)科住院行手術(shù)治療的內(nèi)側(cè)間室受累型膝骨性關(guān)節(jié)炎的患者共40例,對(duì)符合標(biāo)準(zhǔn)的患者按隨機(jī)數(shù)字分組方法將患者分成A、B兩組,每組各納入20例,其中A組患者行單純腓骨近端截骨術(shù);B組患者行膝關(guān)節(jié)鏡下有限清理術(shù)。對(duì)兩組患者均進(jìn)行術(shù)前及術(shù)后1個(gè)月、3個(gè)月、6個(gè)月、12個(gè)月隨訪觀察,隨訪內(nèi)容包括膝關(guān)節(jié)功能HSS、KSS評(píng)分和VAS疼痛評(píng)分以及統(tǒng)計(jì)術(shù)后并發(fā)癥情況,并通過(guò)測(cè)量X線(xiàn)下膝關(guān)節(jié)內(nèi)側(cè)間隙及下肢股脛角(FTA),比較膝關(guān)節(jié)影像學(xué)改變。結(jié)果:共納入的27例符合標(biāo)準(zhǔn)的病例,A組12例,15膝;B組15例,18膝。兩組患者均獲得了12-20個(gè)月的隨訪,A組平均(15.91±2.61)個(gè)月,B組平均(16.53±3.04)個(gè)月。兩組患者術(shù)后均未發(fā)生術(shù)口或關(guān)節(jié)內(nèi)感染、下肢靜脈血栓、神經(jīng)損傷等并發(fā)癥。組內(nèi)差異比較:兩組患者的術(shù)后HSS、KSS評(píng)分較術(shù)前增高,VAS評(píng)分較術(shù)前低,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);A組術(shù)后FTA和內(nèi)側(cè)關(guān)節(jié)間隙較術(shù)前分別增加(3.3±1.0)°、(1.53±0.50)mm,差異有統(tǒng)計(jì)學(xué)意義;B組術(shù)前與術(shù)后的FTA、內(nèi)側(cè)關(guān)節(jié)間隙比較均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。組間對(duì)比:1.VAS:在術(shù)后第1個(gè)月,A組VAS評(píng)分高于B組,第3個(gè)月兩組接近,而在第6、12月時(shí)A組VAS評(píng)分均低于B組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2.HSS:術(shù)后第1月,A組與B組對(duì)比無(wú)統(tǒng)計(jì)學(xué)意義,在第3、6、12月A組HSS評(píng)分均高于B組,差異有統(tǒng)計(jì)學(xué)意義。3.KSS:兩組在術(shù)后第1、3月評(píng)分接近,無(wú)統(tǒng)計(jì)學(xué)意義,在第6、12月A組評(píng)分均高于B組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:在短期療效上,單純腓骨近端截骨術(shù)和膝關(guān)節(jié)鏡有限清理手術(shù)在治療早中期膝內(nèi)側(cè)間室型骨性關(guān)節(jié)炎均具有良好的療效,而隨著時(shí)間的的推移,腓骨近端截骨術(shù)相對(duì)來(lái)說(shuō)能較好地減輕患者疼痛,改善膝關(guān)節(jié)功能,療效優(yōu)于關(guān)節(jié)鏡手術(shù),值得在臨床推廣應(yīng)用。
[Abstract]:Objective: to investigate the short-term clinical efficacy of proximal fibula osteotomy compared with limited debridement of knee arthroscopy in the treatment of early and middle medial compartment involvement knee osteoarthritis. Methods: from January 2015 to December 2016, 40 patients with medial compartment involved knee osteoarthritis were admitted to the Department of Orthopedics and Joint of Guangxi Orthopedic Hospital. Patients who met the criteria were randomly divided into two groups: group A (n = 20) and group B (n = 20). Group A received simple proximal fibula osteotomy and group B underwent limited debridement under knee arthroscopy. The patients in both groups were followed up for 1 month, 3 months, 6 months and 12 months before and after operation. The follow-up included HSS KSS score, VAS pain score and postoperative complications. The radiographic changes of the knee joint were compared by measuring the medial space of the knee joint and the femoral tibial angle of the lower extremity. Results: a total of 27 cases were included in group A (12 cases with 15 knees) and group B (15 cases with 18 knees). Two groups of patients were followed up for 12 to 20 months, with an average of 15.91 鹵2.61 months in group A and 16.53 鹵3.04 months in group B. There were no complications such as intraarticular infection, venous thrombosis and nerve injury in both groups. Comparison of intra-group differences: the postoperative HSS-KSS scores in the two groups were higher than those in the preoperative patients and the VAS scores were lower than those before the operation. The difference was statistically significant in the postoperative FTA and medial articular space in group A (3.3 鹵1.0) 擄and 1.53 鹵0.50 mm, respectively. There was no significant difference in FTAs between pre-and post-operation in group B, and there was no significant difference in the medial articular space between group B and group B (P 0.05). VAS: the VAS score of group A was higher than that of group B at the first month after operation, but the VAS score of group A was lower than that of group B at the 6th and 12th month after operation. The difference was statistically significant (P 0.05). 2. HSS: there was no significant difference between group A and group B in the first month after operation, but the scores of VAS in group A were lower than those in group B at 6 and 12 months after operation. The score of HSS in group A was higher than that in group B in the 3rd month and 12th month, the difference was statistically significant. 3. KSS: the scores of group A were higher than that of group B at the 1st and 3rd month after operation, but the score of group A was higher than that of group B in the 6th and 12th months, the difference was statistically significant (P 0.05). Conclusion: simple proximal fibula osteotomy and limited debridement of knee arthroscopy are effective in the treatment of medial ventricular osteoarthritis of the knee in early and middle period, but with the passage of time. Proximal fibula osteotomy can relieve pain and improve knee joint function, which is worth popularizing in clinic.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 閆國(guó)富;薛晨暉;劉巍;;腓骨近端截骨術(shù)治療不同外翻應(yīng)力角膝關(guān)節(jié)骨關(guān)節(jié)炎患者的療效比較[J];中華老年骨科與康復(fù)電子雜志;2017年01期

2 劉經(jīng)端;古恩鵬;;運(yùn)用現(xiàn)代中醫(yī)思維方法探索性推論腓骨截骨術(shù)防治膝骨性關(guān)節(jié)炎的原理[J];中華中醫(yī)藥雜志;2016年12期

3 董天華;李石倫;于沂陽(yáng);申勇;丁文元;張英澤;;不均勻沉降理論新進(jìn)展[J];河北醫(yī)科大學(xué)學(xué)報(bào);2016年11期

4 趙飛;張劍剛;李存祥;王健;成存輝;孫建輝;寇寧招;王立衛(wèi);;腓骨截骨與關(guān)節(jié)鏡下清理術(shù)治療膝骨關(guān)節(jié)炎伴輕度膝內(nèi)翻療效分析[J];實(shí)用骨科雜志;2016年09期

5 敖傳西;楊威;華賢章;駱淵城;吳美平;王立柞;譚明偉;朱濱;;腓骨上1/3部分截骨治療膝內(nèi)側(cè)間室骨關(guān)節(jié)炎30例[J];中國(guó)中醫(yī)骨傷科雜志;2016年09期

6 金連峰;;骨碎補(bǔ)對(duì)骨性關(guān)節(jié)炎家兔作用的實(shí)驗(yàn)研究[J];中華中醫(yī)藥學(xué)刊;2016年08期

7 黃樂(lè)春;胡惠民;梁宇翔;;膝關(guān)節(jié)功能評(píng)分量表評(píng)述[J];中國(guó)醫(yī)藥科學(xué);2016年13期

8 秦迪;李石倫;鄭占樂(lè);陳偉;張英澤;;膝關(guān)節(jié)骨關(guān)節(jié)炎病因與關(guān)節(jié)軟骨磨損的相關(guān)性研究[J];河北醫(yī)科大學(xué)學(xué)報(bào);2016年02期

9 黃騰;陳佳;翟金帥;田志;張隆;鄭旺;時(shí)莉芳;李西成;;腓骨近端截骨術(shù)術(shù)中大量出血2例原因分析及改進(jìn)措施[J];臨床合理用藥雜志;2016年04期

10 孫佳冰;付春江;鄒吉龍;陳洪均;王旭明;張鵬;畢鄭剛;;膝關(guān)節(jié)軟骨剝脫分期對(duì)腓骨近端截骨治療膝關(guān)節(jié)骨關(guān)節(jié)炎的指導(dǎo)意義[J];中華老年骨科與康復(fù)電子雜志;2016年01期

，

本文編號(hào)：2003827