【摘要】：目的:測量出采用空心拉力螺釘直接固定髖臼四邊體的安全區(qū)的位置方法:獲取于2014年2月~2014年12月采用我院寶石能譜CT對骨盆進(jìn)行CT掃描的成年患者數(shù)據(jù),重新重建出按平行于前柱方向且垂直于四邊體內(nèi)側(cè)面的平面重建出新掃描圖片,男50例,女50例。以4.5mm空心拉力螺釘為標(biāo)準(zhǔn),在重建下的CT上接測量得出以垂直于髖臼前柱并平行于髖臼四邊體內(nèi)側(cè)面的方向,通過螺釘?shù)陌踩ǖ赖姆秶�。結(jié)果:經(jīng)實際測量得出,髖臼四邊體區(qū)域可容納4.5mm空心拉力螺釘?shù)陌踩珔^(qū)域上限為,男性的平均髖臼L1值為(6.45±4.83)mm,平均髖臼L2值為(38.80±7.00)mm,女性的平均髖臼L1值為(11.68±4.69)mm,平均髖臼L2值為(34.73±6.06)mm。男性的髖臼處平均L1值與與女性的髖臼處平均L1值平均比較得出差異有統(tǒng)計學(xué)意義,P=0.02。男性的髖臼處平均L2值與女性的髖臼處平均L2值比較差異沒有統(tǒng)計學(xué)意義(P0.05),得出成年人髖臼安全區(qū)的平均L2值為(36.67±6.77)mm。手術(shù)中采用復(fù)位后使用空心釘直接固定骨盆四邊體時經(jīng)垂直于髖臼前柱的方向,緊貼四邊體的內(nèi)側(cè)面置釘,在以B點作為參照時小于(36.67±6.77)mm或以E點作為參照時男性小于(6.45±4.83)mm、女性小于(11.68±4.69)mm,可以容納4.5mm空心拉力螺釘安全通過。結(jié)論:在術(shù)前采用CT重建測量的方法,可以得到髖臼相對安全區(qū)的數(shù)據(jù),制定個性化方案,指導(dǎo)術(shù)中安全、快速安置經(jīng)四邊體的螺釘,并且節(jié)約花費。對于有髖關(guān)節(jié)炎或者股骨頭壞死的患者不能以本研究的結(jié)果作為參考,需謹(jǐn)慎把握手術(shù)適應(yīng)癥。
[Abstract]:Objective: to measure the position of the safe area of acetabular quadrangular body fixed directly by hollow pull screw. Methods: to obtain the data of adult patients who underwent CT scanning of pelvis with sapphire energy spectrum CT from February 2014 to December 2014. A new scan image was reconstructed from the plane parallel to the anterior column and perpendicular to the four sides of the body, 50 males and 50 females. Using 4.5mm hollow pull screw as the standard, the range of safety passage through the screw was obtained in the direction perpendicular to the anterior column of the acetabular and parallel to the inside side of the four sides of the acetabulum. Results: the upper limit of safe area for the 4.5mm hollow lapping screws in the acetabular quadrangular area was (6.45 鹵4.83) mm for males, (38.80 鹵7.00) mm for acetabular L2, (11.68 鹵4.69) mm for females, and (34.73 鹵6.06) mm for females. The average L1 value of acetabular in males and females was significantly higher than that in females. There was no significant difference between male and female acetabular average L2 values (P0.05). The average L2 value of adult acetabular safety zone was (36.67 鹵6.77) mm. During the operation, the pelvis quadrilateral body was fixed directly by hollow nail after reduction, which was perpendicular to the anterior column of the acetabulum and attached to the medial side of the quadrilateral body. When point B is taken as reference point, it is less than (36.67 鹵6.77) mm or when point E is used as reference, male is less than (6.45 鹵4.83) mm, female is less than (11.68 鹵4.69) mm, which can accommodate the safe passage of 4.5mm hollow lag screw. Conclusion: the data of acetabular relative safety zone can be obtained by using CT reconstruction before operation, and the individualized scheme can be established to guide the safety during operation, to quickly place the screws through the quadrilateral body, and to save the cost. The results of this study should not be used as reference for patients with hip arthritis or osteonecrosis of the femoral head.
【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】：2015
【分類號】：R687.3

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