【摘要】：目的：研究本地區(qū)膝關(guān)節(jié)單髁置換術(shù)（UKA）與膝關(guān)節(jié)表面置換術(shù)（TKA）治療累及單側(cè)間室的骨性關(guān)節(jié)炎的初期療效并作出統(tǒng)計(jì)學(xué)分析。 方法：從我院自開展UKA手術(shù)開始，2013年1月-2014年10月明確診斷為膝關(guān)節(jié)骨性關(guān)節(jié)炎且僅累及單側(cè)間室的患者中篩選，從符合條件的患者中選擇20名患者作為研究對象，其中男性5例，女性15例，有6例患者病患在右膝，其余14例在左膝。將選取的研究對象隨機(jī)兩組，每組各10例。分別給予TKA與UKA治療，對比兩組患者疼痛緩解的情況，，手術(shù)前后HSS評分的變化，術(shù)后1周自主達(dá)到的屈曲角度及術(shù)后3d血紅蛋白（Hb）下降量。隨訪期定為5-14個(gè)月。UKA治療手術(shù)適應(yīng)癥為：①局限于膝關(guān)節(jié)內(nèi)側(cè)間室退行性關(guān)節(jié)病變；②具有完整的前交叉韌帶；③可矯正的內(nèi)翻畸形。 結(jié)果：兩組患者手術(shù)順利，均未出現(xiàn)嚴(yán)重并發(fā)癥。UKA組患者無術(shù)中轉(zhuǎn)TKA手術(shù)者。術(shù)后兩組患者膝關(guān)節(jié)疼痛程度都明顯減輕，且兩者比較無顯著性差異。兩組患者經(jīng)治療1周后膝關(guān)節(jié)屈曲角度均顯著增大，但兩組相比較有明顯差異（P0.05）。與TKA組比較，UKA組術(shù)中出血少（P0.05）. 結(jié)論：治療累及單側(cè)間室的膝關(guān)節(jié)骨性關(guān)節(jié)炎，兩種方法都能夠有效緩解患者痛苦，針對膝關(guān)節(jié)單間室重度OA，在手術(shù)選擇，UKA具有微創(chuàng)，損傷小，術(shù)后恢復(fù)快及更貼近正常生理情況等優(yōu)點(diǎn)。
[Abstract]:Objective: to study the initial curative effect of (UKA) and (TKA) in the treatment of osteoarthritis with unilateral interventricular involvement. Methods: from January 2013 to October 2014, 20 patients with osteoarthritis of the knee were selected from the patients who were diagnosed as osteoarthritis of the knee and only involved in the unilateral compartment from the UKA operation in our hospital, and 20 patients were selected from the eligible patients as the study subjects. There were 5 males and 15 females with 6 patients on the right knee and 14 on the left knee. The subjects were randomly divided into two groups, 10 cases in each group. The patients were treated with TKA and UKA respectively. The pain relief, the changes of HSS score before and after operation, the flexion angle reached 1 week after operation and the decrease of hemoglobin (Hb) on the 3rd day after operation were compared between the two groups. The following up period was 5-14 months. The operative indication of UKA was: 1 was confined to the medial interventricular degenerative joint lesions of the knee and 2 had complete anterior cruciate ligament (ACL) 3 varus deformity. Results: the operation was successful in both groups. There were no severe complications in both groups. There was no intraoperative conversion to TKA in the UKA group. There was no significant difference in knee pain between the two groups. After 1 week of treatment, the knee flexion angle of the two groups increased significantly, but there was significant difference between the two groups (P0.05). Compared with TKA group, intraoperative bleeding was less in TKA group (P0.05). Conclusion: in treating knee osteoarthritis involving unilateral compartment, both methods can effectively relieve the pain of knee joint. The severe OA, of single compartment of knee joint is minimally invasive and minimally injuried. It has the advantages of quick recovery and closer to normal physiological condition after operation.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.4

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