THA術(shù)后靜態(tài)結(jié)構(gòu)對功能影響分析
發(fā)布時間：2019-05-07 00:00
【摘要】：目的:探討全髖關(guān)節(jié)置換術(shù)后相關(guān)靜態(tài)結(jié)構(gòu)客觀參數(shù)的不同對髖關(guān)節(jié)功能的影響及意義。方法:回顧性分析遵義醫(yī)學(xué)院附屬醫(yī)院2015-2016年符合納入標(biāo)準(zhǔn)的131例(153例髖)行全髖關(guān)節(jié)置換術(shù)的臨床資料為試驗組;納入同期健康成年人30例(60例髖)的臨床資料為對照組。將試驗組術(shù)后臨床資料采用髖關(guān)節(jié)Harris評分分為優(yōu)良組及非優(yōu)良組,采用Adobe Photoshop CS6軟件測量對照組、優(yōu)良組及非優(yōu)良組的雙側(cè)股骨頭旋轉(zhuǎn)中心的垂直距離及水平距離、髖臼上移及內(nèi)移、雙側(cè)股骨偏心距、雙側(cè)外展肌力臂、雙側(cè)體重力臂、下肢長度差及髖臼假體外展角;并采用比值關(guān)系對雙側(cè)股骨頭旋轉(zhuǎn)中心的垂直距離及水平距離、雙側(cè)股骨偏心距比值、雙側(cè)外展肌力臂與體重力臂進(jìn)行比較分析。結(jié)果:優(yōu)良組的隨訪時間與非優(yōu)良組的平均隨訪時間相比無統(tǒng)計學(xué)差異(P0.05)。對照組組內(nèi)比較股骨頭旋轉(zhuǎn)中心比值、股骨偏心距比值:右側(cè)與左側(cè)的比值、左側(cè)與右側(cè)的比值兩組相比較未見統(tǒng)計學(xué)明顯的差異性(P0.05)。對照組、優(yōu)良組與非優(yōu)良組股骨頭旋轉(zhuǎn)中心的垂直距離比值三組組間比較具有統(tǒng)計學(xué)差異(P0.05);對照組、優(yōu)良組與非優(yōu)良組股骨頭旋轉(zhuǎn)中心的水平距離比值三組組間比較均未見統(tǒng)計學(xué)差異(P0.05)。優(yōu)良組髖臼假體上移、內(nèi)移與非優(yōu)良組髖臼假體上移、內(nèi)移相比未見統(tǒng)計學(xué)差異(P0.05)。對照組與優(yōu)良組雙側(cè)股骨偏心距比值、外展肌力臂與體重力臂比值相比均未見顯著性差異(P0.05);對照組與非優(yōu)良組、優(yōu)良組與非優(yōu)良組雙側(cè)股骨偏心距比值、外展肌力臂與體重力臂比值相比具有統(tǒng)計學(xué)差異(P0.05)。優(yōu)良組下肢長度差與非優(yōu)良組下肢長度差相比具有統(tǒng)計學(xué)差異(P0.05)。優(yōu)良組的外展角與非優(yōu)良組的外展角相比具有顯著性差異(P0.05)。結(jié)論:盡可能或接近解剖位置上重建髖關(guān)節(jié)的股骨頭旋轉(zhuǎn)中心、重建或適當(dāng)增大股骨偏心距、恢復(fù)下肢長度、髖臼假體外展角置于30o-50o,髖關(guān)節(jié)功能可得到更好的恢復(fù)。
[Abstract]:Objective: to investigate the effect and significance of objective parameters of static structure on hip function after total hip arthroplasty (THR). Methods: the clinical data of 131 patients (153 hips) who met the inclusion criteria in the affiliated Hospital of Zunyi Medical College from 2015 to 2016 were analyzed retrospectively. The clinical data of 30 healthy adults (60 hips) in the same period were included as the control group. The clinical data of the experimental group were divided into good group and non-excellent group by Harris score. The vertical distance and horizontal distance of the rotation center of the femoral head in the control group, the excellent group and the non-excellent group were measured by Adobe Photoshop CS6 software. Acetabular upward and inward displacement, bilateral femoral eccentricity, bilateral abductor muscle arm, bilateral weight arm, lower limb length difference and acetabular pseudo-external angle; The vertical distance and the horizontal distance of the rotation center of the femoral head, the ratio of the eccentric distance of the femur, the arm of abductor muscle and the arm of body weight were compared and analyzed by using the ratio relationship between the rotation center of the femoral head and the rotation center of the femoral head. Results: there was no significant difference in the follow-up time between the excellent group and the non-excellent group (P0.05). In the control group, there was no significant difference in the ratio of rotation center of femoral head, the ratio of femoral eccentricity between the right side and the left side, and the ratio between the left side and the right side (P0.05). The vertical distance ratio of rotation center of femoral head in control group, excellent group and non-excellent group had statistical difference (P0.05). There was no significant difference in the horizontal distance ratio of femoral head rotation center between control group, excellent group and non-excellent group (P0.05). There was no significant difference in acetabular prosthesis between excellent group and non-excellent group (P0.05). There was no significant difference in the ratio of femoral eccentricity, abductor arm and weight arm between the control group and the excellent group (P0.05). The ratio of bilateral femoral eccentricity, abductor arm and weight arm were significantly different between the control group and the non-excellent group, the excellent group and the non-excellent group (P0.05). The difference of lower limb length between excellent and good group was statistically different from that of non-excellent group (P0.05). The abduction angle of excellent group was significantly different from that of non-excellent group (P0.05). Conclusion: reconstruction of femoral head rotation center of hip joint as far as possible or close to anatomical position, reconstruction or appropriate increase of femoral eccentricity, restoration of lower limb length, acetabular pseudo-external angle of 30o ~ 50o, hip joint function can be better recovered.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4
本文編號：2470600
[Abstract]:Objective: to investigate the effect and significance of objective parameters of static structure on hip function after total hip arthroplasty (THR). Methods: the clinical data of 131 patients (153 hips) who met the inclusion criteria in the affiliated Hospital of Zunyi Medical College from 2015 to 2016 were analyzed retrospectively. The clinical data of 30 healthy adults (60 hips) in the same period were included as the control group. The clinical data of the experimental group were divided into good group and non-excellent group by Harris score. The vertical distance and horizontal distance of the rotation center of the femoral head in the control group, the excellent group and the non-excellent group were measured by Adobe Photoshop CS6 software. Acetabular upward and inward displacement, bilateral femoral eccentricity, bilateral abductor muscle arm, bilateral weight arm, lower limb length difference and acetabular pseudo-external angle; The vertical distance and the horizontal distance of the rotation center of the femoral head, the ratio of the eccentric distance of the femur, the arm of abductor muscle and the arm of body weight were compared and analyzed by using the ratio relationship between the rotation center of the femoral head and the rotation center of the femoral head. Results: there was no significant difference in the follow-up time between the excellent group and the non-excellent group (P0.05). In the control group, there was no significant difference in the ratio of rotation center of femoral head, the ratio of femoral eccentricity between the right side and the left side, and the ratio between the left side and the right side (P0.05). The vertical distance ratio of rotation center of femoral head in control group, excellent group and non-excellent group had statistical difference (P0.05). There was no significant difference in the horizontal distance ratio of femoral head rotation center between control group, excellent group and non-excellent group (P0.05). There was no significant difference in acetabular prosthesis between excellent group and non-excellent group (P0.05). There was no significant difference in the ratio of femoral eccentricity, abductor arm and weight arm between the control group and the excellent group (P0.05). The ratio of bilateral femoral eccentricity, abductor arm and weight arm were significantly different between the control group and the non-excellent group, the excellent group and the non-excellent group (P0.05). The difference of lower limb length between excellent and good group was statistically different from that of non-excellent group (P0.05). The abduction angle of excellent group was significantly different from that of non-excellent group (P0.05). Conclusion: reconstruction of femoral head rotation center of hip joint as far as possible or close to anatomical position, reconstruction or appropriate increase of femoral eccentricity, restoration of lower limb length, acetabular pseudo-external angle of 30o ~ 50o, hip joint function can be better recovered.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4
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