發(fā)布時間：2018-09-05 09:57

【摘要】：目的系統(tǒng)評價骨盆截骨術治療Perthes病,揭示預后特征,為科學評價骨盆截骨術提供依據(jù)。方法檢索Pubmed、Embase、Cochrane library、Web of science、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)、中國知網(wǎng)(CNKI)、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫,收集國內外骨盆截骨術治療Perthes病的相關研究,依據(jù)美國醫(yī)療保健研究與質量局(Agency for Healthcare Research and Quality,AHRQ)對橫斷面研究的評價標準進行質量評價,整理提取數(shù)據(jù),采用Meta-analyst軟件進行meta分析。結果1.根據(jù)Stulberg分級評價標準,結果分析表明2-16歲的Perthes病患者行骨盆截骨術后隨訪2.6-15.2年,Stulberg I級的患者為19.2%,II級的患者為38.0%,III級的患者為27.5%,IV級的患者為17.2%,V級的患者為4.0%;根據(jù)Mose分級評價標準,結果分析表明2-14歲的Perthes病患者行骨盆截骨術后隨訪1.5-9.0年,Mose分級為“優(yōu)”的患者為52.4%,“良”的患者為25.0%,“差”的患者為20.3%。2.根據(jù)Mckay髖關節(jié)功能分級評價標準,分析結果表明3-14歲的Perthes病患者行骨盆截骨術后隨訪1.0-6.5年,Mckay髖關節(jié)功能分級“優(yōu)”的患者為88.5%,“良”的患者為9.9%,“可”的患者為3.3%,“差”的患者為0.8%。3.Meta分析不良癥狀(雙下肢不等長、跛行、Trendelenburg征)結果表明:2-17歲的Perthes病患者行骨盆截骨術后隨訪2.8-15.2年,殘留雙下肢不等長的患者為24.1%;2-17歲行骨盆截骨術后隨訪2.8-6.9年殘留Trendelenburg征(+)的患者為19.6%;2-17歲行骨盆截骨術后隨訪3.0-6.5年殘留跛行的患者為40.3%。結論1.按Stulberg分級、Mose分級評價標準,骨盆截骨術后可有效緩解患者臨床癥狀,并延遲或降低遠期骨關節(jié)炎的發(fā)生率。2.按Mckay髖關節(jié)分級評價標準,骨盆截骨術對緩解髖關節(jié)疼痛、改善髖關節(jié)功能效果較好。3.Meta分析表明骨盆截骨術后殘留較多的不良癥狀有跛行、Trendelenburg征(+)及雙下肢不等長。
[Abstract]:Objective to evaluate the effect of pelvic osteotomy in the treatment of Perthes's disease, and to reveal the prognostic features, and to provide scientific basis for the evaluation of pelvic osteotomy. Methods Pubmed,Embase,Cochrane library,Web of science, Chinese biomedical literature database (CBM), (CNKI), Wanfang database and Weip database were searched to collect the relevant research of pelvic osteotomy for Perthes disease at home and abroad. According to the (Agency for Healthcare Research and Quality,AHRQ of the United States Medical Care Research and quality Bureau, the evaluation standard of cross-sectional research was evaluated, the data was collected and the meta was analyzed by Meta-analyst software. Result 1. According to the Stulberg grading criteria, the results showed that the follow-up period of 2.6-15.2 years after pelvic osteotomy in patients with Perthes's disease aged 2-16 years was 19.2g / II, 38.0g / III and 17.2g / V respectively, according to the evaluation criteria of Mose grade. The results showed that the patients with Perthes's disease aged 2 to 14 were followed up for 1.5 to 9.0 years after pelvic osteotomy. The number of patients with "excellent", "good" and "poor" patients were 52.4, 25.0 and 20.33. 2 respectively. According to Mckay hip function grading criteria, The results showed that the patients with Perthes's disease aged 3-14 were followed up 1.0-6.5 years after pelvic osteotomy for a period of 1.0-6.5 years. The scores of "excellent", "good", "can" and "poor" patients were 88.5, 9.9, 3.3 and 3.33, respectively, and those with "poor" and "poor" were analyzed for adverse symptoms by 0.8%.3.Meta. (lower limbs are unequal in length, The results of Trendelenburg's sign showed that patients with Perthes's disease aged 2 to 17 were followed up for 2.8-15.2 years after pelvic osteotomy. Patients with residual lower extremities of varying lengths were followed up for 2.8-6.9 years with residual Trendelenburg sign (2.8-6.9 years) in patients aged from 2 to 17 years. The patients with residual claudication of 3.0-6.5 years after pelvic osteotomy at the age of 19.6 and 17 years were followed up by pelvic osteotomy for 3.0-6.5 years and 40.3% of the patients were followed up after pelvic osteotomy. Conclusion 1. According to the criteria of Stulberg grade and Mose grade, pelvic osteotomy can effectively relieve the clinical symptoms and delay or reduce the incidence of long-term osteoarthritis. According to Mckay hip grading evaluation criteria, pelvic osteotomy was effective in relieving hip pain and improving hip joint function. 3. Meta-analysis showed that the most residual adverse symptoms after pelvic osteotomy were limping Trendelenburg sign and lower extremity.
【學位授予單位】：遵義醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R726.8

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