本文關(guān)鍵詞：全膝關(guān)節(jié)置換術(shù)治療骨關(guān)節(jié)炎術(shù)前、術(shù)后功能改善的療效分析　出處：《青海大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的:晚期骨性關(guān)節(jié)炎在保守治療無(wú)效下應(yīng)用全膝關(guān)節(jié)置換術(shù)(Total Kne Replacement,TKR)治療后觀測(cè)及分析其臨床療效,并探討可能影響我院膝關(guān)節(jié)療效的相關(guān)因素,制定規(guī)范化的診療程序。方法:收集不同程度的骨性關(guān)節(jié)炎患者的病例50例(76膝),雙側(cè)26例(52膝),單側(cè)24例(24膝),男性12例,女性38例,平均年齡61.5歲,并全部在青海大學(xué)附屬醫(yī)院關(guān)節(jié)科室行關(guān)節(jié)置換術(shù),時(shí)間為2014年9月~2015年2月。術(shù)后1月、6月、8月、12月對(duì)其隨訪,并將全部臨床資料進(jìn)行收集、總結(jié)、分析,并且定期隨訪。納入標(biāo)準(zhǔn)參考美國(guó)風(fēng)濕骨病學(xué)會(huì)診斷標(biāo)準(zhǔn),以HSS評(píng)分系統(tǒng)加以評(píng)分,該系統(tǒng)是由不同的七部分匯總而成。本組納入研究所有手術(shù)病例全部選用后穩(wěn)定型假體,整個(gè)手術(shù)過(guò)程中均未采用髕骨置換術(shù)。結(jié)果:本組全部病例均得到隨訪,根據(jù)隨訪結(jié)果統(tǒng)計(jì)顯示其中達(dá)到優(yōu)膝46例(85-96分),良膝28例(72-84分),中2膝,差0膝,優(yōu)良率為97.4%,膝關(guān)節(jié)術(shù)前平均HSS評(píng)分45.7±6.8,術(shù)后HSS平均分86.3±7.7。術(shù)后患者在疼痛方面改善率為37%,膝關(guān)節(jié)活動(dòng)度改善率為12.8%。隨訪結(jié)果與術(shù)前初次入院評(píng)分比較,P0.05,有統(tǒng)計(jì)學(xué)意義。本組50例(76膝)患者直到末次隨訪時(shí)尚未出現(xiàn)切口感染、下肢深靜脈血栓形成等并發(fā)癥。結(jié)論:晚期膝骨性關(guān)節(jié)炎在其它方法治療無(wú)效時(shí)采用TKA術(shù)式進(jìn)行治療,其經(jīng)臨床統(tǒng)計(jì)分析表明效果非常顯著。該手術(shù)最大的優(yōu)點(diǎn)在于矯正膝關(guān)節(jié)畸形方面療效卓越,可值得在青海本地區(qū)臨床中加以推廣應(yīng)用,以解決該類患者的疾苦。
[Abstract]:Objective: to observe and analyze the clinical effect of total Kne replacement in the treatment of advanced osteoarthritis. To explore the related factors that may affect the curative effect of knee joint in our hospital, and to establish a standardized diagnosis and treatment procedure. Methods: 50 cases of osteoarthritis with different degrees of osteoarthritis with 76 knees were collected. Twenty-two bilateral patients with 52 knees and 24 unilateral patients with 24 knees, 12 males and 38 females, with an average age of 61.5 years, underwent arthroplasty in the Department of Arthrology, affiliated Hospital of Qinghai University. It was followed up from September 2014 to February 2015. All clinical data were collected, summarized and analyzed. The American Society of Rheumatological Osteopathy Diagnostic criteria were consulted and scored with the HSS scoring system. The system is composed of seven different parts. All the patients were selected as posterior stable prosthesis. Results: all the patients were followed up. According to the results of follow-up, 46 cases of superior knee were found to have achieved 85-96 points. The average HSS score was 45.7 鹵6.8.The excellent and good rate of good knee was 97.40.The average score of HSS was 45.7 鹵6.8.The average score of good knee was 72-84 minutes, 2 knees of middle knee, 0 knees of poor quality. The average score of postoperative HSS was 86.3 鹵7.7.The improvement rate of postoperative pain was 37 and the improvement rate of knee motion was 12.8. the follow-up results were compared with the preoperative initial admission score. There was no incision infection in 50 patients (76 knees) until the last follow-up. Conclusion: advanced knee osteoarthritis is treated by TKA procedure when other methods are not effective. Clinical statistical analysis shows that the effect is very remarkable. The biggest advantage of this operation lies in the excellent curative effect in correcting knee deformity, and it is worth popularizing and applying in the clinical practice of Qinghai province. In order to solve the suffering of this type of patients.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R687.4

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