本文關鍵詞： 全膝關節(jié)置換術 疼痛 原因分析　出處：《延安大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:對初次行單側全膝關節(jié)置換術(TKA)術后膝關節(jié)疼痛原因進行分析總結,進一步指導臨床,提高手術質量,提高患者術后滿意度。方法:回顧性分析延安大學附屬醫(yī)院從2014年12月至2016年3月初次行單側全膝關節(jié)置換術的患者總計108例,通過門診、住院病房及電話等方式進行為期12個月隨訪。充分收集患者臨床資料,根據(jù)收集病例納入及排除標準,篩選出符合TKA術后膝關節(jié)疼痛的患者,依據(jù)國內外文獻資料總結的TKA術后膝關節(jié)疼痛的常見原因進行臨床分析。所有收集的計量資料行正態(tài)性檢驗服從正態(tài)分布,采用均數(shù)±標準差來描述,組間比較采用方差分析;計數(shù)材料采用率來描述,組間比較采用卡方檢驗,術后膝關節(jié)疼痛具體原因進行描述性分析,對所收集的臨床資料均采用SPSS 20.0統(tǒng)計軟件包進行數(shù)據(jù)處理分析,當P0.05時差異具有統(tǒng)計學意義。結果:108例隨訪患者中,11例出現(xiàn)術后膝關節(jié)不同程度疼痛,疼痛發(fā)生率為10.2%。疼痛原因主要有:1、關節(jié)不穩(wěn)2例(1.9%);2、關節(jié)線上移1例(0.9%);3、膝關節(jié)粘連、僵硬1例(0.9%);4、力線不良1例(0.9%);5、髕骨運動軌跡不良2例(1.9%);6、腰椎病變1例(0.9%);7、髖關節(jié)病變1例(0.9%);8、不明原因疼痛2例(1.9%)。結論:1、TKA術后6月內膝關節(jié)疼痛的主要原因以關節(jié)內病變?yōu)橹?主要有關節(jié)不穩(wěn)、關節(jié)線異常、力線不良、膝關節(jié)粘連和僵硬及髕骨運動軌跡不良,其中以關節(jié)不穩(wěn)、髕骨運動軌跡不良為主。2、TKA術6月以后膝關節(jié)疼痛多由關節(jié)外因素引起,可見于腰椎病變、髖關節(jié)病變、不明原因疼痛等。
[Abstract]:Objective: to analyze and summarize the causes of knee joint pain after unilateral total knee arthroplasty (TKA) for the first time, so as to guide clinical practice and improve the quality of operation. Methods: a total of 108 patients undergoing unilateral total knee arthroplasty from December 2014 to early 2016 in Yanan University Hospital were analyzed retrospectively. The hospital ward and telephone were followed up for 12 months. The clinical data of the patients were fully collected. According to the criteria of inclusion and exclusion of the collected cases, the patients who met the knee pain after TKA operation were selected. The common causes of knee joint pain after TKA were analyzed according to the literature at home and abroad. All the collected measurement data were normal distribution, mean 鹵standard deviation was used to describe, and ANOVA was used in the comparison between groups. The counting materials were described by rate, chi-square test was used for comparison between groups, the specific causes of postoperative knee pain were analyzed, and the clinical data collected were analyzed by SPSS 20.0 statistical software package. Results among 108 cases of follow-up, 11 cases had postoperative pain of knee joint, the incidence of pain was 10.2%. The main causes of pain were 1: 1, 2 cases of instability of joint, 1 case of joint line up, 3 cases of knee joint adhesion, 3 cases of knee joint adhesion, 2 cases of joint instability, 2 cases of joint instability, 2 cases of joint instability, 2 cases of joint instability and 2 cases of joint instability. Stiffness in 1 case was 0. 9%, dyskinesia in 1 case was 0. 95%, patellar motion track was bad in 2 cases, patellar movement track was 1. 9%, lumbar vertebrae disease in 1 case was 0. 9%, hip joint disease in 1 case was 0. 9%, unknown cause pain in 2 cases was 9. 9. Conclusion Intra-articular lesion is the main cause of knee pain in June after 1 TKA operation, conclusion: 1 TKA is the main cause of intra-articular pain after operation 1 TKA, and the main causes of knee pain in June are intra articular lesions. There were mainly instability of joint, abnormal line of joint, malalignment of force line, adhesion and stiffness of knee joint and poor track of patellar movement. The main causes of knee pain after June were joint instability and poor trajectory of patella. After June, the pain of knee joint was caused by external factors. Can be seen in lumbar disease, hip disease, unknown cause of pain and so on.
【學位授予單位】：延安大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.4

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