本文選題：髖臼發(fā)育不良 + 不典型癥狀��； 參考：《安徽醫(yī)科大學(xué)》2015年碩士論文

【摘要】：背景:髖臼發(fā)育不良(acetabular dysplasia,AD)是臨床常見(jiàn)疾患,早期若得不到及時(shí)的診斷和治療,部分患者晚期會(huì)引起髖關(guān)節(jié)骨性關(guān)節(jié)炎,嚴(yán)重影響患者的生活和工作,最終不可避免行全髖關(guān)節(jié)置換術(shù)。目前國(guó)內(nèi)外關(guān)于AD的研究多集中于其治療方法和影像學(xué)分析上,關(guān)于其不典型癥狀的相關(guān)研究未見(jiàn)報(bào)道。目的:分析具有不典型癥狀A(yù)D患者的臨床特征,提高對(duì)AD不典型癥狀的認(rèn)識(shí)。方法:對(duì)2013年1月至2014年5月在我院就診并行骨盆正位片檢查確診的120例AD患者,分為典型癥狀組和不典型癥狀組。記錄患者的一般情況(性別和年齡)、X線表現(xiàn)(Crowe分型)、臨床癥狀(典型癥狀和其他癥狀)和合并癥(如平足癥、拇外翻、膝內(nèi)翻等),進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:(1)在納入的120例AD患者中,男性33例,女性87例,性別比為0.38∶1,年齡16~66歲,平均(46.9±14.1)歲。其中典型癥狀組42例,占35%,男性12例,女性30例,0.40∶1,年齡18~66歲,平均(48.6±15.5)歲;不典型癥狀組78例,占65%,男性21例,女性57例,為0.37∶1,年齡16~58歲,平均(39.0±14.8)歲。典型癥狀組的平均年齡大于不典型癥狀組,2組間年齡分布差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2組患者中女性均多于男性,性別差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。所有患者按年齡分層,≥50歲的患者占不典型癥狀組的7.7%(6/78),占典型癥狀組的28.6%(12/42),50歲以上不典型癥狀的發(fā)生率明顯降低(P0.05)。(2)典型癥狀組中CroweⅠ型占35.7%(15/42),Ⅱ型占42.9%(18/42),Ⅲ型占19.0%(8/42),Ⅳ型占2.4%(1/42);不典型癥狀組中CroweⅠ型占37.2%(29/78),Ⅱ型占43.6%(34/78),Ⅲ型占19.2%(15/78),Ⅳ型占0%(0/78)。2組患者Crowe分型差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(3)典型癥狀組的患者均有不同程度的髖部酸脹疼痛和髖關(guān)節(jié)活動(dòng)受限;不典型癥狀組的患者中以腰痛癥狀為主的占20.5%(16/78),以同側(cè)膝關(guān)節(jié)痛癥狀為主的占15.4%(12/78),無(wú)癥狀的占64.1%(50/78)。(4)典型癥狀組中合并有平足癥的占9.5%(4/42),拇外翻占2.4%(1/42),膝內(nèi)翻占4.8%(2/42);不典型癥狀組中合并有平足癥的占9.0%(7/78),拇外翻占2.6%(2/78),膝內(nèi)翻占5.1%(4/78)。2組患者合并癥差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:具有不典型癥狀的AD患者臨床上較常見(jiàn),單憑患者的癥狀鑒別困難,應(yīng)提高對(duì)AD不典型癥狀的認(rèn)識(shí),重視疑似患者的體檢和骨盆正位片檢查,以提高AD患者的檢出率。
[Abstract]:Background: acetabular dysplasia of acetabulum (ADA) is a common clinical disease. If early diagnosis and treatment are not available, some patients with advanced stage of hip osteoarthritis will be seriously affected the life and work of patients.Finally, total hip replacement was inevitable.At present, most of the researches on AD are focused on its treatment methods and imaging analysis, but there is no report on its atypical symptoms.Objective: to analyze the clinical features of AD patients with atypical symptoms and to improve the understanding of AD atypical symptoms.Methods: from January 2013 to May 2014, 120 patients with AD diagnosed by pelvic radiography were divided into typical symptom group and atypical symptom group.The general data (sex and age) of Crowe classification, clinical symptoms (typical symptoms and other symptoms) and complications (such as pedal syndrome, hallux valgus, knee varus etc.) were recorded for statistical analysis.Results among 120 AD patients, 33 were male, 87 were female, the sex ratio was 0.38: 1, the age was 16 ~ 66 years old with an average of 46.9 鹵14.1 years old.There were 42 cases in typical symptom group, 12 cases in male and 30 cases in female, the age was 1866 years old (mean 48.6 鹵15.5) years old, 78 cases in atypical symptom group (65 cases, 21 cases, male 21 cases, female 57 cases, 0.37: 1, age 160-58 years old, mean 39.0 鹵14.8 years old).The average age of the typical symptom group was larger than that of the atypical symptom group. There was significant difference in age distribution between the two groups.All patients were stratified by age,There was no significant difference in Crowe typing between Crowe 鈪，

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