体位改变对髋臼外展角的影响及临床意义

发布时间：2018-07-25 12:30

【摘要】：目的探究骨盆的内收外展运动对髋臼外展角的影响，提高后外侧入路行THA时髋臼假体外展角的置入精度。方法 1实验方法 1.1实体测量15具正常成人骨盆标本，其中男性标本8具，女性标本7具，共30髋，骨盆标本以矢状轴为旋转轴，分别在不同的旋转角度，测量髋臼外展角的度数。记录并整理所得数据，用SPSS13.0统计学软件统计分析外展角与骨盆旋转角度是否存在直线相关关系，统计分析男女骨盆标本所测外展角在相同骨盆旋转角度时是否有统计学差异。 1.2影像学测量正常人在侧卧位时时骨盆沿矢状轴旋转角度，，60名志愿者取侧卧位，用床边DR拍摄骨盆正位片，用铅垂线在相关接收器上找出并放置金属水平线和垂直线，以作为测量角度时的参考标准，将所得图像用DICOM3.0处理，测量骨盆泪滴连线与垂直线的夹角，统计分析相关数据。 2统计学分析所有测量数据均以均数±标准差（x±s）的形式表示，采用SPSS13.0（SPSS，美国）软件进行数据统计学处理和分析。所测骨盆髋臼外展角与骨盆沿矢状轴旋转角度做散点图，做直线相关分析。分别对男女性髋臼外展角在相同骨盆旋转角度时进行独立样本t检验分析。对影像学所测量的男女骨盆绕矢状轴旋转角度进行独立样本t检验分析，检验水平均取双侧0.05。结果 1.髋臼外展角与骨盆沿矢状轴旋转度数呈直线相关，回归方程为y=47.144+0.942x。 2.男性髋臼外展角在相同骨盆旋转角度时与女性无明显差异(p＞0.05)。 3.正常人侧卧位时骨盆平均外展5.47°。侧卧位时，男女骨盆内收外展角度无统计学差异(p＞0.05)。结论 1.骨盆内收或者外展运动敏感的影响髋臼外展角的变化，后外侧入路行髋关节置换术时要注意限制骨盆内收外展运动，术前和术中应注意适当调整体位。 2.后外侧入路行髋关节置换术时可以忽略性别因素对髋臼假体外展角的影响。
[Abstract]:Objective to investigate the effect of pelvic adductive outreaching motion on acetabular abduction angle and to improve the accuracy of acetabular prosthesis abduction angle placement by posterolateral approach in THA. Methods 1 Experimental method 1.1 measured 15 normal adult pelvic specimens, including 8 male specimens and 7 female specimens (30 hips). The pelvic specimens were sagittal axis as rotation axis and were rotated at different angles. The degree of acetabular abduction was measured. The data were recorded and sorted, and the linear correlation between abduction angle and pelvis rotation angle was analyzed by SPSS13.0 statistical software. Statistical analysis of male and female pelvic specimens measured abduction angle at the same pelvic rotation angle is statistically different. 1.2 Imaging measurement of normal people in lateral position along the sagittal axis of the pelvis rotation angle of 60 volunteers to take lateral position. The pelvis positive film was taken with the bedside Dr, and the metal horizontal line and vertical line were found and placed on the relative receiver with the lead vertical line, which was used as the reference standard when measuring the angle, and the image was processed by DICOM3.0. The angle between the teardrop line of the pelvis and the vertical line was measured and the relevant data were analyzed statistically. 2 all the measured data were expressed as mean 卤standard deviation (x 卤s). SPSS13.0 (SPSS, USA) software was used to process and analyze the data. The acetabular abduction angle and the pelvic rotation angle along the sagittal axis were analyzed. T-test analysis of male and female acetabular abduction angle at the same pelvis rotation angle was carried out. T test analysis of the rotation angle of male and female pelvis around sagittal axis was carried out. The test level was 0. 05 on both sides. Result 1. The acetabular abduction angle was linearly correlated with the degree of rotation of the pelvis along the sagittal axis, and the regression equation was YJ 47.144 0.942 x.2. There was no significant difference in acetabular abduction angle between male and female at the same pelvic rotation angle (p > 0.05). 3. The average abduction of pelvis was 5.47 掳in lateral position. There was no significant difference in the angle of pelvic adduction and abduction between male and female in lateral position (p > 0.05). Conclusion 1. Pelvic adduction or extravasation sensitivities affect acetabular abduction angle changes. Attention should be paid to limiting pelvic adductive abduction movement during hip arthroplasty through posterolateral approach, and proper adjustment of posture should be paid attention to before and during operation. 2. The influence of sex factors on the abduction angle of acetabular prosthesis can be ignored during hip arthroplasty via posterolateral approach.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R687.4;R322

【参考文献】