全膝关节置换术治疗骨关节炎术前、术后功能改善的疗效分析

发布时间：2018-01-16 15:03

本文关键词：全膝关节置换术治疗骨关节炎术前、术后功能改善的疗效分析　出处：《青海大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:晚期骨性关节炎在保守治疗无效下应用全膝关节置换术(Total Kne Replacement,TKR)治疗后观测及分析其临床疗效,并探讨可能影响我院膝关节疗效的相关因素,制定规范化的诊疗程序。方法:收集不同程度的骨性关节炎患者的病例50例(76膝),双侧26例(52膝),单侧24例(24膝),男性12例,女性38例,平均年龄61.5岁,并全部在青海大学附属医院关节科室行关节置换术,时间为2014年9月~2015年2月。术后1月、6月、8月、12月对其随访,并将全部临床资料进行收集、总结、分析,并且定期随访。纳入标准参考美国风湿骨病学会诊断标准,以HSS评分系统加以评分,该系统是由不同的七部分汇总而成。本组纳入研究所有手术病例全部选用后稳定型假体,整个手术过程中均未采用髌骨置换术。结果:本组全部病例均得到随访,根据随访结果统计显示其中达到优膝46例(85-96分),良膝28例(72-84分),中2膝,差0膝,优良率为97.4%,膝关节术前平均HSS评分45.7±6.8,术后HSS平均分86.3±7.7。术后患者在疼痛方面改善率为37%,膝关节活动度改善率为12.8%。随访结果与术前初次入院评分比较,P0.05,有统计学意义。本组50例(76膝)患者直到末次随访时尚未出现切口感染、下肢深静脉血栓形成等并发症。结论:晚期膝骨性关节炎在其它方法治疗无效时采用TKA术式进行治疗,其经临床统计分析表明效果非常显著。该手术最大的优点在于矫正膝关节畸形方面疗效卓越,可值得在青海本地区临床中加以推广应用,以解决该类患者的疾苦。
[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 卤6.8.The excellent and good rate of good knee was 97.40.The average score of HSS was 45.7 卤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 卤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.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.4

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