全膝关节置换术后膝关节疼痛原因分析

发布时间：2018-03-01 16:12

本文关键词： 全膝关节置换术疼痛原因分析　出处：《延安大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:对初次行单侧全膝关节置换术(TKA)术后膝关节疼痛原因进行分析总结,进一步指导临床,提高手术质量,提高患者术后满意度。方法:回顾性分析延安大学附属医院从2014年12月至2016年3月初次行单侧全膝关节置换术的患者总计108例,通过门诊、住院病房及电话等方式进行为期12个月随访。充分收集患者临床资料,根据收集病例纳入及排除标准,筛选出符合TKA术后膝关节疼痛的患者,依据国内外文献资料总结的TKA术后膝关节疼痛的常见原因进行临床分析。所有收集的计量资料行正态性检验服从正态分布,采用均数±标准差来描述,组间比较采用方差分析;计数材料采用率来描述,组间比较采用卡方检验,术后膝关节疼痛具体原因进行描述性分析,对所收集的临床资料均采用SPSS 20.0统计软件包进行数据处理分析,当P0.05时差异具有统计学意义。结果:108例随访患者中,11例出现术后膝关节不同程度疼痛,疼痛发生率为10.2%。疼痛原因主要有:1、关节不稳2例(1.9%);2、关节线上移1例(0.9%);3、膝关节粘连、僵硬1例(0.9%);4、力线不良1例(0.9%);5、髌骨运动轨迹不良2例(1.9%);6、腰椎病变1例(0.9%);7、髋关节病变1例(0.9%);8、不明原因疼痛2例(1.9%)。结论:1、TKA术后6月内膝关节疼痛的主要原因以关节内病变为主,主要有关节不稳、关节线异常、力线不良、膝关节粘连和僵硬及髌骨运动轨迹不良,其中以关节不稳、髌骨运动轨迹不良为主。2、TKA术6月以后膝关节疼痛多由关节外因素引起,可见于腰椎病变、髋关节病变、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 卤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.
【学位授予单位】：延安大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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