关节遗忘评分在全髋关节置换术后的应用

发布时间：2018-04-10 03:30

本文选题：全髋关节置换术　切入点：关节遗忘评分　出处：《昆明医科大学》2017年硕士论文

【摘要】：[目的]验证关节遗忘评分(FJS评分)的效度,比较它与传统关节评分天花板效应,反应度的区别。研究FJS评分在中国人全髋关节置换术后随访的应用。从而推广FJS评分在中国全髋关节置换术术后随访的应用。[方法]收集昆明医科大学第二附属医院骨科从2014年6月到2015年12月行一期单侧全髋关节置换术的患者共51人。平均年龄61. 4岁,其中男性患者29名,平均年龄为61. 2岁;女性患者22名,平均年龄为61. 7岁。左侧18例,右侧33例。股骨头坏死或髋关节骨关节炎41例,股骨颈骨折9例,类风湿关节炎1例。所有患者均在在术后6个月和12个月行Harris髋关节评分(HHS评分)、牛津髋关节评分(OHS评分)、关节遗忘评分(FJS评分)。采用统计软件SPSS18.0进行统计分析,通过比较FJS评分、HHS评分、OHS评分的相关性来验证FJS的效度,比较FJS评分、HHS评分、OHS评分在术后6个月、12个月得分的天花板效应,比较三者得分从6个月到12个月变化的反应度,验证性别,年龄,疾病谱对FJS评分的影响。[结果]FJS评分与HHS评分和OHS评分有着高的相关性,结果分别是r= 0.839和r=0. 835。术后6个月的时候,FJS评分的天花板效应是0, HHS评分是19. 60 %,OHS评分是15. 68%,术后12个月的时候,FJS评分的天花板效应是13. 72%,HHS评分是29.41%,OHS评分是25.49%。术后12个月的时候,FJS评分的天花板效应分别是HHS评分、OHS评分的一半左右。患者术后6个月到术后12个月FJS评分变化的反应度ES值为0. 71,HHS评分变化的反应度ES值为0. 35, OHS评分变化的反应度ES值为0.39。男性患者和女性患者术后6个月、术后12个月时FJS、HHS、OHS评分结果无显著差异,70岁以上患者和70岁以下患者术后6个月、术后12个月时FJS、HHS、OHS评分结果无显著差异,而股骨颈骨折病人和非股骨颈骨折病人术后6个月、术后12个月时FJS评分结果无显著差异,HHS评分和OHS评分却有差异。[结论]FJS评分是一类评价关节置换术后关节状况的病人自评估评分系统(PROs),它已经被多位专家、多个国家验证了其良好的信度、效度、条目的内部一致性。它的潜在减分设置涵盖了以往评分的患者抱怨内容,如:疼痛、僵硬、功能差、活动范围低,而且包含患者心理学测评,它更加注重患者自身的感受,更加以患者为中心。体现现代医疗“患者说好才是真的好”的理念。条目简单便于患者作答和医生随访。与传统的关节评分工具相比它的主要优势在于它有低的天花板效应和高的反应度,使得我们能够观察传统关节评分高分人群的区别,使得我们能够观察患者远期关节的继续变化,便于现代关节置换术的研究,更适合当今医疗水平高、病人要求高的关节置换双高时代。
[Abstract]:[objective] to verify the validity of joint amnesia score (FJS) and compare it with the ceiling effect and response of traditional joint score.To study the application of FJS score in follow-up of total hip arthroplasty in Chinese.Therefore, the application of FJS score in the follow-up of total hip arthroplasty in China was extended.[methods] A total of 51 patients underwent one-stage total hip replacement from June 2014 to December 2015 in Department of Orthopaedics, second affiliated Hospital of Kunming Medical University.The average age is 61.Four years old, including 29 male patients, the average age is 61.Two years old; 22 women with an average age of 61. 1%.Seven years old.Left 18 cases, right 33 cases.Femoral head necrosis or hip osteoarthritis in 41 cases, femoral neck fracture in 9 cases, rheumatoid arthritis in 1 case.All patients were given Harris hip score, Oxford hip score and joint amnesia score at 6 and 12 months postoperatively.Statistical software SPSS18.0 was used for statistical analysis. The validity of FJS was verified by comparing the correlation between FJS score and FJS score. The ceiling effect of FJS score was compared with that of FJS score at 6 and 12 months after operation.The responses of the three groups from 6 months to 12 months were compared to verify the influence of gender, age and disease spectrum on the FJS score.[results] there was a high correlation between FJS score and HHS score and OHS score, the results were r = 0.839 and r = 0 respectively.835.At 6 months after operation, the ceiling effect of FJS score was 0 and the HHS score was 19. 5%.The OHS score is 15.At 12 months after operation, the ceiling effect of FJS score was 13. 5%.The HHS score is 29.41 and the OHS score is 25.49.At 12 months after operation, the ceiling effect of FJS score was about half that of HHS score.The es value of response to the change of FJS score from 6 months to 12 months after operation was 0. 5%.The reactivity of HHS score was 0. 0.The es value of the change of OHS score was 0.39.There was no significant difference in OHS scores between male and female patients 6 months after operation and 12 months after operation. There was no significant difference in the scores of FJS and HHSH OHS in patients over 70 years of age and patients under 70 years of age 6 months after operation, and 12 months after operation.However, there was no significant difference in FJS scores between patients with femoral neck fracture and those with non-femoral neck fracture at 6 months and 12 months after operation. However, there was no significant difference in FJS score and OHS score between patients with femoral neck fracture and those with non-femoral neck fracture.[conclusion] FJS score is a self-assessment system for evaluating joint status after arthroplasty. It has been verified by a number of experts and countries for its good reliability, validity, and internal consistency of items.Its potential score reduction set covers the past scores of patients' complaints, such as: pain, stiffness, poor function, low range of activities, and includes psychological assessment of patients, it pays more attention to patients' own feelings, more patient-centered.Embodies the modern medical treatment, "the patient says good is really good" the idea.The entry is simple and easy for patients to answer and doctors to follow up.Its main advantage over traditional joint scoring tools is that it has a low ceiling effect and a high level of responsiveness, enabling us to observe the differences between traditional joint scoring groups.So that we can observe the long-term joint changes, facilitate the study of modern arthroplasty, more suitable for the current high level of medical treatment, patients with high demand for joint replacement dual high age.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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