对具有不典型症状的髋臼发育不良患者临床特征的研究

发布时间：2018-04-10 15:11

  本文选题：髋臼发育不良 + 不典型症状　； 参考：《安徽医科大学》2015年硕士论文

【摘要】：背景:髋臼发育不良(acetabular dysplasia,AD)是临床常见疾患,早期若得不到及时的诊断和治疗,部分患者晚期会引起髋关节骨性关节炎,严重影响患者的生活和工作,最终不可避免行全髋关节置换术。目前国内外关于AD的研究多集中于其治疗方法和影像学分析上,关于其不典型症状的相关研究未见报道。目的:分析具有不典型症状AD患者的临床特征,提高对AD不典型症状的认识。方法:对2013年1月至2014年5月在我院就诊并行骨盆正位片检查确诊的120例AD患者,分为典型症状组和不典型症状组。记录患者的一般情况(性别和年龄)、X线表现(Crowe分型)、临床症状(典型症状和其他症状)和合并症(如平足症、拇外翻、膝内翻等),进行统计学分析。结果:(1)在纳入的120例AD患者中,男性33例,女性87例,性别比为0.38∶1,年龄16~66岁,平均(46.9±14.1)岁。其中典型症状组42例,占35%,男性12例,女性30例,0.40∶1,年龄18~66岁,平均(48.6±15.5)岁;不典型症状组78例,占65%,男性21例,女性57例,为0.37∶1,年龄16~58岁,平均(39.0±14.8)岁。典型症状组的平均年龄大于不典型症状组,2组间年龄分布差异具有统计学意义(P0.05)。2组患者中女性均多于男性,性别差异无统计学意义(P0.05)。所有患者按年龄分层,≥50岁的患者占不典型症状组的7.7%(6/78),占典型症状组的28.6%(12/42),50岁以上不典型症状的发生率明显降低(P0.05)。(2)典型症状组中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);不典型症状组中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组患者Crowe分型差异无统计学意义(P0.05)。(3)典型症状组的患者均有不同程度的髋部酸胀疼痛和髋关节活动受限;不典型症状组的患者中以腰痛症状为主的占20.5%(16/78),以同侧膝关节痛症状为主的占15.4%(12/78),无症状的占64.1%(50/78)。(4)典型症状组中合并有平足症的占9.5%(4/42),拇外翻占2.4%(1/42),膝内翻占4.8%(2/42);不典型症状组中合并有平足症的占9.0%(7/78),拇外翻占2.6%(2/78),膝内翻占5.1%(4/78)。2组患者合并症差异无统计学意义(P0.05)。结论:具有不典型症状的AD患者临床上较常见,单凭患者的症状鉴别困难,应提高对AD不典型症状的认识,重视疑似患者的体检和骨盆正位片检查,以提高AD患者的检出率。
[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 卤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 卤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 卤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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