伯尔尼髋臼周围截骨术治疗髋关节发育不良疗效分析

发布时间：2018-06-03 20:39

本文选题：伯尔尼髋臼周围截骨术 + 髋关节发育不良　；参考：《遵义医学院》2017年硕士论文

【摘要】：目的:探讨伯尔尼髋臼周围截骨术治疗成人髋关节发育不良的临床疗效。方法:回顾性分析2014年3月~2015年12月采用改良Smith-Peterson入路伯尔尼髋臼周围截骨术治疗16例(16髋)髋关节发育不良患者,其中男患1例,女患15例。平均年龄36.9岁(范围,18~45岁)。T?nnis骨关节炎分期:0期5例,Ⅰ期9例,Ⅱ期2例。其中2例联合股骨近端截骨及髋关节外科脱位,4例联合髋关节外科脱位。搜集手术前后Harris髋关节评分、Harris疼痛评分、VAS评分、LCE较、AC角、ACE角、住院时间、手术时间、失血量、髋关节活动范围、手术并发症等,并进行分析。结果:16例患者均获得随访,随访15~35个月,平均29个月。平均手术时间3.1 h(2.5~6.3 h);平均出血量为620 ml(400~1500 ml);术后输血7例,平均输血400ml(200~600 ml);术后平均引流量106 ml(50~180 ml);平均住院时间13.9天(8~25天)。末次随访,Harris髋关节评分由术前(77.00±13.56)分改善为术后(92.25±4.86)分,其中Harris疼痛评分由术前(30.63±7.72)分改善为术后(42.00±4.79)分;VAS评分为由术前(4.96±1.32)分改善为术后(0.31±0.70)分。LCE角从术前(4.30±8.50)°改善到术后(30.02±5.82)°;ACE角从术前(7.53±3.62)°改善到术后(28.80±4.63)°;AC角从术前(28.08±5.72)°改善到术后(3.04±1.26)°。术前16例Shenton线均不连续,术后5髋不连续。末次随访,12例疼痛消失,4例疼痛症状明显好转,但髋关节平均活动范围较术前减少。结论:伯尔尼髋臼周围截骨术是治疗成人髋关节发育不良有效治疗方法,早期疗效满意,可明显改善股骨头覆盖,减轻或消除患者疼痛症状,有望延缓或阻止骨关节炎进展。
[Abstract]:Objective: To investigate the clinical efficacy of peri acetabular osteotomy for the treatment of dysplasia of the hip in adults. Methods: a retrospective analysis of 16 patients (16 hips) with dysplasia of the hip was performed in December, ~2015, March 2014, with modified Smith-Peterson approach Berne acetabular osteotomy, including 1 male patients and 15 female patients. The average age was 36.9 years old. Staging of.T? NNIS osteoarthritis: 0 stage 5 cases, 9 cases in stage I, 2 cases in stage II. 2 cases combined with proximal femur and hip joint surgical dislocation, 4 cases of joint surgical dislocation of hip joint. Before and after operation, Harris hip joint score, Harris pain score, VAS score, AC angle, ACE angle, hospital time, operation time, lost blood volume, hip joint work Results: 16 patients were followed up for 15~35 months with an average of 29 months. The mean operation time was 3.1 H (2.5~6.3 h); the average bleeding amount was 620 ml (400~1500 ml); after operation 7 cases, average transfusion 400ml (200~600 ml); average postoperative flow rate of 106 ml (50~180); average length of hospitalization for 13.9 days. 25 days). After the last follow-up, the Harris hip score was improved to (92.25 + 4.86) scores before operation (92.25 + 4.86). The Harris pain score was improved to (42 + 4.79) scores before operation (42 + 4.79), and the VAS score was improved from preoperative (4.96 + 1.32) to postoperative (0.31 + 4.86) to postoperative (4.96 + 4.86) degrees. 5.82); ACE angle improved from preoperative (7.53 + 3.62) degrees to postoperative (28.80 + 4.63) degrees; AC angle improved from preoperative (28.08 + 5.72) degrees to postoperative (3.04 + 1.26) degrees. 16 cases of Shenton line were discontinuous before operation and 5 hip discontinuous after operation. Last follow-up, 12 cases of pain disappeared and significant pain symptoms improved obviously, but the average range of hip joint activity was less than that before operation. Conclusion: Bob. The peri acetabular osteotomy is an effective treatment method for the treatment of adult hip dysplasia. The early curative effect is satisfactory. It can obviously improve the femoral head cover, reduce or eliminate the pain symptoms of the patients. It is expected to delay or prevent the progress of osteoarthritis.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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