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对年轻人髌骨软化症研究的若干进展
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对年轻人髌骨软化症研究的若干进展
官方公共微信作者：&作者本人请参看导师姓名：&学位授予单位：&授予学位：硕士学位年度：2014专业：&关键词：&&&&&摘要:（摘要内容经过系统自动伪原创处理以避免复制，下载原文正常，内容请直接查看目录。）本课题分为两部门,第一部门研讨640层CT活动成像在正常人髌骨活动轨迹的中的运用价值；第二部门研讨640层静态容积CT活动成像对髌股关节对合不良患者的运用价值,并将所获得的数据与第一部门获得的正常人的髌骨活动轨迹停止比较第一部门640层静态容积CT扫描对正常人髌骨活动轨迹的运用价值目标在非负重状况下,采取640层静态容积CT活动扫描成像技巧在正常人髌骨活动轨迹的静态持续活动变更中的运用价值,为髌股关节对合不良的病人的诊断,供给必定正常值的参考尺度。资料和办法研讨对象：前瞻性归入2013年9月～11月九龙病院共20例正常人,个中男15例,女5例,年纪18～51岁,均匀35.95岁,取被检讨者两侧膝关节,故为40只膝关节。一切人均用Toshiba Aquilion one640层静态容积CT停止髌骨活动轨迹的持续扫描。两种丈量办法：被检讨者仰卧于CT检测床上,将两侧膝关节放于丈量台上,固定受检者两侧膝关节的内、外上髁,调剂2点连线平行于丈量台；经由过程调剂体位固定股骨头几何中间和内、外上髁中点的连线平行于丈量台,取膝关节全伸位为丈量肇端点。详细的办法以下：(1)分离于膝关节愚昧角度为30°时,丈量髌骨合适角、髌骨外侧角、髌股指数、股骨滑车角及髌骨高度这5组数据的值。(2)640层静态容积CT对40只膝关节行为态容积扫描,全伸位树立3D坐标,坐标原点为髌骨中间点,扫描时光共为13s,我们可以获得膝角为0°～60°时的膝关节的活动轨迹,并剖析膝关节稳固性的3D坐标值。成果合计丈量40只正常人的膝关节,所得成果以下：1.正常人膝关节的髌股关节稳固性的分级成果为：Ⅰa级4个(10%),Ⅰb级2个(5%),Ⅳa级24个(60%),Ⅳb级10个(25%),Ⅰc、Ⅳc、Ⅱ、Ⅲ级皆为0个。2.跟着膝角在0°-10°之间时,髌骨在X轴上轻度向内侧挪动,尔后跟着膝角的变更(20°～60°),髌骨连续赓续的向外侧移位；跟着膝关节角度的变更(0。-60。),在Y轴(矢状位)上,髌骨连续赓续的向下滑行；髌骨在Z轴的活动轨迹,跟着膝关节愚昧角度的变更,髌骨滑行的轨迹整体是向后的。初始阶段,髌骨的活动幅度变更不年夜,跟着膝关节角度的变更,个中于50。-60。时,髌骨的滑行幅度到达最年夜。结论640层静态容积CT不只可以供给传统的诊断髌股关节稳固性所要的数值,并且可以或许供给髌骨活动轨迹的的三维坐标值,为临床诊断髌股关节稳固性供给加倍周全的材料。第二部门640层静态容积CT扫描对髌股关节对合不良患者的髌骨活动轨迹的运用价值目标：在非负重状况下,应用640层静态容积CT成像技巧,评论辩论髌股关节对合不良病人的髌骨活动轨迹的运用价值,将正常人髌骨活动轨迹与髌股关节对合不良病人的髌骨活动轨迹停止对比剖析。资料和办法：搜集2013年9月～11月九龙病院髌股关节对合不良的病人20例,男9例,女11例,年纪18～55岁,均匀33.55岁,取病人两侧膝关节,共40只膝关节。详细的丈量办法及统计学办法与第一部门雷同。成果：髌股关节对合不良病人的膝关节合计40只：(1).所获得的40只髌股关节对合不良病人的膝关节稳固性的分级成果为：Ⅰa级9个(22.5%),Ⅰb级25个(62.5%),Ⅰc级3个(7.5%),Ⅲb级2个(5%),Ⅳa级1个(2.5%),余Ⅳb-c、Ⅱ、 Ⅲa、c级皆为0个。2.跟着膝关节愚昧角度由0°～60°之间变更,髌骨连续赓续的向内侧移位；在Y轴上跟着膝角的变更(0。-60。),髌骨的活动轨迹像正常人的活动轨迹一样连续赓续的向下滑行；在Z轴上,跟着膝曲角度的变更,髌骨滑行的轨迹是明显向前的。结论：将正常人和髌股关节对合不良患者的传统膝关节稳固性的丈量值停止比较及二者的髌骨活动轨迹在三维坐标轴中的数值停止比较,可以得知,640层静态容积CT扫描成像不只能像传统的膝关节丈量值那样断定髌股关节的稳固性,并且可供给加倍准确的坐标值,为临床对髌股关节稳固性的诊断供给供给更加周全的诊断办法和根据。Abstract:This paper is divided into two departments, the first Department of research activities of 640 slice CT imaging in normal human patell second departments on the 640 layer of static volume CT imaging of the value activities of patellofemoral joint use of poor patients, and will obtain normal patellar tracking data obtained with the first Department of stop comparing the first department using 640 layers of static volume CT scan on normal human patellar tracking value target in non weight bearing condition, take the change static sustained activity 640 layer static volume CT scan imaging skills in normal human patellar tracking in value, for the diagnosis of patellofemoral joint and poor patient, the supply must be normal reference scale. Materials and methods: a total of 20 cases of normal persons, 15 cases of male and 35.95 female, aged from 18 to 5 years old, aged 40 to 51 years old were included in this study. All Aquilion one640 Toshiba layer static volume CT to stop the continuous scanning of the patellar activity trajectory. Two measurement methods: review supine on the CT examination bed, put on both sides of the knee joint on the measuring station, fixed subjects both sides of the knee joint and lateral epicondyle, adjust 2 line parallel to measure and Taiwan. Through adjust posture fixation of femoral head geometry intermediate and internal and external condyle midpoint line parallel to measure and Taiwan, from the knee joint in full extension and measure its starting point. With the following measures: (1) isolated in ignorance of the knee angle of 30 degrees, suitable for measuring the patella angle, lateral patellar angle, patellofemoral indices, femoral trochlea angle and patellar height of the 5 groups of data values. (2) 640 static volume CT on the behavior of 40 knee joints, the full extension of the 3D coordinates, the coordinates of the origin of the middle point of the patella, scanning time was 13s, we can get the knee angle of 0 degrees to 60 degrees of knee joint activity, and analysis of the 3D coordinates of the knee joint. Results total measurement of 40 normal knee joint, the results below: 1. Normal knee joint of the patellofemoral joint stable classification results for A-level I 4 (10%), I B level 2 (5%), level IV 24 (60%), IV B grade 10 (25%), I C, IV C, II, III are all 0. . follow the knee angle between 0 to - 10 degrees in patellar in X axis mild move to the medial. Thereafter follow knee angle changes (20 degrees to 60 degrees) to the patella continuous ceaseles follow the knee joint angle changes (0. -60. In Y axis (sagittal), patella continuous
patella in Z axis motion and follow the ignorance of knee joint angle changes, the overall patellar glide trajectory is backward. In the initial stage, the change of the activity of the patella is not large, and the change of the knee joint angle is 50. -60. At the maximum, the sliding rate of the patella reached the maximum. Conclusion 640 layer static volumetric CT not only can supply traditional diagnosis patellofemoral stability to numerical, and could provide the patella trajectory of the 3D coordinates of and for the clinical diagnosis of patellofemoral joint stable supply of double round material. The second part 640 layer static volumetric CT scans of patellofemoral joint on the poor patients with patella trajectory using the value target: in non weight bearing status, 640 layer static volumetric CT imaging technique application, review debate patellofemoral joint on the poor patient patella trajectory of the use value, normal activities of the patella trajectory and patellofemoral joint on the poor patients of patella trajectory carries on the contrast analysis. Materials and methods: to collect 2013 September to November 9 dragon hospital patellofemoral joint of 20 cases of adverse patient, 9 cases were male, 11 female patients, aged 18 to 55 years old, uniform 33.55 years, patients on both sides of the knee, a total of 40 knee. Detailed measures of measurement and statistical methods and the same as the first department. Results: patellofemoral joint on the poor patients of knee joint total 40: (1). The forty patellofemoral joint on the poor patients of knee joint stability of classification results for A-level I 9 (22.5%), I B level 25 (62.5%), I C grade 3 (7.5%) III grade B 2 (5%), IV level 1 (2.5%), more than the B-C IV, II, III A, C level are all 0. 2. Follow the angle of knee joint ignorance from 0 degrees to 60 degrees change patellar continuous ceaselessly on the Y axis following knee angle changes (0. -60. ), patella trajectory like normal trajectory as continuous
on the Z axis, followed the knee bending angle changes, patellar glide trajectory is obvious forward. Conclusion: normal and patellofemoral joint of traditional knee joint in patients with poor stable measurement value comparison and patella trajectory in the three-dimensional coordinate axis numerical, can be learned, 640 layer static volumetric CT imaging not only like a conventional knee joints measurement values that determine the patellofemoral stability, and can supply more accurate coordinates for clinical on the patellofemoral stability diagnosis to provide a more comprehensive diagnostic methods and according to.目录:中文摘要4-7Abstract7-9引言11-13第一部分 640层动态容积CT对正常人髌骨运动轨迹的应用价值13-22&&&&材料和方法13-16&&&&结果16-18&&&&讨论18-22第二部分 640层动态容积CT对髌股关节对合不良病人的髌骨运动轨迹的应用价值22-29&&&&材料和方法22-23&&&&结果23-26&&&&讨论26-29参考文献29-32结论32-33附图33-37综述37-48&&&&参考文献44-48中英文缩略词表48-49攻读学位期间公开发表的论文49-50致谢50-51原价：￥20.00元折价：￥5.00元分享到：相关文献|