股骨头坏死骨髓水肿的临床分析【临床医学专业论文设计】

《股骨头坏死骨髓水肿的临床分析【临床医学专业论文设计】》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、临床医学论文•股骨头坏死骨髓水肿的临床分析【摘要】探讨股骨头坏死骨髓水肿（bonemarrowedema,BME）与临床症状和影像学改变的相关性。〔方法〕40例（70髓）股骨头坏死患者，通过MRI脂肪压抑图像确认BME，并对其分级:0级25髓（无BME）1级20骯（BME弥散在股骨头），2级14競（BME弥散在股骨头、颈）；3级11競（BME弥散在股骨头、颈以及股骨近端）。分析BME与年龄，病因、ARCO分期、疼痛分组、坏死范围以及股骨头塌陷之间的相关性；运用多个独立样本非参数检验和列联表X2检验。〔结果〕BME与年龄、病因无相关性；

2、各分期中BME分级的差异有显著意义（X2=21.1，P=0・0003），各分期的BME发生有显著差异（X2=28.51»P<0.0001）；不同坏死范围中，BME分级有显著差异（X2=9・77，P二0・021），但BME的发生无显著差异（X2=6.227P=0.101）般骨头塌陷与BME分级无相关性（X2=2・558，P=0.465），但BME的发生勻股骨头塌陷有相关性（X2=22.799，P<0.001）；不同疼痛程度中BME分级有显著性差异（X2=26・66，P<0.001），BME的发生与疼痛程度有相关性（X2=40.855，P

3、vO.OOl）。〔结论〕BME的发生与年龄、病因无相关性；BME弥散程度勻坏死范围、疼痛程度、股骨头塌陷存在相关性，BME的发生与坏死范围无关，与疼痛、塌陷密切相关；BME可能是由股骨头塌陷所导致的病理改变。【关键词】骨坏死股骨头骨髓核磁共振成像Abstract:[Objective]Toevaluatetherelationshipbetweentheclinicalsymptoms,imageologychangesandthebonemarrowedema(BNE)inosteonecrosisoffemoralhead(ONF

4、)onmagneticresonanceimages(MRI)・〔Method〕Thesubjectswere40patientswith70hipsshowingONF.BEMwasdiagnosedaccordingfatsuppressionimagesofMRI,associatedfocalanddiffuseBMEweregradedasgrade0with25hips(noBME),grade1with25hips(BMEdiffusetothefemoralhead),grade2with14hips(BMEdiffu

5、setothefemoralheadandneck),grade3with11hips(BMEdiffusetothefemoralheadandneck,proximalfemur)・CorrelationofBMEwasevaluatedtoage,etiologicalfactor,stagesofONF,paingrade,theextentofONFandtocollapseofthefemoralhead.〔Result〕TherewasnocorrelationofBMEtoageandtoetiologicalfact

6、or.ThegradesofBMEcorrelatedsignificantlywiththestagesofONF(X2=21.1，P=0.0003).ThepresenceofBMEcorrelatedsignificantlywiththestagesofONF(X2=28・51，P<0.0001).ThegradesofBMEcorrelatedsignificantlywiththeextentofONF(X2=9.77‘P二0.021),buttherewasnocorrelationofthepresenceofBMEt

7、otheextentofONF(X2=6.227，P二0.101).TherewasnocorrelationofthegradesofBMEtocollapseofthefemoralhead(X2=2・558，P=0.465),butthepresenceofBNEcorrelatedsignificantlywiththecollapse(X2=22.799'P<0.001).Ineachthegroupsofpain,thegradesofB^'IEwasofgreatsignificantdifference(X2=26.6

8、6，Pv0.001),thepresenceofBMEwasofgreatsignificantdifference(X2=40・855，PvO.001)・(Conclusion]ThepresenceofBMEdoes