犬全髋关节置换实验性手术结果的初步分析

Preliminary analysis of results of BioMedtrix total hip replacement practice

为探讨国内兽医师关于犬全髋关节置换手术(total hip replacement,THR)的认证通过水平,分析了2种不同手术方式的得分和通过率是否有差异性、学习曲线以及影响通过率最大的因素等。收集25名兽医师完成的101例作业,其中骨水泥型(cement fixation,CFX)33例,生物型(biologic fixation,BFX)68例,由三名国外专家双盲评审打分,对其分数及评审结果进行讨论分析。BFX的通过率(56%)优于CFX的通过率(48%);其中有20名兽医师完成了2次及以上的作业,末次作业得分优于首次作业得分(P=0.006);BFX与CFX的总体得分与植入物得分差异无统计学意义(P>0.05);影响通过率的最大因素为臼杯与植入物的选择错误、扩孔深度未达要求、股骨截骨术不佳以及植入物的冠状面、矢状面与股骨长轴的位置以及倾斜角度不当。BFX植入物的THR通过率略高于CFX植入物的THR,作业通过率与作业完成次数成正比,如果能在上述提到的4个方面完成得更好,可提高该手术实操考核的通过率。

In order to identify the certification level,learning curve and the most influential factors of the passing rate of domestic veterinary surgeons in canine total hip replacement practice,a total of 101 cases were selected from 25 domestic veterinarians,including 33 cases of cement fixation(CFX)and 68 cases of biologic fixation(BFX).The pass rate of BFX(56%)was higher than that of CFX(48%).20 veterinarians completed two or more assignments,and the score of the last assignment was higher than that of the first assignment(P=0.006).There was no significant difference between the overall scores of BFX and CFX and the prosthesis score(P>0.05).The most important factors affecting the pass rate were the wrong choice of cup and implant,the depth of reaming not meeting the requirements,poor osteotomy of femur,and the inappropriate position between the coronal and sagittal planes of the femoral stalk and the long axis of the femur,and the inappropriate inclination angle.The pass rate of canine total hip replacement practice with biological implant was slightly higher than that with the cement implant practice.The pass rate of certification was directly proportional to the number of times of operation.If the above four items of the technology had been completed better,the pass rate would have been much higher.