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研究生:楊嬿臻
研究生(外文):YANG, YEN-CHEN
論文名稱:比較接受傳統或新式固定法之前十字韌帶重建手術對病患術後膝關節症狀與功能、生活品質之影響
論文名稱(外文):Compare the effects of knee joint symptoms and function and quality of life in postoperative patients receiving traditional or new fixation of anterior cruciate ligament reconstruction surgery
指導教授:吳樺姍吳樺姍引用關係
指導教授(外文):WU, HUA-SHAN
口試委員:翁佩韋彭逸稘吳樺姍
口試委員(外文):WENG, PEI-WEIPENG, YI-CHIWU, HUA-SHAN
口試日期:2022-07-15
學位類別:碩士
校院名稱:亞洲大學
系所名稱:健康產業管理學系健康管理組碩士在職專班
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2022
畢業學年度:110
語文別:中文
論文頁數:103
中文關鍵詞:前十字韌帶撕裂前十字韌帶重建術膝關節症狀與功能生活品質
外文關鍵詞:Anterior cruciate ligament tearAnterior cruciate ligament reconstructionKnee joint symptoms and functionQuality of life
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背景:前十字韌帶撕裂有多達25%的患者在進行重建手術後,仍未能恢復滿意的膝關節症狀與功能、生活品質,透過新式固定法之前十字韌帶重建手術對於病患關節功能及生活品質評估有必要深入探討。
目的:比較接受傳統或新式固定法之前十字韌帶重建手術對病患術後膝關節症狀與功能、生活品質之影響。
方法:本研究以台北某區域醫院骨科門診專科醫師蒐集自2015年7月1日至2017年10月31日之研究計畫原始資料庫所建立國際膝部文件委員會主觀膝部評估表、膝關節損傷和骨關節炎結果評分、單一評估的數據評值工具、Tegner活動量表之參數進行次級資料分析,以描述性統計及兩組獨立樣本T檢定,了解傳統或新式固定法之前十字韌帶重建手術患者膝關節症狀與功能、生活品質之影響。
結果:接受新式與傳統固定法之前十字韌帶重建手術病患在各變項之比較資料分析,並無明顯統計學上差異;唯「KOOS_功能,體育及娛樂活動的分數」項目的分數顯示新式比傳統在術後有升高的趨勢。
結論:接受新式固定法之前十字韌帶重建手術病患在術後進行一次性追蹤之功能,體育及娛樂活動表現感受性較好,但仍需未來嚴謹研究驗證。


Background: More than 25% patients with anterior cruciate ligament tear who unederwent reconstruction sugeries, still unable to get satisfactory recovery in knee joint function and quality of life. It is required to assess the improvement of knee joint fuction and quality of life the ough the new fixation method of an anterior cruciate ligament reconstruction sugery.
Objectives:This study aimed to compare qualitiy of life and knee joint function between patients underwent traditional or new anterior cruciate ligament reconstruction sugeries.
Method:A secondary analysis was conducted with data collection from July1,2015 to October 31,2017, in an Orhthopedics clinic of a regional hospital in Taipei. Through a descriptive statistic and two sample t test, the outcomes were compare using International Knee Documentation Committee (IKDC) Subjestive Knee Evaluation form, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner Activity Level (TAL) to understand the effects of traditional or new anterior cruciate ligament reconstruction surgeries in improving knee joint symptoms and function and quality of life.
Results:No significant difference in all variables between the traditional and new reconstruction sugery groups. Only the scores for KOOS subscale Function, sports and recreational activities showed an increased trend in the new reconstruction sugery group, compared to the traditional group.
Conclusion:The scores for KOOS subscale Function, sports and recreational activities are more responsive for patients undergoing new fixation method anterior cruciate ligament reconstruction. However, further rigorous studies are needed to verify the conclusion.


目錄 i
圖目錄 iii
表目錄 iv
中文摘要 v
英文摘要 vii
第一章 緒論 1
第一節 研究背景及動機 3
第二節 對護理的重要性 7
第三節 研究目的 9
第四節 名詞界定 10
第二章 文獻查證 16
第一節 前十字韌帶撕裂及其後果 16
第二節 前十字韌帶重建手術及術後護理 21
第三節 前十字韌帶重建手術對膝關節症狀與功能之影響 25
第四節 前十字韌帶重建手術對術後生活品質之影響 30
第五節 研究架構 36
第六節 研究假設 37
第三章 研究方法 38
第一節 研究設計 38
第二節 研究場所及對象 39
第三節 研究工具 40
第四節 研究步驟 46
第五節 研究倫理考量 47
第六節 資料處理及分析 48
第四章 研究結果 49
第一節 研究對象基本屬性及各變項之分布 50
第二節 實驗組與對照組各變項之比較 51
第五章 討論 54
第六章 結論與建議 56
第一節 結論 57
第二節 研究限制及建議 58
第三節 研究結果應用 60
參考文獻
中文文獻 62
英文文獻 63
附錄
附錄一 國際膝部文件委員會主觀膝部評估表IKDC 88
附錄二 膝關節損傷和骨關節炎結果評分KOOS 91
附錄三 Tegner活動量表(TAS) 94
附錄四 人體臨床試驗研究訓練證書 95
圖 目 錄
圖一 ACL RetroConstruction / FlipCutter® 11
圖二 ACL RetroConstruction 11
圖三 ACL RetroConstruction RT+Screw 11
圖四 前十字韌帶重建術之傳統固定法之術後X光圖 11
圖五 可調式懸掛固定扣 12
圖六 Intra-tunnel bio-interference screw fixation 12
圖七 前十字韌帶重建術之新式固定法之術後X光圖 12
圖八 抽屜試驗(Anterior drawer test) 18
圖九 拉赫曼試驗(Lachman test) 19
圖十 傳統固定法之ACLR皮下螺絲釘頭 23
圖十一 傳統固定法之ACLR皮下不可吸收線頭 23
圖十二 研究架構 36
表 目 錄
表4-1-1研究對象基本屬性及各變項之分布(N=64) 52
表4-2-1實驗組與對照組各變項之比較 53
中文文獻
姚開屏(2002).台灣版世界衛生組織生活品質問卷之發展與應用.台灣醫學,6(2),193-200。doi:10.6320/FJM.2002.6(2).09
賴金鑫、陳昭瑩、詹美華、柴惠敏(1994).前十字韌帶重建手術後膝部等速肌力之物理治療效果.中華物理治療雜誌,19.46-51。
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