背景:股骨头坏死是骨科难治性疾病之一,不同分期、分型下的股骨头坏死自然塌陷病程影响着该病的进展及预后。目的:探究不同中日友好医院(China-Japan Friendship Hospital,CJFH)分型下国际骨循环研究协会(Association Research Circulat...背景:股骨头坏死是骨科难治性疾病之一,不同分期、分型下的股骨头坏死自然塌陷病程影响着该病的进展及预后。目的:探究不同中日友好医院(China-Japan Friendship Hospital,CJFH)分型下国际骨循环研究协会(Association Research Circulation Osseous,ARCO)Ⅱ期股骨头坏死未塌陷患者5年内自然塌陷病程,并分析不同CJFH分型的股骨头塌陷率及塌陷风险。方法:回顾性选取2016年10月至2017年10月在西安交通大学附属红会医院门诊确诊为ARCOⅡ期股骨头坏死未塌陷的患者为研究对象,根据是否塌陷将患髋分为塌陷组(n=82)和未塌陷组(n=70),统计不同CJFH分型的股骨头塌陷风险以及5年内塌陷时间、塌陷数量和塌陷率,并绘制不同CJFH分型股骨头的Kaplan-Meier生存曲线图。结果与结论:①共纳入患者97例,152髋,随访期间有82髋塌陷,总塌陷率为53.9%,其中M型、C型、L1型、L2型和L3型塌陷率分别为0.0%,36.7%,51.4%,72.2%和77.8%,各组间比较差异有显著性意义(P<0.05);②在塌陷风险方面,L1型塌陷风险为C型的1.704倍(P>0.05),而L2型、L3型塌陷风险分别为C型的3.866倍、6.423倍(P<0.05);③在Kaplan-Meier生存曲线方面,ARCOⅡ期患者股骨头中位生存时间为3年,95%置信区间为2.885-3.471年,第1,3,5年股骨头生存率分别为65.1%(99/152),50.7%(77/152),46.1%(70/152);④结果表明,不同CJFH分型影响着ARCOⅡ期股骨头坏死患者的塌陷率,其中L3型患者塌陷率最高,L2型和L1型患者次之,C型患者塌陷率较低,M型患者无塌陷,这表明股骨头外侧柱的保留对股骨头坏死自然塌陷病程有重要意义。展开更多
The method proposed in this paper is based on the fact that the damage in different types of structural members has distinctive influence on the structural stiffness. The intrinsic mechanical property of the structure...The method proposed in this paper is based on the fact that the damage in different types of structural members has distinctive influence on the structural stiffness. The intrinsic mechanical property of the structure is tapped and fully utilized for damage detection. The simplified model of the flexibility of frames treats the individual storeys as springs in series and the frame as an equivalent column. It fully considers the main deformation of all beams and columns in the frame. The deformation property of the simplified model accorded well with that of the actual frame model. The obtained increment of lateral displacement change (IOLDC) at the storey level was found to be very sensitive to the local damage in the frame. A damage detection method is pro- posed using the IOLDCs as the damage identification parameters. Numerical examples demonstrate the potential applicability of this method.展开更多
文摘The method proposed in this paper is based on the fact that the damage in different types of structural members has distinctive influence on the structural stiffness. The intrinsic mechanical property of the structure is tapped and fully utilized for damage detection. The simplified model of the flexibility of frames treats the individual storeys as springs in series and the frame as an equivalent column. It fully considers the main deformation of all beams and columns in the frame. The deformation property of the simplified model accorded well with that of the actual frame model. The obtained increment of lateral displacement change (IOLDC) at the storey level was found to be very sensitive to the local damage in the frame. A damage detection method is pro- posed using the IOLDCs as the damage identification parameters. Numerical examples demonstrate the potential applicability of this method.
