臺灣博碩士論文加值系統

人類生活環境，隨著工業革命而不斷的進步，卻也因習慣的改變，而產生許多的變化。生活的便利性為人類帶來的更舒適的生活，卻也因環境汙染的惡化而對身健康造成了傷害，其中最嚴重的就是有21世紀黑死病之稱的癌症，本文所要探討的屬於癌症中骨轉移的一部份--骨盆髖臼癌症骨轉移溶蝕病理的補強方式。
以目前先進的醫療科技對於癌症骨盆髖臼骨轉移溶蝕病理有許多的治療方式，從開刀置入人工髖關節，到微創手術置入骨釘及填充骨水泥，依據每個病患個別不同的溶蝕狀況及其生理狀況來做分析及治療，其復原時間也根據不同的手術方式而有長短之分。
本文試圖透過有限元素分析軟體來分析溶蝕骨打入螺釘後的應力程度，所用的骨釘補強方式不同於以往的由上而下方式，是針對骨盆不同方向具有不同寬度的骨面，希望從不同方向的骨頭來作為強化溶蝕骨部分的有效支撐，並從中挑選適當大小、長度的骨釘來做為輔助，期望能在精簡手術時間及縮短病患復原時間的期望下，仍能有著充分的強度來改善骨盆髖臼骨轉移溶蝕病理造成病患生活上的痛楚與不便。
研究結果顯示，其改良的方式相較於傳統打骨釘的方式，是有助於強化支撐的，因此對於醫師處理骨盆髖臼癌症骨轉移溶蝕病理的補強方式又多了一種可以參考的方式。

The environment of human live, not only continuous progress of the Industrial Revolution, but also changes of habits. The convenience of life brings more comfortable life to human beings, but it also causes harm to the health of the body by Environmental pollution. The most serious one is the cancer of the 21st century Black Death. The study researches discussion on the method of reinforcing and fixing the pathological fracture of pelvic acetabular cancer metastasis
With advanced medical technology, there are many treatments for the pathology of pelvic acetabular bone metastasis in cancer. From the placement of artificial hip joints to the minimally invasive surgery, the placement of bone nails and bone cement, according to each patient's individual dissolution and physiological conditions for analysis and treatment, the recovery time is also different with surgery methods.
The study attempts to analyze the degree of stress after the fractured bone is driven into the screw through the finite element analysis software. The bone nail reinforcement method used is different from the previous top-down method. It is a bone surface with different widths for different directions of the pelvis. It is hoped that bones from different directions can be used as an effective support for strengthening the dissolved bone part, and an appropriate size is selected from the length of the nail is used as an aid. It is expected that with the expectation of streamlining the operation time and shortening the recovery time of the patient, there is still sufficient strength to improve the pain and inconvenience of the patient in the pelvic acetabular bone metastasis pathology.
The results of the study show that the improved method is more conducive to strengthening the support than the traditional method of bone-piercing nails. Therefore, there is another way to refer to the way of strengthening the pathology of bone metastasis of pelvic acetabular cancer.

摘要......i
ABSTRACT......ii
誌謝......iii
目錄......iv
表目錄......vi
圖目錄......vii
第一章 緒論......1
1.1 研究動機與目的......1
1.2 髖臼剖面構造......2
1.3 髖臼運動與生物力學......4
第二章 文獻回顧......6
2.1 癌症轉移併病理性骨折......6
2.2 髖臼手術......8
2.2.1 髖臼杯(Acetabular cup)......9
2.2.2 骨水泥(cemented)......9
2.2.3 經皮固定髖臼(Percutaneous fixation of acetabular)......11
2.3 材料性質......14
第三章 材料與方法......16
3.1 研究流程......16
3.2 建模與分析軟體......16
3.2.1 髖臼模型的建立......16
3.3 參數設定......17
3.3.1 物質成分......18
3.3.2 螺釘大小......18
3.3.3 受力方向與負載......18
3.3.4 限制條件......21
第四章 實驗結果與討論......22
4.1 正常髖臼應力......24
4.2 病理性骨折應力......24
4.3 手術方法有限元素分析......25
4.3.1 傳統方式應力......25
4.3.2 改良方式應力......26
4.3.3 應力比較......27
第五章 結論......28
5.1 結論......28
5.2 未來展望......28
參考文獻......29
Extended Abstract......32

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