摘要
目的:复习体外冲击波的治疗原理,探讨体外冲击波重建骨组织结构在治疗股骨头缺血性坏死方面的应用价值。方法:①应用计算机检索Medline数据库和万方数据库1990/2007与体外冲击波重建骨组织结构相关文献。②收集武警医学院附属医院骨科2000-01/2007-09收治,利用液电式体外冲击波进行治疗的64例股骨头缺血性坏死患者的临床资料,均为Ficat分期Ⅰ、Ⅱ、III期患者,其中双侧发病者43例,单侧发病者21例;应用激素者52例,有外伤史者12例。③结合文献和作者的治疗体会,阐述体外冲击波重建骨组织结构在治疗股骨头缺血性坏死方面的应用价值。结果:①作者治疗体会:64例股骨头缺血性坏死患者经冲击波治疗4～6次,56例患者均取得了良好的治疗效果,有效率为87.5%;经2～4年随访观察无复发,36例3年后复查表现患侧股骨头密度略增高,无股骨头进一步塌陷现象。②结合文献讨论:冲击波治疗股骨头缺血性坏死的原理可能包括刺激血管再生、诱导骨生长、改变组织结构及重建骨骼等,其优势在于损伤轻微,一般采用简单麻醉或不必麻醉,治疗时间短、风险小,无需特殊的术后处理,且术后恢复较快,治疗费用远低于开放式手术。结论:体外冲击波在治疗股骨头缺血性坏死、促进破坏区愈合有确切疗效,为股骨头缺血性坏死患者提供了一种非侵袭性的治疗方法。
AIM： Based on the principle of shock wave therapy, to investigate the application value of extracorporeal shock wave for reconstructing osseous tissue for the treatment of ischemic necrosis of the femoral head. METHODS： （1）A computer-based online search of Medline and Wanfang databases were undertaken to identify articles about extracorporeal shock wave for reconstructing osseous tissue dated from 1990 to 2007. （2）Clinical data of 64 patients with ischemic necrosis of the femoral head who treated by hydroelectric shock waves in Department of Orthopaedics, Hospital Affdiated to Medical College of Chinese People＇s Armed Police Force between January 2000 and September 2007 were collected, including 43 patients with bilateral femoral heads, and 21 with unilateral; 52 cases treated using hormone, and 12 cases with a history of trauma. All patients were stages Ⅰ, Ⅱ, and Ⅲ by Ficat classification. （3）Based on the references and our treatment experience, the application value of extracorporeal shock wave for reconstructing osseous tissue to treat ischemic necrosis of the femoral head was expounded. RESULTS： （1）Treatment experience： Of 64 patients, 56 ones were treated successfully after extracorporeal shock wave therapy for 4-6 times, and the efficiency rate was 87.5%. After 2-4 years of follow up, no relapse was found; bone density of affected femoral head in 36 cases was increased 3 years after treatment, but femoral head collapse did not occur. （2）Reference-based discussion： Extracorporeal shock wave treats ischemic necrosis of the femoral head by stimulating angiogenesis, inducing osteogenesis, altering tissue structure, and reconstructing skeleton. Extracorporeal shock wave therapy has many advantages such as minimal injury, simple anesthesia even no anesthesia, short treating time, low risk, no special postoperative treatment, rapid recovery, and low treating cost. CONCLUSION： Extracorporeal shock wave is an effective method to treat ischemic necrosis of the femoral head, and accelerate wound healing. It is a noninvasive therapy for ischemic necrosis of the femoral head.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第13期2547-2550,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
武装警察部队科研立项(编号WKH2004-10)~~
