摘要
目的探讨ARCOⅡ-Ⅲb期成人股骨头坏死微创治疗方法。方法2012年1月至2015年3月ARCOⅡ-Ⅲb期成人股骨头坏死患者9例（14个髋），采用影像导引下的微创髓芯减压，应用磷酸钙骨水泥（CPC）复合骨形态生成蛋白（BMP）作为植入物，填充替代股骨头坏死区域的坏死骨组织，采用Harris髋关节功能评分和影像学评价，进行临床疗效综合评估。结果分别于术后6个月及12个月各随访1次．其后不定期随访，随访最长3年。术前Harris评分平均84．50分，术后末次随访平均91-36分，差异有统计学意义。术后影像学末次评估14个股骨头塌陷1个，未塌陷13个，其中坏死面积无变化8个，面积缩小5个；水肿消退或范围缩小10个，无明显变化者3个，加重1个。结论髓芯减压结合磷酸钙骨水泥＋BMP治疗ARCOⅡ-Ⅲb期成人股骨头坏死能明显改善患者症状和髋关节功能，预防股骨头塌陷或防止股骨头进一步塌陷，临床疗效满意。
Objective The minimally invasive treatment of femoral head necrosis in adults with ARCOⅡ-Ⅲb. Methods Collected from January 2012 to March 2012, a total of nine patients （ 14 hips ） with ARCOⅡ-Ⅲb adult femoral head necrosis, with Image - guided minimally invasive core decompression, marrow needle relief application of calcium phosphate cement （ CPC ） composite BMP as implants, filled replacement tissue necrosis area of femoral head necrosis, used preoperative Harris hip function score and postoperative radiographic evaluation, for the comprehensive assessment of clinical curative effect. Results The patients were followed up for 6 months and 12 months respectively. The patients＇ longest follow-up period was 3 years. The average Harris score was 84.50 points before operation, and the average follow-up was 91.36 points at the end of the operation, and there was statistical significance between the preoperative and postoperative （P〈0.05） . In last postoperative radiographic assessment, there was 1 femoral head collapse,13 did not collapse, 8 necrotic area, 5 necrotic area no change, 10 edema, fade or narrow, 3 no obvious change, 1 aggravation. Conclusion Imramedullary needle decompression combined with phosphate calcium phosphate cement BMP treatment ARCOⅡ-Ⅲb period of adult femoral head necrosis can obviously improve the symptoms and the function of hip joint and prevent femoral head collapse or prevent further femoral head collapse, curative effect is satisfactory.
出处
《浙江临床医学》
2017年第3期464-465,468,共3页
Zhejiang Clinical Medical Journal
基金
浙江省金华市科技计划项目（2013-3-049）
关键词
股骨头坏死
微创
髓芯减压
磷酸钙骨水泥
骨形态生成蛋白
Osteonecosis of the femoral head Minimally invasive Marrow needle relief Calcium phosphate cement BMP
