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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:

第26卷

期数:

2014年05期

页码:

9-12

栏目:

临床研究

出版日期:

2014-05-31

文章信息/Info

Title:

Clinical study on medullary core decompression combined with tanshinoneⅡA mixed with bone grafting in the treatment of osteonecrosis of the femoral head in FicatⅡperiod

作者:

李晓明¹; 郭东辉¹; 石国君¹; 李瑞亮¹; 张洪相¹; 苏长生²; 沈润斌¹; 王红玉¹; 李运美¹; 袁福禄¹; 韩广普¹

1.河北省沧州中西医结合医院,河北 沧州 061000; 2.河北省泊头市人民医院,河北 泊头 062150

Author(s):

Li Xiaoming^*; Guo Donghui; Shi Guojun; Li Ruiliang; Zhang Hongxiang; Su Changsheng; Shen Runbin; Wang Hongyu; Li Yunmei; Yuan Fulu; Han Guangpu.^*

Cangzhou Hospital of Integration Traditional and Western Medicine,Cangzhou 061000,Hebei,China

关键词:

股骨头坏死 丹参酮ⅡA 减压术; 外科 骨移植

Keywords:

Femur head necrosis;  Tanshinone ⅡA;  Decompression; surgical;  Bone transplantation

摘要:

目的:观察丹参酮ⅡA结合髓芯减压打压植骨治疗FicatⅡ期股骨头坏死的临床疗效和安全性。方法:将60例符合要求的Ficat分期Ⅱ期股骨头坏死患者随机分为2组,每组30例。治疗组采用丹参酮ⅡA结合髓芯减压打压植骨治疗,对照组采用单纯髓芯减压打压植骨治疗。分别于术前和术后12个月采用Harris髋关节功能评分法评定患者的髋关节功能,并进行X线检查观察股骨头塌陷程度,同时观察比较2组患者术后及随访期间并发症的发生情况。结果:①髋关节功能。术前2组患者髋关节功能Harris评分比较,差异无统计学意义[(75.73±7.43)分,(73.60±10.12)分,t=1.105,P=0.273]; 术后12个月治疗组Harris评分高于对照组,差异有统计学意义[(95.81±2.88)分,(94.76±4.02)分,t=12.590,P=0.000]。②股骨头塌陷程度。治疗组优25髋、良7髋、中5髋、差3髋; 对照组优23髋、良6髋、中5髋、差4髋。2组患者股骨头塌陷程度比较,差异无统计学意义(Z=-0.287,P=0.774)。③并发症发生情况。2组患者均获随访,随访时时间13～18个月,中位数15.5个月。术后2组患者切口均甲级愈合,术后及随访期间未出现手术相关并发症。结论:丹参酮ⅡA结合髓芯减压打压植骨可有效减缓FicatⅡ期股骨头坏死患者股骨头塌陷的病理进程,改善髋关节功能,而且具有较高的安全性。

Abstract:

Objective:To observe the clinical curative effect and safety of medullary core decompression combined with tanshinoneⅡA(TSNⅡA)mixed with bone grafting in the treatment of osteonecrosis of the femoral head(ONFH)in FicatⅡperiod.Methods:Sixty patients with ONFH in FicatⅡperiod enrolled in the study were randomly divided into 2 groups,30 cases in each group.Patients in the treatment group were treated with the therapy of medullary core decompression combined with TSNⅡA mixed with bone grafting,while the others in the control group were treated with the medullary core decompression combined with bone grafting.The hip joint functions were evaluated by Harris Score before treatment and 12 months after the treatment respectively,and the degrees of femur head collapse were also observed through X-ray examination,meanwhile the 2 groups were observed and compared with each other in complications during postoperative period and follow-up period.Results:There was no statistical difference in Harris scores between the 2 groups before the treatment(75.73+/-7.43 vs 73.60+/-10.12 points,t=1.105,P=0.273),and the Harris scores of treatment group were higher than that of control group 12 months after the treatment(95.81+/-2.88 vs 94.76+/-4.02 points,t=12.590,P=0.000).The results of degrees of femur head collapse showed that 25 hips in patients obtained an excellent result,7 good,5 fair and 3 poor in the treatment group,while 23 hips in patients obtained an excellent result,6 good,5 fair and 4 poor in the control group.There were no statistical difference in the degrees of femur head collapse between the 2 groups(Z=-0.287,P=0.774).The patients in the 2 groups were all followed up for 13-18 months with a median of 15.5 months.All of the patients in the 2 groups got primary healing in the operative incisions after the treatment,and there were no operation-related complications occurred during postoperative period and follow-up period.Conclusion:The therapy of medullary core decompression combined with TSNⅡA mixed with bone grafting of higher safety can effectively slowed the pathological process of femoral head collapse and improve the hip joint function in patients with ONFH in FicatⅡperiod.

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更新日期/Last Update: 1900-01-01