CAJ | 학술논문

目的股骨头成形术对股骨头坏死的预防和治疗的动物实验研究分析.方法 60只中国白兔,随机分为4组,除A组为正常组其余三组在股骨头颈交界处钻孔造成股骨头缺损,并加用95%酒精30分钟灌注造成股骨头缺损模型.B组股骨头作为自然修复对照.C组股骨头造成缺损酒精填充后填充骨水泥.D组股骨头造成股骨头缺损酒精填充后填充造影剂骨水泥.四组动物于术后12周处死,立即取股骨头标本观察关节软骨性状.然后分别行病理学检查及生物力学测试.结果股骨头关节软骨观察显示骨水泥组和造影剂骨水泥组股骨头外形始终保持完整无变形,四组股骨头软骨厚度自然修复组(314.03±39.45)比正常组(511.74±69.00)、骨水泥组(468.36±82.99)、造影剂骨水泥组(515.61±64.65)降低,差异有统计学意义(P<0.05,P<0.01).抗压试验正常组[(884.66±52.29)N/mm]、骨水泥组[(1178.40±170.45)N/mm]和造影剂骨水泥组[(928.60±104.42)N/mm]刚度荷均数均高于自然修复组[(676.57±50.92)N/mm],差异有统计学意义(P<0.05,P<0.01).结论股骨头成形术操作简单、创伤较小,可以保持股骨头外形完整,能暂缓或替代关节置换术,有望成为治疗FicatⅡ期～Ⅲ期年轻患者的新型手术方法.
목적 고골두성형술대고골두배사적예방화치료적동물실험연구분석.방법 60지중국백토,수궤분위4조,제A조위정상조기여삼조재고골두경교계처찬공조성고골두결손,병가용95%주정30분종관주조성고골두결손모형.B조고골두작위자연수복대조.C조고골두조성결손주정전충후전충골수니.D조고골두조성고골두결손주정전충후전충조영제골수니.사조동물우술후12주처사,립즉취고골두표본관찰관절연골성상.연후분별행병이학검사급생물역학측시.결과 고골두관절연골관찰현시골수니조화조영제골수니조고골두외형시종보지완정무변형,사조고골두연골후도자연수복조(314.03±39.45)비정상조(511.74±69.00)、골수니조(468.36±82.99)、조영제골수니조(515.61±64.65)강저,차이유통계학의의(P<0.05,P<0.01).항압시험정상조[(884.66±52.29)N/mm]、골수니조[(1178.40±170.45)N/mm]화조영제골수니조[(928.60±104.42)N/mm]강도하균수균고우자연수복조[(676.57±50.92)N/mm],차이유통계학의의(P<0.05,P<0.01).결론 고골두성형술조작간단、창상교소,가이보지고골두외형완정,능잠완혹체대관절치환술,유망성위치료FicatⅡ기～Ⅲ기년경환자적신형수술방법.
Objective An experiment study on the femoral head plastic operation to prevent and treat aseptic necrosis of the femoral head. Methods 60 Chinese white rabbits were equally random divided into 4 groups. The four groups except A group were made a globose defect and filled with 95% alcohol tampon for 30 minutes. The B group was natural repair group. The C group was filled with bone cement after being made defect. The D group was filled with bone cement added barium sulfate agent after being made defect. After 12 weeks, all rabbits in four groups were killed. The specimens were random divided into two parts. The articular cartilage was observed and measured immediately. The other specimen was determined with histological examination and extreme anti-pressure rigidity test . Result The femoral heads of bone cement group and the femoral heads of contrast agent bone cement group kept their outline all the time through the articular cartilage observation. After 12 weeks the cartilage thickness of natural repair group (511.74 ± 69.00) was thinner than the other three groups [ control group ( A group ) (511.74 ± 69 00 );Bone cement group ( C group) (468. 36 ± 82. 99 ); Bone cement group contrast agent ( D group ) ( 515.61 ±64. 65 ) ], and it had significant difference ( P < 0. 05, P < 0. 01 ). The rigidity of natural repair group [ (676. 57 ±50. 92) N/mm] had significant difference with that of the other three groups[ A group( 884. 66±52. 29)N/mm;C group(1178.40 ± 170.45) N/mm;D group(928.60 ± 104.42) N/mm] ( P <0.05, P<0. 01 ). Conclusions Femoral head plastic operation was simple and it could release pain. And femoral head outline could be kept integrity. It would be a new operation which was used to treat young patients in Ficat Ⅱ～Ⅲ period to postpone or substitute total hip replacement.