CAJ | 학술논문

目的：根据股骨头缺血性坏死的病因，阐明介入治疗的应用原理和内服外敷中药的作用，并讨论影响疗效的因素。方法：采用Seldinger技术经股动脉穿刺插管，选择进入患侧旋股内侧动脉和旋股外侧动脉，缓慢灌注6542-2、复方丹参、低分子右旋糖酐、尿激酶等。术后继续静脉用尿激酶、654-2，连续5天，并内服复方丹参片持续半年，外敷东方活血膏连续3个月。一个月后重复治疗一次，半年后再重复一次。结果：根据髋关节屈曲、后伸、外展、内收、外旋和内旋这6种运动的度数和为260°～320°的改变来判断髋关节的运动功能，190°～260°为I度，160°～190°为Ⅱ度，130°～160°为Ⅲ度，130°以下为Ⅳ度。治疗后其功能明显改善，尤其是疼痛症状更为好转。6～12个月后影像学检查发现死骨有所吸收，有新生肉芽组织形成。结论：股骨头坏死进行介入治疗并内服外敷中药是一种非常有效的治疗方法，其痛苦小、简便、安全，尤其对于早期病人更为适宜，可有效地恢复髋关节功能。
목적：근거고골두결혈성배사적병인，천명개입치료적응용원리화내복외부중약적작용，병토론영향료효적인소。방법：채용Seldinger기술경고동맥천자삽관，선택진입환측선고내측동맥화선고외측동맥，완만관주6542-2、복방단삼、저분자우선당항、뇨격매등。술후계속정맥용뇨격매、654-2，련속5천，병내복복방단삼편지속반년，외부동방활혈고련속3개월。일개월후중복치료일차，반년후재중복일차。결과：근거관관절굴곡、후신、외전、내수、외선화내선저6충운동적도수화위260°～320°적개변래판단관관절적운동공능，190°～260°위I도，160°～190°위Ⅱ도，130°～160°위Ⅲ도，130°이하위Ⅳ도。치료후기공능명현개선，우기시동통증상경위호전。6～12개월후영상학검사발현사골유소흡수，유신생육아조직형성。결론：고골두배사진행개입치료병내복외부중약시일충비상유효적치료방법，기통고소、간편、안전，우기대우조기병인경위괄의，가유효지회복관관절공능。
Objective: To evaluate the curative effect of percutaneous transcatheter femoral artery perfusion with traditional Chinese medicine for avascular necrosis of femoral head (AvNFH) due to the different causes. Methods:A catheter was selectively introduced via femoral artery into lateral femoral circumflex artery or medial femoral circumflex artery by Seldinger technique, and followed by slow injection of medicines via the catheter including 654-2, FuFangDanShen, low-molecular dextran, urokinase and so on. After operation, intravenous administration of 654-2 and urokinase for 5 days,oral administration of FuFangDanShen for half years and Dongfanghuexuegao ointment for external application for 3 months were given. The mentioned therapy above was repeated one month and 6 months later, respectively. Results: Based on the sum of the degrees of the 6 angular movements including flexion,backward stretch,adduction,abduction, external and internal rotation (the normal sum of 260 ～ 320 degree), the hip joint motor function was judged as follows: Ⅰ 190° ～ 260°, Ⅱ 160° ～190°, Ⅲ 130°～ 160°, IV ＜ 130°. Following operation, the function of hip joint was dramatically improved and the pain was markedly relieved. Imaging studies demonstrated that necrotic bones were slightly absorbed and new granulation tissues grew 6 to 12 months later.Conchusion: Interventional therapy together with traditional Chinese medicine is a very effective and safe treatment for AvNFH. It can recover the function of hip joint effectively.