CAJ | 학술논문

目的：髋关节腔、股骨颈髓腔自体骨髓移植药液灌注并中医药治疗在股骨头坏死术后的临床应用，探索力学刺激的影响。方法：自2005年～2011年采用开放和微创术式治疗股骨头缺血性坏死患者17例（23髋），年龄19～60岁，平均22．4岁，ARCO分期为ⅠA 期3例，ⅡA 期8例，ⅡC 期3例，ⅢA期3例。全部病例均行自体骨髓移植并药液局部灌注在血管束植入、骨移植及微创术后的应用，术后随访1～7年，根据手术前后Harris评分变化，X线影像学表现随访观察。结果：术后患者Harris评分变化均提高35．71分（平均术前56．29分，术后92分），影像学表现17例保持稳定。结论：自体骨髓移植药液局部灌注并中药治疗在股骨头缺血性坏死术后的应用，操作简单，取材方便，无排异反应。术后恢复快，力学刺激对成骨、成软骨、新生血管形成有一定促进作用。
목적：관관절강、고골경수강자체골수이식약액관주병중의약치료재고골두배사술후적림상응용，탐색역학자격적영향。방법：자2005년～2011년채용개방화미창술식치료고골두결혈성배사환자17례（23관），년령19～60세，평균22．4세，ARCO분기위ⅠA 기3례，ⅡA 기8례，ⅡC 기3례，ⅢA기3례。전부병례균행자체골수이식병약액국부관주재혈관속식입、골이식급미창술후적응용，술후수방1～7년，근거수술전후Harris평분변화，X선영상학표현수방관찰。결과：술후환자Harris평분변화균제고35．71분（평균술전56．29분，술후92분），영상학표현17례보지은정。결론：자체골수이식약액국부관주병중약치료재고골두결혈성배사술후적응용，조작간단，취재방편，무배이반응。술후회복쾌，역학자격대성골、성연골、신생혈관형성유일정촉진작용。
Objective:To investigate the clinical effect and mechanical stimulation after applying autologous bone marrow implantation in hip joint and femur neck cavity combined with focal reperfusion of traditional Chinese medicine and pharmacy to treat ANFH .Meth-ods:Seventeen patients (23 hips) with ANFH were treated by open and minimally invasive methods from 2005 to 2011 years.The aver-age age of the patients was 22.4 years ranging from 19 to 60 years.Three cases were of IA of ARCO , eight cases were of ⅡA, three ca-ses were of ⅡC, three cases were of ⅢA.All patients were treated by these methods and followed up for 1-7 years postoperatively . Clinical outcomes were evaluated based on the Harris score and X -ray examination .Results:The mean level of Harris score was in-creased 35.71 after operation (92) compared before operation (56.29).Radiography of all patients was all keep stable .Conclusion:Treatment of ANFH by autologous bone marrow implantation combined with focal reperfusion of traditional Chinese medicine shows good results and with the advantage to obtain , operability, no immune rejection and recovery quickly , promoting osteogenesis and angigenesis .