中医正骨
中醫正骨
중의정골
THE JOURNAL OF TRADITIONAL CHINESE ORTHOPEDICS AND TRAUMATOLOGY
2014年
5期
9-12
,共4页
李晓明%郭东辉%石国君%李瑞亮%张洪相%苏长生%沈润斌%王红玉%李运美%袁福禄%韩广普
李曉明%郭東輝%石國君%李瑞亮%張洪相%囌長生%瀋潤斌%王紅玉%李運美%袁福祿%韓廣普
리효명%곽동휘%석국군%리서량%장홍상%소장생%침윤빈%왕홍옥%리운미%원복록%한엄보
股骨头坏死%丹参酮ⅡA%减压术,外科%骨移植
股骨頭壞死%丹參酮ⅡA%減壓術,外科%骨移植
고골두배사%단삼동ⅡA%감압술,외과%골이식
Femur head necrosis%Tanshinone ⅡA%Decompression,surgical%Bone transplantation
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。
目的：觀察丹參酮ⅡA結閤髓芯減壓打壓植骨治療FicatⅡ期股骨頭壞死的臨床療效和安全性。方法：將60例符閤要求的Ficat分期Ⅱ期股骨頭壞死患者隨機分為2組，每組30例。治療組採用丹參酮ⅡA結閤髓芯減壓打壓植骨治療，對照組採用單純髓芯減壓打壓植骨治療。分彆于術前和術後12箇月採用Harris髖關節功能評分法評定患者的髖關節功能，併進行X線檢查觀察股骨頭塌陷程度，同時觀察比較2組患者術後及隨訪期間併髮癥的髮生情況。結果：①髖關節功能。術前2組患者髖關節功能Harris評分比較，差異無統計學意義[（75．73±7．43）分，（73．60±10．12）分，t＝1．105，P＝0．273]；術後12箇月治療組Harris評分高于對照組，差異有統計學意義[（95．81±2．88）分，（94．76±4．02）分，t＝12．590，P＝0．000]。②股骨頭塌陷程度。治療組優25髖、良7髖、中5髖、差3髖；對照組優23髖、良6髖、中5髖、差4髖。2組患者股骨頭塌陷程度比較，差異無統計學意義（Z＝-0．287，P＝0．774）。③併髮癥髮生情況。2組患者均穫隨訪，隨訪時時間13～18箇月，中位數15．5箇月。術後2組患者切口均甲級愈閤，術後及隨訪期間未齣現手術相關併髮癥。結論：丹參酮ⅡA結閤髓芯減壓打壓植骨可有效減緩FicatⅡ期股骨頭壞死患者股骨頭塌陷的病理進程，改善髖關節功能，而且具有較高的安全性。
목적：관찰단삼동ⅡA결합수심감압타압식골치료FicatⅡ기고골두배사적림상료효화안전성。방법：장60례부합요구적Ficat분기Ⅱ기고골두배사환자수궤분위2조，매조30례。치료조채용단삼동ⅡA결합수심감압타압식골치료，대조조채용단순수심감압타압식골치료。분별우술전화술후12개월채용Harris관관절공능평분법평정환자적관관절공능，병진행X선검사관찰고골두탑함정도，동시관찰비교2조환자술후급수방기간병발증적발생정황。결과：①관관절공능。술전2조환자관관절공능Harris평분비교，차이무통계학의의[（75．73±7．43）분，（73．60±10．12）분，t＝1．105，P＝0．273]；술후12개월치료조Harris평분고우대조조，차이유통계학의의[（95．81±2．88）분，（94．76±4．02）분，t＝12．590，P＝0．000]。②고골두탑함정도。치료조우25관、량7관、중5관、차3관；대조조우23관、량6관、중5관、차4관。2조환자고골두탑함정도비교，차이무통계학의의（Z＝-0．287，P＝0．774）。③병발증발생정황。2조환자균획수방，수방시시간13～18개월，중위수15．5개월。술후2조환자절구균갑급유합，술후급수방기간미출현수술상관병발증。결론：단삼동ⅡA결합수심감압타압식골가유효감완FicatⅡ기고골두배사환자고골두탑함적병리진정，개선관관절공능，이차구유교고적안전성。
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 1 2 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 peri-od 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+/-1 0.1 2 points,t=1 .1 05,P=0.273),and the Harris scores of treatment group were higher than that of control group 1 2 months after the treatment(95.81 +/-2.88 vs 94.76 +/-4.02 points,t=1 2.590,P=0.000).The results of degrees of femur head col-lapse 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 1 3-1 8 months with a medi-an of 1 5 .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 de-compression 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.
