中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
7期
757-759
,共3页
股骨头坏死%自体外周血干细胞移植%多孔钽棒植入
股骨頭壞死%自體外週血榦細胞移植%多孔鐽棒植入
고골두배사%자체외주혈간세포이식%다공단봉식입
Femur head necrosis%Autologous peripheral blood stem cell transplantation%Porous tantalum rod implantation
目的 探讨联合应用多孔钽棒植入与自体外周血干细胞移植治疗股骨头缺血性坏死(ANFH)的效果.方法 2009年7月至2011年3月联合应用多孔钽棒植入与自体外周血干细胞移植治疗36例(36髋)早期ANFH患者,左侧19例,右侧17例.按照国际骨循环研究会(ARCO)分类标准的ANFH病变Ⅰ、Ⅱ期患者36例(36髋).临床评价术前与术后疼痛评分、Harris髓关节评分及患者MRI低信号区所占股骨头体积的百分比.结果 全部获得随访,随访12～15个月,Harris髓关节评分术后为(91.70±6.90)分,与术前(68.32±7.10)分比较,Harris髓关节术后评分明显升高,差异有统计学意义(t =4.364,P＜0.01),患者疼痛症状显著改善[术前疼痛评分为(15.55±6.60)分,术后为(29.78±5.67)分；t=3.423,P＜0.05],髋关节屈伸和内外旋转功能明显恢复.MRI示术后股骨头坏死区域比术前明显缩小,与术前比较差异有统计学意义[(38.20±8.30)％与(21.43±5.10)％;t =6.527,P＜0.05].结论 联合应用多孔钽棒植入与自体外周血干细胞移植治疗ANFH,可显著减轻关节疼痛,明显恢复关节功能,可有效防止股骨头塌陷,延缓病情发展,具有较好的临床效果.
目的 探討聯閤應用多孔鐽棒植入與自體外週血榦細胞移植治療股骨頭缺血性壞死(ANFH)的效果.方法 2009年7月至2011年3月聯閤應用多孔鐽棒植入與自體外週血榦細胞移植治療36例(36髖)早期ANFH患者,左側19例,右側17例.按照國際骨循環研究會(ARCO)分類標準的ANFH病變Ⅰ、Ⅱ期患者36例(36髖).臨床評價術前與術後疼痛評分、Harris髓關節評分及患者MRI低信號區所佔股骨頭體積的百分比.結果 全部穫得隨訪,隨訪12～15箇月,Harris髓關節評分術後為(91.70±6.90)分,與術前(68.32±7.10)分比較,Harris髓關節術後評分明顯升高,差異有統計學意義(t =4.364,P＜0.01),患者疼痛癥狀顯著改善[術前疼痛評分為(15.55±6.60)分,術後為(29.78±5.67)分；t=3.423,P＜0.05],髖關節屈伸和內外鏇轉功能明顯恢複.MRI示術後股骨頭壞死區域比術前明顯縮小,與術前比較差異有統計學意義[(38.20±8.30)％與(21.43±5.10)％;t =6.527,P＜0.05].結論 聯閤應用多孔鐽棒植入與自體外週血榦細胞移植治療ANFH,可顯著減輕關節疼痛,明顯恢複關節功能,可有效防止股骨頭塌陷,延緩病情髮展,具有較好的臨床效果.
목적 탐토연합응용다공단봉식입여자체외주혈간세포이식치료고골두결혈성배사(ANFH)적효과.방법 2009년7월지2011년3월연합응용다공단봉식입여자체외주혈간세포이식치료36례(36관)조기ANFH환자,좌측19례,우측17례.안조국제골순배연구회(ARCO)분류표준적ANFH병변Ⅰ、Ⅱ기환자36례(36관).림상평개술전여술후동통평분、Harris수관절평분급환자MRI저신호구소점고골두체적적백분비.결과 전부획득수방,수방12～15개월,Harris수관절평분술후위(91.70±6.90)분,여술전(68.32±7.10)분비교,Harris수관절술후평분명현승고,차이유통계학의의(t =4.364,P＜0.01),환자동통증상현저개선[술전동통평분위(15.55±6.60)분,술후위(29.78±5.67)분；t=3.423,P＜0.05],관관절굴신화내외선전공능명현회복.MRI시술후고골두배사구역비술전명현축소,여술전비교차이유통계학의의[(38.20±8.30)％여(21.43±5.10)％;t =6.527,P＜0.05].결론 연합응용다공단봉식입여자체외주혈간세포이식치료ANFH,가현저감경관절동통,명현회복관절공능,가유효방지고골두탑함,연완병정발전,구유교호적림상효과.
Objective To investigate the effects of Porous tantalum rod implantation and autologous peripheral blood stem cell transplantation on the treatment of avascular necrosis of femoral head (ANFH).Methods Thirty-six cases with early ANFH (19 cases on the left side and 17 cases on the right side) treated by Porous tantalum rod implantation and matrix induced autologous peripheral blood stem cell trans-plantation from July 2009 to March 2011.The 36 cases had osteonecrosis of the femoral head(ONFH) lesions Ⅰ and Ⅱ according to the international bone circulation Research Association (ARCO) classification of ONFH lesion.All patients were followed up for 12-15 months.Clinical evaluation included preoperative and postoperative pain score,the Harris hip score,percentage of low signal MRI area in the volume of femoral head.Results All the patients were followed up for 12 to 15 months.The postoperative Harris hip score was significantly higher than pre-operation ((91.70 ± 6.90) vs.(68.32 ± 7.10) ; t =4.364,P ＜ 0.01).Pain symptoms reduced markedly ((15.55 ±6.60) vs.(29.78 ±5.67);t =3.423,P ＜0.05).Hip flexion and external rotation function was restored.MRI showed that after the operations the volume of areas with femoral head necrosis significantly reduced in compared with the pre-operation ((38.20 ± 8.30) ％ vs.(21.43 ± 5.10) ％ ; t =6.527,P ＜ 0.05).Conclusion Porous tantalum rod implantation and autologous peripheral blood stem cell transplantation can significantly reduce joint pain,dramatically restore joint function,effectively prevent collapse of the femoral head,retard progression and has good clinical efficacy in the treatment of early femoral head necrosis.
