CAJ | 학술논문

目的：观察放散式冲击波治疗早中期股骨头缺血性坏死临床疗效。方法选取就诊的股骨头缺血性坏死患者36例64髋，应用发散式冲击波治疗系统，选用D20探头，压力：2．0～4．0 bar，频率：10～15 Hz，手持压力中－重，对股骨头坏死区进行冲击治疗4000～5000次，每1周治疗1次，共治疗9次。观察治疗前后视觉模拟评分法（VAS）、Harris评分、影像学改善情况及临床疗效。结果治疗前VAS为（7．4±1．5）分，Harris评分为（46．5±9．4）分，经冲击波治疗后1个月VAS为（2．1±0．6）分、治疗后3个月VAS为（1．9±0．4）分、治疗后6个月VAS为（1．6±0．3）分，与治疗前相比有统计学差异（P＜0．01）；治疗后1个月Harris评分为（83．7±14．4）分、治疗后3个月Harris评分为（84．4±13．5）分、治疗后6个月（85．4±11．7）分，较治疗前明显改善（P＜0．01）；经6个月治疗，复查骨盆X线片或双髋关节MRI，36例64髋，共治愈18髋，显效19髋，有效19髋，无效8髋；不同分期与临床疗效间有统计学差异（P＜0．05），病情越重，疗效越差。结论放散式冲击波是治疗早期股骨头缺血性坏死的一种有效的治疗方法。
목적：관찰방산식충격파치료조중기고골두결혈성배사림상료효。방법선취취진적고골두결혈성배사환자36례64관，응용발산식충격파치료계통，선용D20탐두，압력：2．0～4．0 bar，빈솔：10～15 Hz，수지압력중－중，대고골두배사구진행충격치료4000～5000차，매1주치료1차，공치료9차。관찰치료전후시각모의평분법（VAS）、Harris평분、영상학개선정황급림상료효。결과치료전VAS위（7．4±1．5）분，Harris평분위（46．5±9．4）분，경충격파치료후1개월VAS위（2．1±0．6）분、치료후3개월VAS위（1．9±0．4）분、치료후6개월VAS위（1．6±0．3）분，여치료전상비유통계학차이（P＜0．01）；치료후1개월Harris평분위（83．7±14．4）분、치료후3개월Harris평분위（84．4±13．5）분、치료후6개월（85．4±11．7）분，교치료전명현개선（P＜0．01）；경6개월치료，복사골분X선편혹쌍관관절MRI，36례64관，공치유18관，현효19관，유효19관，무효8관；불동분기여림상료효간유통계학차이（P＜0．05），병정월중，료효월차。결론방산식충격파시치료조기고골두결혈성배사적일충유효적치료방법。
Objective To observe the efficacy of radial shock wave therapy ( RSWT) for avascular necrosis of the femoral head ( ANFH) .Methods A total of 64 hips of 36 patients with ANFH were treated with radial shock waves .D20 impact of RSWT was used on the area of necrosis of the femoral head with 4000~5000 impulses.Pressure:2.0~4.0 bar;frequency:10~15HZ;The treatment was scheduled once every week for successive 9 times.The Visual Analogue Score(VAS),the hip Har-ris Score and CR ,CT or MRI and the clinical effects were obtained .Results The VAS and Harris Score of pretreatment was (7.4 ±1.5)and (46.5 ±9.4)respectively.One month,3 months,and 6 months after treatment,the VAS was(2.1 ±0.6), (1.9 ±0.4),and (1.6 ±0.3) respectively.The hip Harris Score was (83.7 ±14.4),(84.4 ±13.5),and (85.4 ±11.7)re-spectively.The scores were improved greatly (P<0.01).X-ray or MRI examination was performed on the 64 hips after radial shock wave therapy ,among which 18 were cured ,19 hips were evidently effective ,another 19 effective and 8 ineffective .Signifi-cant differences existed between different stages of clinical efficacy (P<0.05).The more severe the disease was,the worse the effect.Conclusion Radial shock wave therapy is an effective therapeutic method for ischemic necrosis of the femoral head .