CAJ | 학술논문

目的：探讨经皮髓芯减压支撑术联合介入治疗围塌陷期成人股骨头坏死的方法及疗效。方法25例(37髋)非创伤性围塌陷期股骨头缺血性坏死患者，根据ARCO分期ⅡB9髋、ⅡC4髋、ⅢA11髋、ⅢB9髋、ⅢC4髋，首先对患髋行经皮髓芯减压并坏死区空心钛钉支撑术，3d后通过介入方法置入动脉导管向股骨头供血动脉内灌注溶栓、扩血管及活血化瘀药物，治疗完成后扶拐，减少患髋负重，随访1年，以Harris评分及X线检查进行疗效评价。结果25例患者均顺利完成治疗，Harris评分分值显著提高（P＜0.05），股骨头塌陷程度无显著加重（P＞0.05）。结论经皮髓芯减压支撑术联合介入治疗创伤小，能明显缓解症状，改善髋关节功能，阻止或延缓股骨头的塌陷，是治疗围塌陷期成人股骨头坏死的有效方法。
목적：탐토경피수심감압지탱술연합개입치료위탑함기성인고골두배사적방법급료효。방법25례(37관)비창상성위탑함기고골두결혈성배사환자，근거ARCO분기ⅡB9관、ⅡC4관、ⅢA11관、ⅢB9관、ⅢC4관，수선대환관행경피수심감압병배사구공심태정지탱술，3d후통과개입방법치입동맥도관향고골두공혈동맥내관주용전、확혈관급활혈화어약물，치료완성후부괴，감소환관부중，수방1년，이Harris평분급X선검사진행료효평개。결과25례환자균순리완성치료，Harris평분분치현저제고（P＜0.05），고골두탑함정도무현저가중（P＞0.05）。결론경피수심감압지탱술연합개입치료창상소，능명현완해증상，개선관관절공능，조지혹연완고골두적탑함，시치료위탑함기성인고골두배사적유효방법。
Objective??To?study?the?methods?and?efficacy?of?percutaneous?core?decompression?and?internal?bracket?implanting?surgery?combined?with?interventional?therapy?for?the?treatment?of?per-sink?period?avascular?necrosis?of?the?femoral?head.?Method At ifrst, 25 cases (37 hips) with per-sink period ANFH,?according?to?ARCO?stages,?ⅡB?9?hips,?ⅡC?4?hips,?ⅢA?11?hips,?ⅢB?9?hips,?ⅢC?4?hips,?were?treated?by?percutaneous?core?decompression?and?hollow?titanium?screw?implanting?surgery.?After?3?days,?an?catheter?was?put?in?the?femoral?head’s?feeding?artery,?drugs?for?invigorating?blood?circulation?were?infused?into?it.?After?the?treatment?crutches?were?used?to?reduce?the?hip’s?weight-bearing.?1?year?later,?Harris?score?and?X-ray?examination?were?used?score?and?X-ray?examination?were?used?to?evaluate?the?curative?effect.?Result??All?of?25?cases?of?patients?successfully?completed?treatment,?Harris?score?signiifcantly increased (P<0.05), the degree of femoral head collapse was no signiifcant aggravation (P>0.05).?Conclusion??Percutaneous?core?decompression?and internal bracket implanting surgery combined with intervention can signiifcantly relieve symptoms, improve hip’s function and delay or prevent the collapse?of?the?femoral?head.?It?is?a?safe?and?effective?method?for?the?treatment?of?per-sink?period?avascular?necrosis?of?femoral?head.