重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2015年
3期
343-344,348
,共3页
李磊%杨宇%蔡立雄%杨海韵
李磊%楊宇%蔡立雄%楊海韻
리뢰%양우%채립웅%양해운
股骨头坏死%骨髓移植%髓芯减压%自体浓缩骨髓有核细胞移植%早期
股骨頭壞死%骨髓移植%髓芯減壓%自體濃縮骨髓有覈細胞移植%早期
고골두배사%골수이식%수심감압%자체농축골수유핵세포이식%조기
osteonecrosis of femoral head%bone marrow transplantation%core decompression%bone marrow mesenchymal stem cell transplantation%early
目的:观察髓芯减压联合自体浓缩骨髓有核细胞移植治疗早期股骨头坏死(ONFH)的临床疗效。方法回顾性分析该院收治的早期ONFH患者56例(82髋),将患者分为观察组(30例,44髋)和对照组(26例,38髋),观察组采用骨髓间充质干细胞移植联合髓芯减压治疗,对照组采用单纯髓芯减压治疗。通过比较两组患者术前和术后3、6、18个月髋关节Harris髋关节评分及术后18个月影像学变化、坏死面积百分比改变程度等,了解两种治疗方法的临床疗效。结果观察组Harris髋关节评分升高至(88.24±5.53)分,优良率达84.09%;对照组升高至(75.84±4.20)分,优良率为71.05%;MRI坏死面积:观察组逐渐减少到(13.86±4.27)%,对照组降至(19.53±5.29)%,两组比较差异有统计学意义(P<0.05)。术后两组Harris髋关节评分和影像学变化均较术前有所改善(P<0.05)。结论髓芯减压联合自体浓缩骨髓有核细胞移植治疗早期ONFH的临床疗效明显优于单纯髓芯减压。
目的:觀察髓芯減壓聯閤自體濃縮骨髓有覈細胞移植治療早期股骨頭壞死(ONFH)的臨床療效。方法迴顧性分析該院收治的早期ONFH患者56例(82髖),將患者分為觀察組(30例,44髖)和對照組(26例,38髖),觀察組採用骨髓間充質榦細胞移植聯閤髓芯減壓治療,對照組採用單純髓芯減壓治療。通過比較兩組患者術前和術後3、6、18箇月髖關節Harris髖關節評分及術後18箇月影像學變化、壞死麵積百分比改變程度等,瞭解兩種治療方法的臨床療效。結果觀察組Harris髖關節評分升高至(88.24±5.53)分,優良率達84.09%;對照組升高至(75.84±4.20)分,優良率為71.05%;MRI壞死麵積:觀察組逐漸減少到(13.86±4.27)%,對照組降至(19.53±5.29)%,兩組比較差異有統計學意義(P<0.05)。術後兩組Harris髖關節評分和影像學變化均較術前有所改善(P<0.05)。結論髓芯減壓聯閤自體濃縮骨髓有覈細胞移植治療早期ONFH的臨床療效明顯優于單純髓芯減壓。
목적:관찰수심감압연합자체농축골수유핵세포이식치료조기고골두배사(ONFH)적림상료효。방법회고성분석해원수치적조기ONFH환자56례(82관),장환자분위관찰조(30례,44관)화대조조(26례,38관),관찰조채용골수간충질간세포이식연합수심감압치료,대조조채용단순수심감압치료。통과비교량조환자술전화술후3、6、18개월관관절Harris관관절평분급술후18개월영상학변화、배사면적백분비개변정도등,료해량충치료방법적림상료효。결과관찰조Harris관관절평분승고지(88.24±5.53)분,우량솔체84.09%;대조조승고지(75.84±4.20)분,우량솔위71.05%;MRI배사면적:관찰조축점감소도(13.86±4.27)%,대조조강지(19.53±5.29)%,량조비교차이유통계학의의(P<0.05)。술후량조Harris관관절평분화영상학변화균교술전유소개선(P<0.05)。결론수심감압연합자체농축골수유핵세포이식치료조기ONFH적림상료효명현우우단순수심감압。
Objective To observe the clinical outcome of core decompression combined with autologous concentrated bone mar‐row cell transplantation for treatment of early osteonecrosis of femoral head .Methods Forty six patients (82 hips) included in this retrospective analysis were divided into observation group (30 cases ,44 hips) and the control group (26 cases ,38 hips) .The obser‐vation group were treated by autologous BMMSCs transplantation joint core decompression treatment while control group treated only with core decompression .The therapeutic effect of 2 methods of treatment were summarized by comparing the 2 groups after 3 ,6 ,18 months postoperative with Harris hip score and the imaging changes and necrosis area percentage change degree at 18 months postoperatively .Results The Harris scores of the observation group after operation increased significantly [(88 .24 ± 5 .53) score] ,the excellent and good rate was 84 .09% ;the Harris scores of the control group after operation increased significantly [(75 .48 ± 4 .20)% ] ,the excellent and good rate was 71 .05% ;MRI necrosis area of the observation group after operation reduced gradually[(13 .86 ± 4 .27)% ] and the MRI necrosis area of the control group after operation reduced gradually [(19 .53 ± 5 .29)% ] .There was significant difference between them (P<0 .05) .Harris scores and the imaging changes and necrosis area per‐centage change degree of both group had been improved after the operation (P<0 .05) .Conclusion The core decompression com‐bined with autologous concentrated bone marrow cell transplantation for treatment of early osteonecrosis clinical efficacy might be better than core decompression .