CAJ | 학술논문

目的观察体外冲击波联合自体骨髓间充质干细胞移植治疗早期股骨头坏死的临床疗效.方法根据股骨头坏死国际骨循环研究学会(ARCO)的股骨头坏死的分期标准,选取Ⅰ期和Ⅱ期股骨头坏死患者40例,按随机数字表法分为治疗组20例(29个髋关节),对照组20例(27个髋关节).2组患者均采用BMSC移植术进行治疗,治疗组患者于BMSC移植术后第2天行ESWT治疗.2组患者均于治疗前和术后3、6、12、24个月采用髋关节Harris评分评定患者的髋关节功能、疼痛程度和疗效,同时采用骨盆正位、蛙式位X线片对患者进行ARCO分期评定.结果术后3、6、12、24个月,2组的Harris评分以及Harris量表中的疼痛程度评分与组内治疗前比较,差异均有统计学意义(P＜0.05);且术后6、12、24个月,治疗组的HaHis评分以及Harris量表中的疼痛评分与对照组治疗后比较,差异均有统计学意义(P＜0.05).治疗12个月后,治疗组髋关节优8个,良18个,中1个;对照组髋关节优5个,良13个,中8个,组间差异有统计学意义(P＜0.05).术后12个月,2组换ARCO分期评定组间比较,差异有统计学意义(P＜0.05).结论体外冲击波联合自体骨髓间充质干细胞移植治疗早期股骨头坏死可明显缓解疼痛,改善患者的关节功能.
목적 관찰체외충격파연합자체골수간충질간세포이식치료조기고골두배사적림상료효.방법 근거고골두배사국제골순배연구학회(ARCO)적고골두배사적분기표준,선취Ⅰ기화Ⅱ기고골두배사환자40례,안수궤수자표법분위치료조20례(29개관관절),대조조20례(27개관관절).2조환자균채용BMSC이식술진행치료,치료조환자우BMSC이식술후제2천행ESWT치료.2조환자균우치료전화술후3、6、12、24개월채용관관절Harris평분평정환자적관관절공능、동통정도화료효,동시채용골분정위、와식위X선편대환자진행ARCO분기평정.결과 술후3、6、12、24개월,2조적Harris평분이급Harris량표중적동통정도평분여조내치료전비교,차이균유통계학의의(P＜0.05);차술후6、12、24개월,치료조적HaHis평분이급Harris량표중적동통평분여대조조치료후비교,차이균유통계학의의(P＜0.05).치료12개월후,치료조관관절우8개,량18개,중1개;대조조관관절우5개,량13개,중8개,조간차이유통계학의의(P＜0.05).술후12개월,2조환ARCO분기평정조간비교,차이유통계학의의(P＜0.05).결론 체외충격파연합자체골수간충질간세포이식치료조기고골두배사가명현완해동통,개선환자적관절공능.
Objective To observe the therapeutic effects of extracorporeal shock wave therapy (ESWT) combined with autologous bone marrow stem cells (BMSC) transplantation in treating early-stage osteonecrosis of the femoral head (ONFH).Methods Forty patients diagnosed as stage Ⅰ or Ⅱ according to the classification of osteonecrosis of the femoral head put forward by the Association Research Circulation Osseous were randomly divided into a treatment group and a control group with 20 cases in each group.Both groups were treated with BMSC transplantation,while the treatment group was further treated with ESWT the next day.Harris scores were assigned before the treatment and 3,6,12 and 24 months after the treatment to evaluate hip function,the degree of pain and the effects of the treatment.Frog-bit X-rays of the anteroposterior pelvis were taken to assess the stages.Results There were significant differences in the Harris scores and pain degree of the two groups before and at the different time points after the treatment.After 6,12 and 24 months,significant differences were observed in the two values between the two groups.After 12 months the number of hips rated excellent,good and medium level were 8,18 and 1 in the treatment group and 5,13 and 8 in the control group,showing significant differences.Conclusion Extracorporeal shock wave therapy along with autologous bone marrow stem cell transplantation can be used to treat patients with early stage osteonecrosis of the femoral head,relieving their pain and improving their joint function.