CAJ | 학술논문

目的：探讨早中期股骨头坏死疼痛与坏死面积及关节积液分级的相关性。方法76例（116髋）患者进行研究。其中男47例，女29例；平均年龄39岁（21～62岁）；左侧55髋，右侧61髋。其中Ⅰ期5髋，Ⅱ期44髋，Ⅲ期67髋。所有患者均行标准正位和蛙式位 X 线片、轴位 CT 扫描及冠状位、矢状面重建等检查，所有患者均接受 MRI 检查判断早期坏死范围及关节积液等级。根据 MRI、CT 及 X 线片表现确定 ARCO 分期，参考 Liu 等关节积液分级作为关节积液量评判标准，以语言模拟评分法（verbal rating scale，VRS）作为描述性疼痛的程度分级法，以 Kruskal-Wallis 秩和检验作为检验方法。结果随着股骨头坏死的进展，疼痛也逐渐加重；Ⅱ期和Ⅲ期中坏死范围越大，疼痛症状加重；关节积液分级与疼痛呈正相关。结论早中期股骨头坏死疼痛与坏死范围及关节积液均有密切联系，坏死范围大，积液多则疼痛重。
목적：탐토조중기고골두배사동통여배사면적급관절적액분급적상관성。방법76례（116관）환자진행연구。기중남47례，녀29례；평균년령39세（21～62세）；좌측55관，우측61관。기중Ⅰ기5관，Ⅱ기44관，Ⅲ기67관。소유환자균행표준정위화와식위 X 선편、축위 CT 소묘급관상위、시상면중건등검사，소유환자균접수 MRI 검사판단조기배사범위급관절적액등급。근거 MRI、CT 급 X 선편표현학정 ARCO 분기，삼고 Liu 등관절적액분급작위관절적액량평판표준，이어언모의평분법（verbal rating scale，VRS）작위묘술성동통적정도분급법，이 Kruskal-Wallis 질화검험작위검험방법。결과수착고골두배사적진전，동통야축점가중；Ⅱ기화Ⅲ기중배사범위월대，동통증상가중；관절적액분급여동통정정상관。결론조중기고골두배사동통여배사범위급관절적액균유밀절련계，배사범위대，적액다칙동통중。
Objective To study the correlation between necrosis area,joint effusion and pain in early and medium-term osteonecrosis of the femoral head. Methods 76 cases(116 hips)with osteonecrosis of the femoral head were studied. There were 47 male and 25 female with a mean age of 39 years old(21 ~ 62 y ). And there were 55 case of left hip,cases of the right hip. There 5 hips in stage Ⅰ,44 hips in stage Ⅱ,67 hips in stage Ⅲ according to ARCO. All cases underwent standard antero-posterior and frog-leg X -ray;axial CT scans and coronal,sagittal reconstruction. All cases underwent MRI examination to esti-mate the necrotic area and the effusion grade. The ARCO stage were judged according to the findings of MR,CT and X -rayg. The joint effusion estimated according to the methods of Liu. The degree of pain was judged using the methods of VRS(Verbal rating scale). The Kruskal-Wallis rank-sum test was used. Results The pain gradually worsened with the progress of the fem-oral head necrosis,The pain symptoms were worse with the necrotic area greater in stage Ⅱ and stage Ⅲ. The joint effusion and pain were positively correlated. Conclusion The correlation exist between the pain symptoms of osteonecrosis of the femo-ral head and the necrotic area and joint effusion. The pain symptoms were worse with the necrotic area and fluid volume increa-ses.