儿童股骨头无菌性坏死的手术治疗  

Surgical treatment for children with ischemic necrosis of femoral head

作　　者：李建炜[1] 罗玉琛[1] 冯燕翔[1] 

机构地区：[1]广东省湛江中心人民医院,广东湛江524037

出　　处：《河北医学》2004年第9期791-793,共3页Hebei Medicine

摘　　要：目的 :对儿童股骨无菌性坏死的三种手术方法进行疗效比较。方法 :将 89例 (95髋 )儿童股骨头无菌性坏死按 3种不同的手术方法分组进行疗效观察。分组如下 :A组 (髋关节滑膜切除 +股骨头钻孔减压 +旋股外侧动静脉血管束植入 ) 2 9髋 ;B组 (A组方法 +骨盆截骨术 ) 34髋 ;C组 (A组方法 +股骨上端截骨术 ) 32髋。结果 :经 2～ 1 3年随访 ,3组的优良率分别为 :A组 75 .8% ;B组 :91 .2 % ;C组 :90 .6 %。B、C组疗效优于A组 ,B组和C组的疗效相差不大。结论 :降低骨内压和关节内压以及改善股骨头血循环是治疗Perthes病的有效方法 ;在此基础上增加对股骨头的包容和减少对股骨头的机械压迫 ,疗效更好。Objective: To compare clinical effects of three operative methods for femoral head ischemic necrosis in children. Method: 89 Children with femoral heal ischemic, necrosis were divided into three groups as A (synovetomy of hip joint + decompression by hole-boring in femoral head + transplantation of lateral femoral circumflex vessel bundles), which consists of 29 hips, B( method of Group A + pelvicotomy), 34 hips, and C (methodof Group A + Profimal femoral oseteotom ), 32 hips . Result: All cases were followed-up for 2 to 13 years, the excellent or good results was observed in 75.8% of Group A , 91.2% of Group B, and 90.6% of Group C , respevtively. By comparing these results ,it is suggest that there is a better clinical effect in Group B and Group C than in Group A . And no significant difference between Group B and Group C . Conclusion: Decompression of inside femoral head and hip joint capsule and blood circulatory improvement of femoral head are effective to treat the disease. Besides, based on these procedure, increasing the hip joint accomodation for femoral head and decreasing the mechanic pressure upon femoral heal should gain a better outcome.

关 键 词：股骨头坏死 Legg-Calve-Perthes病 血管移植术 截骨术 

分 类 号：R726.8[医药卫生—儿科]