带血管蒂髂骨瓣移位治疗青少年镰状细胞病股骨头缺血性坏死(英文)  

Treatment Ischemic Necrosis of the Femoral Head with Vacularized Iliac Graft in Young Patients with Sickle-Call Disease

作　　者：吴昊 梁源[2] Hernigou Philippe 

机构地区：[1]法国享利蒙多医院矫形与创伤外科,克雷岱依94010 [2]广西壮族自治区人民医院放射科

出　　处：《中国修复重建外科杂志》2005年第9期717-720,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 探讨带血管蒂髂骨瓣移位治疗青少年镰状细胞病股骨头缺血性坏死的临床疗效。 方法1998年-2001年在尼日尔的马腊迪省医院,治疗患者12例14髋,其中男5例,女7例;单侧10例10髋,双侧2例4髋;年龄11-22岁。均为Ficat Ⅲ、Ⅳ期患者。Harris评分平均75分。采用带血管蒂髂骨瓣移位12例12髋,有2例双髋患者,仪作一侧手术。结果 术后患者均获随访24-30个月,平均27.4个月。髋部疼痛消失,无感染等并发症,Harris评分平均90分,X线片示病变无进展,无重复手术,近期疗效满意。结论 对于青少年Ficat Ⅲ、Ⅳ期的镰状细胞病股骨头缺血性坏死患者,采用带血管蒂髂骨瓣移位术治疗,能解除疼痛,恢复髋关节功能,延缓人工全髋关节置换的时间。Objective To investigate the therapeutic effects of the vacularized iliac graft for ischemic necrosis of the femoral head in Niger young patients with sickle cell disease. Methods From November 1998 to Apirl 2001, 12 patients（5 males and 7 females, aging 11-22 years） with sickle cell disease suffered from ischemic necrosis of the femoral head in 14 hips. The lesion was on one hip in 10 patients and on bilateral hip in 2 patients. Necrosis was classified as Ficat Stage Ⅲ- Ⅳ in all patients. Twelve hips in 12 patients were treated with vascularized iliac graft in Maradi Province Hospital of Niger. The effects were evaluated on the basis of the Harris hip score and radiological examination. Results The patients were followed up 24-30 months after operation（27.4 months on average） .The clinical results were satisfactory though no radiological evidence of improvement was noted. The mean Harris hip score increased from 75 points to 90 points. Pain relief and hip function improvement were achieved in all patients. No patients needed revision during short-term follow-up of 24-30 months. Conclusion The method is recommendation for treatment of ischemic necrosis of the femoral head in the Ficat Stages Ⅲ- Ⅳ in young patients with sickle cell disease for pain relief and restoration of hip joint function, This procedure may prolong the timing and acting of total hip arthroplasty.

关 键 词：镰状细胞病 股骨头 缺血性坏死 带血管蒂髂骨瓣移位术 青少年 

分 类 号：R687.3[医药卫生—骨科学]