经皮穿刺骨水泥注射防治股骨头坏死关节面塌陷实验研究  

An experimental study of percutaneous injection of bone cement to prevent and treatment the articular surface collaps for necrosis of femoral head

作　　者：侯昌龙[1] 吕维富[1] 张学彬[1] 王伟昱[1] 张行明[1] 

机构地区：[1]安徽省立医院影像科介入病房

出　　处：《医学影像学杂志》2006年第10期1097-1101,共5页Journal of Medical Imaging

基　　金：安徽省教育厅自然科学研究项目(2004kj2432C)

摘　　要：目的:通过对股骨头供血动脉栓塞建立股骨头缺血性坏死(avascular necrosis of femoral head,ANFH)(FicatⅡ期以前)动物模型行经皮穿刺骨水泥注射,研究该法防治股骨头坏死关节面塌陷影像学及病理学变化,初步探讨该方法的安全性、可行性。方法:以真丝线段微绒毛行家猪股骨头供血动脉栓塞,建立ANFH动物模型。对ANFH FicatⅡ期模型经皮穿刺骨水泥注射治疗并与对照组作影像及病理对照研究。结果:经股骨头供血动脉栓塞研制动物模型,方法新颖、成功率高,可控性强;TAE术后股骨头坏死进行性加重,平均塌陷时间为1.5个月;组织病理学示骨细胞逐渐坏死,高倍镜下单位面积的空缺骨陷窝数百分比(PBL)增多及骨小梁(TBV)减少;A组与B组、B组治疗前后的PBL与TBV比较差异有显著性(P<0.05)。结论:经股骨头供血动脉栓塞术建立ANFH模型方法新颖、有良好可控性,同时建立模型的周期缩短;而经皮穿刺骨水泥注射防治股骨头坏死关节面塌陷,对FicatⅡ期病变可以有效地阻止病变进展,防治其塌陷,是一种安全、有效及微创的方法。在进一步完善动物实验后,可以考虑有选择的进行临床实验性治疗。Objective：To study the technical way of animal model of ANFH with TAE （transcatheter arterial embolization） and to observe the effect with percutaneous injection of CPC （ calcium phospate cement） to prevent the articular surface from collapsing for ANFH （avascalar necrosis of femoral head） in pigs. To explore a new method in the treatment of bone necrosis and collapse of the femoral head. Several technical points involved in TAE and CPC injection were discussed. Methods： Branch arteries of the animals left femoral head were embolised with the segments of silk. They were randomly divided into two groups ＇after about I month assessed by its images. Group A （n = 8） called model group, with only TAE and then surveried the avasctllar necrosis procedure of femoral head by imaging , pathologic and histologic examination. The other group, Group B （n = 12）, called percutaneous injection of calcium phosphate cement interventional treatment group, with pereutaneous injection of calcium phospate cement to ANFH at the stage Ficat Ⅱ . Results： The animal models of ANFH in early stage were established by embolization of feeding artery. In Group A, bone collapse occurred in all of left femoral heads in 3 months after TAE. The mean time was 1.5 months. Imaging showed that the necrosis of femoral head aggravated gradually in Group A. Technical success rate of pereutaneous injection CPC was high and technical criticalities were precise injection time, rigorous pereutanous fixing of bone , suitable proportion of CPC power to liquid. CT scan of femoral head with injection CPC showed that it diffused well. Volume of bone trabecula（TBV） and percentage of bone lactma（PBL） at unit area in microscope were also inspected in two groups. TBV and PBL of two groups were compared between them in the different special time and every P-value was calculated（ P 〈 0.05）. Conclusion：The experimental technology of animal model established with TAE is very novel and controllability was easy. Time of format

关 键 词：股骨头坏死 缺血性 血管造影术 动物 实验研究 磷酸钙骨水泥 

分 类 号：R681.8[医药卫生—骨科学] R815[医药卫生—外科学]