经皮穿刺骨水泥注射防治股骨头坏死关节面塌陷实验观察  

Experimental survey on percutaneous injection of calcium phospate cement in prevening the articular surface collapsing secondary to avascular 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,合肥230001

出　　处：《介入放射学杂志》2007年第6期401-405,共5页Journal of Interventional Radiology

基　　金：安徽省教育厅自然科学研究项目(2004kj2432C)

摘　　要：目的股骨头供血动脉栓塞建立股骨头缺血性坏死(ANFH)动物模型并研究经皮穿刺骨水泥注射,防治股骨头坏死关节面塌陷影像学及病理学变化,初步探讨该法的安全性和可行性。方法对20头猪以真丝线段微绒毛行股骨头供血动脉栓塞,建立ANFH动物模型。对ANFH FicatⅡ期模型行经皮穿刺骨水泥注射治疗(B组)并与对照组(A组)作影像及病理对照研究。结果经股骨头供血动脉栓塞造模成功;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比较差异有统计学意义(P<0.05)。结论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、有效的微创方法。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 for animal model of ANFH with TAE （transcatheter arterial embolization）and to observe the image and pathologic changes of pereutaneous injection with CPC （Calcium Phospate Cement）in prevening the articular surface collapsing secondary to ANFH （avaseular necrosis of femoral head）in pigs and its feasibility and safety. Methods Branch arteries of the pig＇s left femoral head were embolized with woolly threads. Twenty pigs were randomly divided into A and B groups, and after about 1 month changes were assessed by imagings. Group A（n = 8）was sevend as eontral of model contrast group, with only TAE and then surveried the avaseular necrosis features of femoral head by imaging together with pathologic and histologic examinations. Group B（n = 12） was designated as percutaneous injection with CPC for interventional treatment group of ANFH at the stage Float Ⅱ. Results The animal models of ANFH in early stage were established by embolization of feeding arteries. In Group A, bone collapse occurred in 1.5 months after TAE, with imaging features of femoral head necrosis aggravated gradually. In group B, technical success of percutaneous injection with CPC was high and technical criteria included precise injection time, vigorous pereutanous fixing of bone ,suitable proport^ion of CPC powder to liquid. CT scan of femoral head with injection CPC showed that it diffused well. Volume of bone trabeeula （TBV）and percentage of bone lacuna （PBL）at unit area under microscopy were also inspected in two groups. TBV and PBL of two groups were compared in different special times and calculated especially for group B （P 〈 0.05）. Conclusion The pereutanous injection of CPC to femoral head is a quite safe and effective palliative therapy for ANFH in early stage.（J Intervent Radiol, 2007, 16： 401-405）

关 键 词：股骨头坏死 缺血性 放射学 介入性 血管造影术 动物 实验观察 磷酸钙骨水泥 

分 类 号：R681.8[医药卫生—骨科学]