人工骨与骨水泥混合植入治疗青壮年股骨头缺血性坏死  

Artificial bone and cement implantation in younger patients with avascular necrosis of the femoral head.

作　　者：王效柱[1] 杨学义[1] 洪定刚[1] 容安[1] 周建飞[1] 于小中[1] 吴沅鸿[1] 

机构地区：[1]广西中医学院第三附属医院骨一科,柳州545001

出　　处：《中国医学创新》2008年第32期7-9,共3页Medical Innovation of China

基　　金：广西卫生厅青年基金资助项目(Z2005196)

摘　　要：目的观察采用人工骨(羟基磷灰石)与骨水泥混合植入治疗各种不同原因所致的青壮年股骨头缺血性坏死的疗效。方法 2003年10月至2008年1月期间对FicatⅡ～Ⅲ期的15例(19髋)股骨头缺血性坏死患者行死骨清除人工骨与骨水泥混合植入治疗。术后定期门诊随访,观察疗效,并摄X线片。随访时间3个月至5年,平均24.6个月。结果手术前后采用改良Merled'Aubigne评分法对患髋功能进行评价。19髋由术前平均11.68分改善至术后平均15.11分。术后X线片示股骨头塌陷均有所恢复,外形改善,复查时大部分患者的股骨头仍能维持术后的形态,坏死范围未见扩大,患者均对治疗结果感到满意。结论人工骨与骨水泥混合植入法能防止股骨头进一步塌陷,保留髋关节功能,推迟人工髋关节置换术的时间,具有创伤小、手术简单、术后恢复快等优点,适用于FicatⅡ～Ⅲ期患者,尤其适用于年轻患者。Objective To investigate the clinical outcomes of treatment of younger patients avascular necrosis of the femoral head with artificial bone and cement implantation. Methods Fifteen patients （ 19 hips ） with Ficat stage Ⅱ to Ⅲ avascular necrosis of the femoral head were treated with dead bone debridement , artificial bone and cement implantation from October 2003 to January 2008. Follow up ranges form 3 to 60 months （ the average of 24. 6 months）. Results We followed up patients progress with pre - and post - operative modification Merled Aubigne Hip Scores, All patients realized immediate post - operative pain relief and improvement in function. Mean Hip Scores improved significantly from 11.68 to 15.11. Pre - and post - operative radiographs demonstrated collapse and restoration of femoral head sphericity. Conclusion Artificial bone and cement implantation could restore head sphericity and prevent further collapse. It is technically simple, burns no bridges and enables patients a rapid recovery. The method can be used as an alternative for treatment of avascular necrosis of femoral head at Ficat stage Ⅱ to Ⅲ especially for younger patients.

关 键 词：股骨头 缺血性坏死 羟基磷灰石类 

分 类 号：R687.3[医药卫生—骨科学]