选择性血管造影评价青壮年股骨颈骨折早期股骨头血流分布  

Selective Digital Subtraction Angiography in Estimation of Blood Circulation of Femoral Head in Young Patients with Femoral Neck Fracture

作　　者：袁希[1] 刘洋 张建章 夏述琳 蔡林[1] 周福祥[2] 

机构地区：[1]武汉大学中南医院骨科,湖北武汉430071 [2]武汉大学中南医院放化疗科,湖北武汉430071 [3]武汉市第五医院放射科,湖北武汉430000

出　　处：《医学新知》2009年第2期105-108,共4页New Medicine

基　　金：基金项目：武汉市科技计划基金资助项目（编号WX08D24）

摘　　要：目的探讨应用选择性血管造影检查评价青壮年股骨颈骨折早期股骨头血液循环损伤的价值。方法对12例青壮年股骨颈骨折在2～5d内进行旋股内、外及支持带动脉造影，造影中均采用中立位无牵引、中立位5kg牵引及内旋位无牵引3种形式。结果12例中髋关节囊内出血1例，骨内出血7例，12例均出现持带动脉损伤和血供减少；患髋牵引时支持带动脉供血减少；髋关节维持伸直内旋位时所有支持带动脉无明确显影或仅显示其主干。结论骨折早期选择性旋股动脉及支持带动脉造影技术可以评价早期股骨颈骨折后股骨头血液循环损伤情况，对早期预测股骨头坏死的可能性有重要价值。Objective To observe the influence of femoral neck fracture on blood circulation of femoral head by selective digital subtraction angiography （DSA）. Methods 12 middle -age patients with single femoral neck fracture underwent DSA of selective deep femoral artery and femoral circumflex artery from 2 to 5 days after fracture in the absence of traction, in the presence of 4 kg hip traction in the neutral position and in the intorted position without traction. Results Intra -articular hemorrhage was observed in 1 patient and intra - osseous hemorrhage in 7 patients. The injury of retinacular arteries and reduction of blood supply were found in each case. In the presence of hip traction, blood flow of retinacular arteries reduced markedly. Few branches and little femoral head blood perfusion were observed in all of retinacular arteries, while hip joint was internally rotated with the sick leg straightened in the patients. Conclusion Selective femoral circumflex artery and retinacular artery DSA is an important technique for assessment of femoral head blood circulation and investigation on its influent factors after femoral neck fracture. We can predict the possibility of avascular osteonecrosis of the femoral head after femoral neck fracture and then provide effective treatment at the early stage of femoral neck fracture.

关 键 词：青壮年 股骨颈骨折 血管造影术 血管损伤 

分 类 号：R683.42[医药卫生—骨科学] R814.43[医药卫生—外科学]