植骨支撑术加中药治疗45例围塌陷期股骨头坏死的回顾研究  

A Retrospective Research on 56 Hips of Avascular Necrosis of Femoral Head in Pericollapse Stage treated by Bone Grafts and Internal Fixation Support Combined with Traditional Chinese Medicine

作　　者：王海彬[1] 何伟[1] 樊粤光[1] 张德兴[1] 刘少军[1] 唐立明[1] 曾意荣[1] 张庆文[1] 方斌[1] 姜自伟[1] 

机构地区：[1]广州中医药大学第一附属医院髋关节中心,广州510405

出　　处：《中国中医骨伤科杂志》2009年第6期20-22,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：广东省科技厅基金(NO:2005B33001023)资助;广东省自然基金(8151040701000016)资助

摘　　要：目的:探讨植骨支撑术加中药,治疗股骨头缺血性坏死的疗效。方法:对2004年1月～2005年3月在我院应用股骨头髓心减压加松质骨植骨、自体腓骨移植术、空心加压钉内固定的方法,并口服通络生骨胶囊,治疗45例(56个髋)股骨头坏死,并对患者进行回顾性的分析。根据ARCO分期标准,ⅡA期6例,ⅡB期15例,ⅡC期9例,ⅢA期3例,ⅢB期15例,ⅢC期8例。结果:随访12～27个月,平均17.5个月,临床评价总的优良率85.7%,Ⅱ期优良以上结果有27髋(90.0%),Ⅲ期优良者21髋(80.7%)。影像学评价总的优良率为37髋(66.0%)。结论:植骨支撑术,并口服中药能有效地治疗股骨头坏死。Objective：To study the effect of surgical treatment with core depression plus trabecular bone and autogenous fibular grafting on osteonecrosis of the femoral head. Methods：From January 2004 to March 2005, 45 patients with necrosis of the femoral head （56 hips） were treated with core depression, trabecular bone and antogenous fibular grafting, which were fixed by hollow compression screw. Meanwhile, they were also given Tongluo Shenggu Capsule orally, according to ARCO classification system, 6 hips fell into stage Ⅱ A, 15 hips in stage Ⅱ B, 9 hips in stage Ⅱ C, 3 hips in stage Ⅲ A, 15 hips in stage ⅢB, and 8 hips in stage ⅢC. Results：All patients were followed up for 12 to 27 months （17. 5months on average）. The total good and effective rate was 85.7% according Harris hip score. In stage Ⅱ , the good and effective rate was 90. 0% including 27 hips, and it was 80.7% in stage Ⅲ including 21 hips. Imaging evaluation presented 66% good and effective rate （37 covered）. Conclusion： Core decompression combined with bone grafting and hollow compression screw fixation can effectively cure osteonecrosis of the femoral head.

关 键 词：非创伤性股骨头坏死 围塌陷期 植骨支撑术 中药 空心加压螺钉 

分 类 号：R681.8[医药卫生—骨科学]