综合介入法治疗股骨头缺血性坏死  

Synthetical Interventional Therapy for Avascular Necrosis of the Femoral Head

作　　者：吴文泽[1] 向燕萍[1] 谭国卫[1] 刘佩武[1] 刘四斌[1] 黄源义[1] 

机构地区：[1]华中科技大学同济医学院附属荆州医院放射科,湖北荆州434020

出　　处：《实用放射学杂志》2009年第10期1499-1501,1505,共4页Journal of Practical Radiology

基　　金：荆州市医药卫生科技攻关计划项目,编号：[2008]14号

摘　　要：目的评价综合介入法连续性治疗股骨头缺血性坏死（ANFH）的临床疗效。方法经X线平片、CT、MRI检查及临床证实的ANFH 130例病人，首先进行经动脉介入治疗，3d后行股骨头经皮髓芯减压术，同时行经皮介入外置管治疗，保留外引流管1周。观察治疗前后动脉数目和静脉回流的变化，临床症状的改变，并行DSA、X线平片及MRI定期随访。结果治疗后1年复查显示：①X线平片随访结果，45例复查显示骨质完全修复，余85例有不同程度的骨质修复。②DSA血管造影随访结果：显示动脉数目的变化，107例动脉数目明显增多，10例动脉数目略多，不增多13例；静脉回流时间变化，298例静脉回流加快，2例静脉无变化。③MRI随访结果：118例显示骨髓水肿消退，12例显示残留散在小斑点状骨髓水肿信号病灶。④临床症状随访结果：67例治疗后疼痛完全消除，大部分缓解34例，部分缓解29例，未改善0例，其临床症状改善率100%。结论综合介入法治疗ANFH,是一种简便、安全可靠的疗法。Objective To evaluate the clinical effect of synthetical interventional therapy for the continuity treatment of avascular necrosis of the femoral head（ANFH）. Methods 130 patients with ANFH diagnosed on the basis of radiographs,CT,MRI and clinical symptom. All cases underwent interventional therapy through catheterizing medial and lateral femoral circumflex arteries, three days later,treated with percutaneous core decompression and the external catheters were set for one week. The changs of arterial numbers,venous return volume and clinical symptom were observed and followed-up with X-ray,DSA and MRI before and after therapy. Results One year after therapy,radiographs showed repair of the femoral head completely in 45 patients and in different degrees in 85 patients. DSA showed that the arterial numbers increased obviously in 107 patients, the arterial numbers increased slightly in 10 patients,without chang in 13 patients,the veinous return volume promoted in 298 patients, without changs in 2 patients. MRI showed the marrow edema of the femoral head disappeared in 118 patients, small dot-like edema signal focus remains in 12 patients. Hip pain and disorders of joint function were eliminated completely in 67 patients,alleviated and improved in different degrees in 63 patients,the improved rate of clinical symptoms was 100%. Conclusion Synthetical interventional therapy is a very effective and safe treatment for ANFH.

关 键 词：骨 股骨头坏死 介入放射学 

分 类 号：R681.8[医药卫生—骨科学] R815[医药卫生—外科学]