髓芯减压骨髓细胞移植治疗股骨头缺血坏死术前术后DSA评价  

Evaluate of digital subtraction arteriography （DSA） before and after operations.in patients with necrosis of femoralhead（NFH） by Decompression and Reconstituted Autologous Bone Marrow Cells Transplantation combined with vascularized bone flap methods

作　　者：邓兴杰 徐振文 钟惠茹 

机构地区：[1]广东惠州中心医院放射科,516001 [2]广东惠州中医中医院骨科,516001 [3]广东惠州中心医院病案室,516001

出　　处：《内蒙古中医药》2010年第12期104-105,共2页Inner Mongolia Journal of Traditional Chinese Medicine

摘　　要：目的：研究髓芯减压自体骨髓细胞移植联合3种带血管蒂骨瓣方法治疗股骨头缺血性坏死的疗效和术前术后数字减影动脉造影术（DSA）评价.方法：60例股骨头缺血性坏死患者均实行髓芯减压自体骨髓细胞移植,按血管蒂的骨瓣移植手术方法分为3组：带血管蒂髂骨瓣移植术（A组）20例,25髋;带血管蒂大转子骨瓣移植术髂骨瓣移植术（B组）20例,23髋和吻合血管的腓骨瓣移植术（C组）20例,22髋,了解其术前股骨头血供情况,评价术后疗效.结果：3组Harris评分术后均高于术前（t=2.292,t=2.212,t=2.273,P均〈0.05）;3组总有效率比较无显著性差异（χ^2=1.945,χ^2=1.815,7 χ^2=1.835,P均〉0.05）;手术后DSA造影显示：全部病例随手术方式不同DSA表现出现髋部血管发生解剖性改变.结论：股骨头坏死术前DSA造影可准确判断病侧股骨头动脉供血情况,手术后DSA造影对判断疗效具有重要价值.Objectlve To study the curetive effect of Decompression and Reconstituted Autologous Bone Marrow Cells Transplantation combined with vascularized bone flap and evaluate through digital subtraction arteriography （DSA） before and after operations.performed on the patients with necrosis of femoralhead （NFH）.Methods 60 eases with isehemie Necrosis of Femoral Head implementation Decompression and Reconstituted Autologous Bone Marrow Cells Transplantation according vascularized bone flap grafting defferent were divided into three groups： Vascularized with iliac bone graft （A group） 20 cases,25 hips; Vascularized with greater trechanter bone graft flap（B group）20 eases,23 hips; Vascularized with fibula flap graft（C group）20 cases,22 hips. To comprehend the preoperative blood supply for femoral head and evaluate the postoperative curative effects, by digital subtraction arteriography （DSA）.Resuhs Harris score in 3 group were higher than those before surgery （t=2.292, t=2.212,t=2.273,P all〉 0.05）;The total effective rate in 3 group were no significant differenee（χ^2=1.945,χ^2=1.815,χ^2=1.835,P are〉0.05）;DSA manifestations of hip had anatomical changesin in all patients with surgery Conclusion The DSA before operation could exactly show exacthlood supply for the necrotic femoralhead,The DSA after operation plays an important role in judgement of curative effect.

关 键 词：股骨头缺血坏死 自体骨髓细胞 髓芯减压 带血管蒂骨移植 数字减影动脉造影术(DSA) 

分 类 号：R681.8[医药卫生—骨科学]