髓芯减压及自体外周血干细胞移植治疗成人早期股骨头坏死的临床观察  

Clinical observation of core decompression and autologous peripheral blood stem cell transplantation for the treatment of early femoral head necrosis

作　　者：乔巨峰[1] 高飞[1] 汤奇[1] 高峰[1] 李铭章[1] 杨海宝[1] 

机构地区：[1]中山大学附属东华医院骨一科,广东东莞523110

出　　处：《中国骨与关节外科》2010年第6期458-461,共4页Chinese Journal of Bone and Joint Surgery

基　　金：东莞科技计划项目(200672)

摘　　要：目的探讨联合应用髓芯减压、人工可诱导骨基质及自体外周血干细胞移植治疗股骨头缺血性坏死的疗效。方法 2006年1月至2008年7月联合应用髓芯减压、人工可诱导骨基质及自体外周血干细胞移植治疗12例(16髋)早期股骨头坏死患者,男9例,女3例;年龄32～55岁,平均45岁。左侧10例,右侧6例,其中双侧4例。Ficat分期:Ⅰ期5髋,Ⅱ期8髋,Ⅲ期3髋。术前疼痛评分平均为(17.44±5.60)分,Harris髋关节评分平均为(64.2±6.8)分,患者MRI低信号区所占股骨头体积的百分比术前为(39.50±7.33)%。术后及随访期间进行疼痛评分和Harris髋关节评分,对X线片、CT及MR检查结果进行评估。结果全部获得随访,随访时间12～16个月,Harris髋关节术后评分明显升高至平均(90.2±4.6)分。患者疼痛症状显著改善,髋关节屈伸和内外旋转功能明显恢复,MR示术后股骨头坏死区域比术前明显缩小,与术前比较差异有统计学意义(P<0.01)。患者满意度评价:优6髋,良8髋,可1髋,差1髋,优良率为87%。结论联合应用髋关节髓芯减压、人工可诱导骨基质及自体外周血干细胞移植治疗早期股骨头坏死,可显著减轻关节疼痛,明显恢复关节功能,延缓病情发展,具有较好的临床疗效。Objective To investigate the effects of core decompression,artificial bone and matrix induced autologous peripheral blood stem cell transplantation for treatment of avascular necrosis.Methods 12 cases with femoral head necrosis were treated with core decompression,artificial bone and matrix induced autologous peripheral blood stem cell transplantation. Results All patients were followed up 12 to 16 months,The postoperative Harris hip score was significantly improved to an averaac of average（90.2±4.6）.The pain and the range of motion also improved.The outline of the femoral head was clear according to CT or MRI,and the cystic changes disappeared,the bone mineral density improved. There was significant difference compared with the preoperative（P0.01 ）.Evaluated as excellent in hips,good in 8 hips,fair in 1 hips,and good-to-excellent rale was 87%.Conclusion One decompression,artificial bone and matrix induced autologous peripheral blood stem cell transplantation is a reliable method for treatment of early femoral head necrosis.

关 键 词：股骨头坏死 自体外周血干细胞移植 髓芯减压 

分 类 号：R687.3[医药卫生—骨科学]