髓芯减压联合自体骨髓干细胞移植治疗早中期股骨头坏死近期疗效  

Early Clinical Result of Core Decompression Combined with Implantation of Autologous Bone Marrow Stem Cells(BMSCs) for Treatment of Moderate and Advanced Osteonecrosis of the Femoral Head(ONFH)

作　　者：李鑫[1] 刘谟震[1] 汤欣[1] 吕德成[1] 

机构地区：[1]大连医科大学附属第一医院骨科,辽宁省大连市116023

出　　处：《中国骨与关节损伤杂志》2011年第10期887-889,共3页Chinese Journal of Bone and Joint Injury

基　　金：辽宁省自然科学基金资助项目(20092167);辽宁省教育厅高等学校科研项目计划(2009A197)

摘　　要：目的观察髓芯减压联合自体骨髓干细胞移植治疗早中期股骨头坏死的临床疗效。方法笔者自2004年1月～2008年11月选取符合国际骨循环研究会(ARCO)骨坏死分期标准共41例(55髋),经过自体骨髓干细胞采集、分离、髓芯减压及干细胞移植。随访观察患髋疼痛缓解程度,手术前后Harris评分及影像学进展情况。结果 35例(47髋)获得2年以上随访。髋关节Harris评分由术前(56.73±8.41)分升至(82.49±6.20)分,差异有统计学意义(P<0.05)。髋关节影像学检查:术后X线片显示患髋坏死面积减小,密度均匀;MRI测得坏死面积百分比,由术前的(33.58±6.89)%降至术后的(12.36±5.09)%,差异有统计学意义(P<0.05)。结论髓芯减压联合自体骨髓干细胞移植治疗早中期股骨头坏死近期疗效肯定,远期疗效有待进一步观察。Objective To discuss the early clinical result of the treatment in moderate and advanced ONFH by core decompression combined with implantation of autologous BMSCs. Methods Forty one cases （55 hips） were treated by core decompression combined with implantation of autologous BMSCs from January 2004 to November 2008. All patients were up to Association Research Circulation Osseous （ARCO） stage. Core decompression combined with implantation of autologous BMSCs after the collection and centrifugation of autologous BMSCs. Clinical evaluation included the pain relief, Harris hip score and the change of radiographs. Results Thirty five eases （47 hips） were followed up for an average of 2.2 years. The Harris scores of patients after operation increased significandy （82.49±6.20） compared with that before operation （56.73±8.41, P 〈0.05）. After operation, the X-ray showed necrotic area diminished and the density became uniform. The average percentage of necrotic area diminished significantly from （12.36±5.09）% （after operation） to （33.58±6.89）% （before operation, P 〈0.05）. Conclusion Core decompression combined with implantation of autologous BMSCs is an effective method to treat moderate and advanced ONFH, but long-term effect need to be observed further.

关 键 词：股骨头坏死 减压术 细胞移植 

分 类 号：R331.22[医药卫生—人体生理学]