超选择血管内介入治疗儿童股骨头骨骺缺血性坏死的疗效分析  

Efficacy of the Superselective Endovascular Intervention Treatment in Ischemic Necrosis of Femoral Head Epiphysis in Children

作　　者：刘新献[1] 黄穗[1] 刘帆[1] 丁竞[1] 姚刚[1] 

机构地区：[1]湖北省武汉市妇女儿童医疗保健中心影像中心,430016

出　　处：《临床放射学杂志》2012年第8期1160-1163,共4页Journal of Clinical Radiology

摘　　要：目的探讨经导管超选择血管内介入治疗儿童股骨头骨骺缺血性坏死的临床疗效及影像学评价。方法对我院2010年9月至2011年4月收治的30例股骨头骨骺缺血性坏死患儿,采用Seldinger技术经对侧股动脉穿刺插管超选择行患侧旋股内、外动脉和闭孔动脉造影,分别采用尿激酶4～5千U、低分子右旋糖酐40 ml作局部灌注,再行造影,观察治疗后的影像学变化。21例需行第二次治疗。治疗结束后评定治疗效果,并行股骨头X线平片或CT、MR随访评估疗效。结果 DSA显示治疗后所有患者股骨头区血管计数较治疗前增加,股骨头染色增强;24例患髋疼痛症状明显减轻,跛行明显改善,治疗总有效率80%,无不良反应和并发症发生。影像学检查发现病侧股骨头塌陷变凸、死骨吸收、新骨形成。结论患儿骨质生长处于旺盛期,超选择血管内介入治疗股骨头骨骺缺血性坏死是一种创伤小、安全、并发症少、疗效肯定的方法,关节功能及股骨头形态均得到不同程度的改善。Objective To study the clinical efficacy of superselective endovascular intervention treatment in ischemic necrosis of femoral head epiphysis in children.Methods Thirty children with ischemic necrosis of femoral head epiphysis received superselective endovascular Intervention treatment from September 2010 to April 2011.Super selective digital subtraction angiography（DSA）was performed for medila and lateral circumflex femoral arteries and obtuator arter using Seldinger technology through opposite side of femoral artery catheterization,4-5 thousand units of urokinase,dextran 40ml were injected slowly for perfusion.21 patients need secondary inventional treatment.X-ray,or CT,MR examination were followed for assessing the therapeutic efficacy.Results After interventional therapy,the arteries supplying of femoral head was increased,and the stain of femoral head was enhanced,the pain was released or disappeared in 24 patients.The total effective rate was 80% and no adverse reactions and complications occurred,The imaging revealed femoral head collapse deformation,dead bones adsorption,and new bones formation.Conclusion The superselective endovascular intervention treatment has the advantages of minimal invasion,safety,and more efficacy.The joint function and femoral head shape recovered after treatment.

关 键 词：介入治疗 缺血性坏死 股骨头骨骺 疗效分析 

分 类 号：R726.8[医药卫生—儿科]