多孔钽棒植入联合外周血干细胞移植治疗早期股骨头坏死的临床效果观察  

Clinical observations of efficacy of porous tantalum rod implantation and autologous peripheral blood stem cell transplantation for the treatment of early femoral head necrosis

作　　者：宋建治[1] 肖少雄[1] 徐礼森[1] 

机构地区：[1]湖北省武汉市第一医院骨科,430022

出　　处：《中国综合临床》2013年第7期757-759,共3页Clinical Medicine of China

摘　　要：目的探讨联合应用多孔钽棒植入与自体外周血干细胞移植治疗股骨头缺血性坏死（ANFH）的效果。方法2009年7月至2011年3月联合应用多孔钽棒植入与自体外周血干细胞移植治疗36例（36髋）早期ANFH患者，左侧19例，右侧17例。按照国际骨循环研究会（ARCO）分类标准的ANFH病变I、Ⅱ期患者36例（36髋）。临床评价术前与术后疼痛评分、Harris髓关节评分及患者MRI低信号区所占股骨头体积的百分比。结果全部获得随访，随访12—15个月，Harris髓关节评分术后为（91．70±6．90）分，与术前（68．32±7．10）分比较，Harris髓关节术后评分明显升高，差异有统计学意义（t=4．364，P〈0．01），患者疼痛症状显著改善[术前疼痛评分为（15．55±6．60）分，术后为（29．78±5．67）分；t=3．423，P〈0．05]，髋关节屈伸和内外旋转功能明显恢复。MRI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[（38．20±8．30）％与（21．43±5．10）％；t=6．527，P〈0．05]。结论联合应用多孔钽棒植入与自体外周血干细胞移植治疗ANFH，可显著减轻关节疼痛，明显恢复关节功能，可有效防止股骨头塌陷，延缓病情发展，具有较好的临床效果。Objective To investigate the effects of Porous tantalum rod implantation and autologous peripheral blood stem cell transplantation on the treatment of avascular necrosis of femoral head （ANFH）. Methods Thirty-six cases with early ANFH （19 cases on the left side and 17 cases on the right side） treated by Porous tantalum rod implantation and matrix induced autologous peripheral blood stem cell trans-plantation from July 2009 to March 2011. The 36 cases had osteonecrosis of the femoral head（ONFH） lesions I and H according to the international bone circulation Research Association （ARCO） classification of ONFH lesion. All patients were followed up for 12 - 15 months. Clinical evaluation included preoperative and postoperative pain score, the Harris hip score, percentage of low signal MRI area in the volume of femoral head. Results All the patients were followed up for 12 to 15 months. The postoperative Harris hip score was significantly higher than pre-operation （ （91.70 ± 6. 90） vs. （ 68. 32 ± 7.10 ） ; t = 4. 364, P 〈0. 01 ）. Pain symptoms reduced markedly （ （ 15.55± 6.60） vs. （ 29. 78 ± 5.67 ） ; t = 3.423, P 〈 0. 05 ）. Hip flexion and external rotation function was restored. MRI showed that after the operations the volume of areas with femoral head necrosis significantly reduced in compared with the pre-operation （ （38. 20 ± 8.30） % vs. （21.43 ± 5.10） % ; t = 6. 527, P 〈 0. 05 ）. Conclusion Porous tantalum rod implantation and autologous peripheral blood stem cell transplantation can significantly reduce joint pain, dramatically restore joint function, effectively prevent collapse of the femoral head, retard progression and has good clinical efficacy in the treatment of early femoral head necrosis.

关 键 词：股骨头坏死 自体外周血干细胞移植 多孔钽棒植入 

分 类 号：R687.3[医药卫生—骨科学]