髋关节腔、股骨颈髓腔自体骨髓移植药液灌注并中医药治疗在股骨头坏死术后的临床应用(附17例报告)  

The Clinical Application of Autologous Bone Marrow Implantation in Hip Joint and Femur Neck cavity Combined with Focal Reperfusion of Traditional Chinese medicine and Pharmacy for the Treatment of ANFH (with a report of 17 cases)

作　　者：李华峰[1] 李文通[2] 王勇[3] 李华玲 周庶文 陈祖全[1] 

机构地区：[1]甘肃省天水市第二人民医院,甘肃天水741020 [2]四川大学华西医院医院骨科 [3]扬州大学医学院生化教研室 [4]四川成都骨康医院骨科 [5]四川成都同仁医院麻醉科

出　　处：《中国伤残医学》2013年第7期20-22,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：髋关节腔、股骨颈髓腔自体骨髓移植药液灌注并中医药治疗在股骨头坏死术后的临床应用，探索力学刺激的影响。方法：自2005年～2011年采用开放和微创术式治疗股骨头缺血性坏死患者17例（23髋），年龄19～60岁，平均22．4岁，ARCO分期为ⅠA 期3例，ⅡA 期8例，ⅡC 期3例，ⅢA期3例。全部病例均行自体骨髓移植并药液局部灌注在血管束植入、骨移植及微创术后的应用，术后随访1～7年，根据手术前后Harris评分变化，X线影像学表现随访观察。结果：术后患者Harris评分变化均提高35．71分（平均术前56．29分，术后92分），影像学表现17例保持稳定。结论：自体骨髓移植药液局部灌注并中药治疗在股骨头缺血性坏死术后的应用，操作简单，取材方便，无排异反应。术后恢复快，力学刺激对成骨、成软骨、新生血管形成有一定促进作用。Objective：To investigate the clinical effect and mechanical stimulation after applying autologous bone marrow implantation in hip joint and femur neck cavity combined with focal reperfusion of traditional Chinese medicine and pharmacy to treat ANFH .Meth-ods：Seventeen patients （23 hips） with ANFH were treated by open and minimally invasive methods from 2005 to 2011 years.The aver-age age of the patients was 22.4 years ranging from 19 to 60 years.Three cases were of IA of ARCO , eight cases were of ⅡA, three ca-ses were of ⅡC, three cases were of ⅢA.All patients were treated by these methods and followed up for 1-7 years postoperatively . Clinical outcomes were evaluated based on the Harris score and X -ray examination .Results：The mean level of Harris score was in-creased 35.71 after operation （92） compared before operation （56.29）.Radiography of all patients was all keep stable .Conclusion：Treatment of ANFH by autologous bone marrow implantation combined with focal reperfusion of traditional Chinese medicine shows good results and with the advantage to obtain , operability, no immune rejection and recovery quickly , promoting osteogenesis and angigenesis .

关 键 词：自体骨髓细胞 股骨头缺血性坏死 灌注 流体静力压 

分 类 号：R687[医药卫生—骨科学]