钽棒置入治疗早期股骨头坏死近期疗效分析  

Short-term curative effects of Tantalum rod treatment in early avascular necrosis

作　　者：叶福生[1] 倪哲吉[1] 储小兵[2] 何帮剑[3] 厉驹[2] 童培建[2] 

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]浙江中医药大学附属第一医院,浙江杭州310006 [3]浙江中医药大学附属第三医院,浙江杭州310006

出　　处：《中国骨伤》2013年第8期646-650,共5页China Journal of Orthopaedics and Traumatology

基　　金：浙江省自然科学基金资助重大和重点项目(编号:Z303656);高等学校博士学科点专项科研基金(编号:20060344003);浙江省中管局资助项目(编号:2007GA021);浙江省中管局重点项目(编号:2011ZZ005)~~

摘　　要：目的:探讨钽棒置入治疗早期股骨头坏死的近期临床疗效。方法:回顾分析2008年1月至2008年11月接受钽棒置入术治疗且随访资料完整的早期股骨头坏死患者25例(39髋),男9例(11髋),女16例(28髋);年龄18～54岁,平均37岁。酒精性4例(6髋),激素性6例(8髋),创伤性2例(2髋),特发性13例(23髋)。Steinberg术前分期:Ⅰ期7髋,Ⅱ期24髋,Ⅲ期8髋。疗效分析包括术前、术后Harris评分,影像学变化及以接受髋关节置换术为随访终点的股骨头生存率。结果:25例患者术后获得随访,时间6～47个月,平均37.4个月。12髋影像学出现进展,包括钽棒退出1髋,股骨头塌陷3髋,股骨头坏死面积增加8髋。6髋行全髋关节置换术,包括有影像学进展5髋占41.7%(5/12),无影像学进展1髋3.7%(1/27)。所有髋关节Kaplan-Meier生存曲线显示钽棒置入后6个月生存率为(97.4±2.5)%,1年生存率为(94.7±3.6)%,2年生存率为(88.6±5.4)%,3年生存率为(72.5±11.2)%。结论:钽棒治疗SteinbergⅠ、Ⅱ期股骨头坏死近期疗效确切,能有效延缓股骨头置换时间。Objective：To explore the recent clinical curative effect of Tantalum rod in treating the early avascular necro- sis. Methods：From January 2008 to November 2008,the 25 patients （39 hips） with early avascular necrosis accepted tanta- lum rod placement and included 9 males （11 hips） and 16 females （28 hips） with an average age of 37 years old ranging from 18 to 74 years old. Four patients （6 hips） caused by Alcoholic,6 patients （8 hips） by hormone,2 cases （2 hips） by traumatic, 13 cases （23 hips） by idiopathic. Steinberg preoperative stage involved 7 hips in period I,24 hips in period II,8 hips in period III. Curative effect analysis included preoperative and postoperative Harris score ,radiographic changes and hip replacement for follow up to accept the end of the femoral head survival rate. Results：All patients were followed up for 6 to 47 months （aver- aged 37.4 months）. All 12 hips imaging appeard progress,including tantalum rod exit in 1 hip,hip hemiarthroplasty collapse in 3 hips,the area increased to avascular necrosis in 8 hips. Six hips accepted total hip replacement ,including imaging progress in 5 hips （41.7%,5 / 12）,no imaging progress in 1 hip （3.7%,1 / 27）. All hips＇ Kaplan-Meier survival curves showed 6 month survival rate was（97.4±2.5）% after tantalum stick insertion,1 year survival rate was （94.7±3.6）,and 2 year survival rate was （88.6±5.4）%,3 year survival rate was （72.5±11.2）. Conclusion：It is effective for treatment of avascular necrosis of femoral head in Steinberg I and II by Tantalum rod,and it can effectively relieve femoral head replacement time.

关 键 词：股骨头坏死 骨折固定术 内 存活率 

分 类 号：R274.918[医药卫生—中西医结合]