钽棒置入联合外周血干细胞介入治疗早期股骨头坏死  

Tantalum rod implantation with peripheral blood stem cell intervention for early-stage femoral head osteonecrosis

作　　者：刘福存[1] 单乐天[2] 储小兵[1] 厉驹[1] 邹建琴[1] 童培建[1] 肖鲁伟[2] 

机构地区：[1]浙江中医药大学第一临床医学院骨伤科,浙江杭州310006 [2]浙江中医药大学骨伤研究所

出　　处：《中国骨与关节损伤杂志》2016年第4期353-355,共3页Chinese Journal of Bone and Joint Injury

基　　金：中国博士后科学基金面上项目(2014M561793);中国博士后科学基金特别资助(2015T80637);浙江省重点科技创新团队自主项目(2011R50022-02);浙江省中医药科技计划项目(2013ZQ007);2013国家自然科学基金青年项目(81302989)

摘　　要：目的评估钽棒置入联合外周血干细胞介入治疗早期股骨头坏死（ON）的临床疗效。方法笔者自2009-01—2011-08采用钽棒置入治疗28例（43髋）ON,并于钽棒置入1-2周后进行了外周血干细胞介入,部分患者4-6周后接受第2次细胞疗法。结果 27例（42髋）获得平均48（36-60）个月随访,1例（1髋）失访,无一例死亡。术后36个月时股骨头的生存率为91.7%,HHS评分从术前的（56.3±12.8）分改善为术后的（90.5±19.3）分,差异有统计学意义（t=9.224,P〈0.001）。39髋HHS评分优26髋,良10髋,可3髋,优良率92.3%。第2次介入发现股骨头内血管数目增多,血管变粗。术后1例发生大粗隆部位的滑囊炎,未发生其他术后并发症。结论钽棒置入联合外周血干细胞介入治疗早期股骨头坏死可以有效缓解疼痛,改善髋关节功能、避免或者延迟关节置换手术,应用前景广阔。Objective To evaluate the clinical efficacy of tantalum rod implantation with peripheral blood stem cell intervention for early-stage femoral head osteonecrosis. Methods Between January 2009 and August 2011, 43 hips with consecutive tantalum rod implantations were performed in combination with stem cell interventional therapy administered 1-2weeks postoperatively. Some patients received a second stem cell intervention approximately 4-6 weeks later. Results Twenty seven patients（42 hips） got a mean 48（36-60）months follow-up. One（1 hip） was lost to follow-up, no patients died. The overall survivorship of the combined technique was 91.7% at 36 months. The mean HHS significantly increased from（56.3±12.8） preoperatively to（90.5±19.3） postoperatively（t =9.224, P〈0.001）. Twenty six from 39 hips achieved excellent HHS scores, 10 good, 3 fair. 92.3% obtained a good or excellent HHS scores. The second DSA revealed significant thickening of the interventional blood vessels, increases in the number of vascular branches. One patient experienced bursitis in the greater trochanter, no other postoperative complications were observed. Conclusion The combination of tantalum rod implantation and peripheral blood stem cell interventional therapy can effectively allay pain, improve hip joint function, and enable avoidance or delay of hip arthroplasty in patients with early osteonecrosis of the femoral head.

关 键 词：早期股骨头坏死 钽棒 干细胞 介入治疗 生存率 

分 类 号：R683.42[医药卫生—骨科学]