不同类型股骨头坏死保头治疗效果的对比研究  

A Comparative Study on the Therapeutic Effect of Different Types of Femoral Head Necrosis

作　　者：阎亮[1] 王上增[1] 孙永强[1] 翟沛[1] 

机构地区：[1]河南省中医院,郑州450002

出　　处：《中国中医骨伤科杂志》2016年第6期13-15,20,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的：观察采用钻孔减压自体松质骨打压植骨异体腓骨支撑术分别治疗激素型和酒精型股骨头坏死的临床疗效。方法：对2008年9月至2013年7月采用钻孔减压自体松质骨打压植骨异体腓骨支撑术治疗的激素型、酒精型早期（ARCOⅠ、Ⅱ期）股骨头坏死的患者进行回顾性分析。其中,激素型股骨头坏死53例（62髋）：男27例（30髋）,女26例（32髋）;年龄21～33岁,平均26.5岁;病史3～6个月,平均4.2个月。酒精型股骨头坏死61例（70髋）：均为男性;年龄29～35岁,平均32.7岁;病史2～6个月,平均4.8个月。从术前、术后2年X线片的股骨头坏死是否出现塌陷和髋关节Harris评分对疗效进行评价。结果：所有患者均得到随访,激素组优良率87.1%,酒精组优良率98.5%,两者之间差异有统计学意义（P〈0.05）;两组患者术前Harris评分差异无统计学意义（P〉0.05）,两组术后均较术前有显著提高（P〈0.05）,术后2年激素组（88.71±3.17）分,酒精组（92.54±3.21）分,两者患者之间差异有统计学意义（P〈0.05）。结论：由于激素型与酒精型股骨头坏死在发病机制、股骨头内修复的方式不同,导致激素型股骨头坏死保头治疗效果要差于酒精型股骨头坏死。Objective：To observe the clinical effect of core decompression with compacted autograft combining nonvascularized allo-fibular-graft in the treatment of alcoholic and steroid-induced femoral head necrosis.Methods：From September2008 to July 2013,a retrospective analysis was performed on the patients with alcoholic（ARCO I and II）and steroid-induced femoral head necrosis treated by core decompression with compacted autograft combining nonvascularized allo-fibular-graft.There were 53cases（62hips）of the steroid-induced type,including 27males（30hips）and 26females（32hips）,aged between 21 and 33,with an average age of 26.5years.The medical history was 3~6months,average 4.2months.There were 61patients（70hips）of the alcoholic type,all of which were male,aged between 29 and 35,with an average age of 32.7years.The medical history was 2~6months,average 4.8months.According to the Harris score of the hip joint,the collapse of the femoral head in the X-ray film before and 2years after the operation,the efficacy of the patients was evaluated.Results：All patients were followed up.The excellent and good rate was 87.1%in the steroid-induced group and98.5%in alcohol group,with a significant difference between the two groups（P〈0.05）.There was no significant difference in Harris scores between the two groups（P〉0.05）.The postoperative Harris scores of the two groups were significantly improved（P〈0.05）.After 2years,the steroid-induced group was（88.71＋3.17）points and the alcohol group was（92.54＋3.21）points,with significant difference between the two groups（P〈0.05）.Conclusion：Due to the different mechanisms and repair methods of steroid induced and the alcohol femoral head necrosis,the treatment effect of steroid induced necrosis of the femoral head is worse than that of the alcohol type.

关 键 词：激素型股骨头坏死 酒精型股骨头坏死 保头治疗 

分 类 号：R681.8[医药卫生—骨科学]