经导管动脉灌注术治疗ARCOⅢA期股骨头缺血性坏死中远期疗效评价  

Evaluation of the effect on transcatheter arterial infusion of ARCOⅢA avascular necrosis of the femoral head: middlelong term follow-up results

作　　者：林俊东 徐建成[1] 刘洋[1] 

机构地区：[1]福建省漳州市中医院放射科,福建漳州363000

出　　处：《医学影像学杂志》2016年第10期1906-1910,共5页Journal of Medical Imaging

基　　金：福建省漳州市自然科学基金项目(编号ZZ2013J36)

摘　　要：目的评价经导管动脉灌注术治疗ARCOⅢA期股骨头缺血性坏死的中远期疗效。方法 TAI组和对照组分别32髋和36髋,前者使用微导管"嵌入"靶血管灌注治疗,后者除了止痛药外未使用其他医疗措施,随访6~60月,回顾性分析患者的临床资料。结果 TAI组在随访的6月、12月、36月、60月中分别有0髋、2髋(6.2%)、9髋(28.1%)、12髋(37.5%)因无效行髋关节置换术,其他20髋临床症状改善,股骨头坏死区病灶稳定,见增生、硬化及囊变缩小。对照组在随访的6月、12月、36月、60月中分别有1髋(2.8%)、3髋(8.3%)、26髋(72.2%)、36髋(100%)因无效行髋关节置换术。结论 TAI治疗ARCOⅢA期股骨头缺血性坏死微创、安全、有效,有助于保留股骨头,延缓关节置换时间或最终避免假体置换,值得临床推广。Objective To evaluate the middle-long term effects on transcatheter arterial infusion （TAI） of ARCO ⅢA avascular necrosis of the femoral head （ANFH）. Methods There were 32 hips for TAI group and 36 hips for control group respectively. The former used microcatheter to ＂embed＂ the vessel of ANFH, none of medical treatment was used in the later except taking the painkiller only when they needed it. All the patients were followed-up for 6 to 60 months. The clinical data were retrospectively analyzed. Results For TAI group, in the followed-up of 6 months, 12 months, 36 months and 60 months, there were 0 hip, 2 hips （6.2%）, 9 hips （28.1%）, 12hips （37.5%） uneffective and treated with total hip arthroplasty. The clinical symptoms had improved in other 20 hips, and the necrotic area of femoral head showed hyperplasia, sclerosis, and reduction of cystic changes. In the control group,there were 1 hip （2.8%）, 3 hip^（8.3% ）, 26 hips （72.2%）, 36 hips （ 100% ） with uneffective treament with total hip arthroplasty in followed-up for 6 months, 12 months, 36 months and 60 months. Conclusion For the treatment of ARCOⅢA ANFH, TAI is mini-invasive, safe and reliable, which helps to retain the femoral head, delay or avoid hip replacement. It is worthy popularizing this technique in clinical practice.

关 键 词：介入放射学 动脉 插管 股骨头缺血性坏死 

分 类 号：R815[医药卫生—放射医学] R681.8[医药卫生—临床医学]