髓芯减压联合干细胞移植与钽棒植入术治疗Ⅱ期非创伤性股骨头坏死的临床研究  

Comparison of core decompression with stem cell transplantation and tantalum rod implanting in treating stage Ⅱnon traumatic osteonecrosis of femoral head

作　　者：何帮剑[1] 厉驹[2] 吕一[1] 童培建[2] 

机构地区：[1]浙江中医药大学附属第三医院骨伤科,浙江杭州310005 [2]浙江中医药大学附属第一医院骨伤科,浙江杭州310006

出　　处：《中国骨伤》2016年第12期1119-1124,共6页China Journal of Orthopaedics and Traumatology

基　　金：浙江省中医药重点学科(中医老年骨伤学)建设项目资助(编号:2012-xk-A17);浙江省中管局资助项目(编号:2007GA021)~~

摘　　要：目的 ：比较髓芯减压联合干细胞移植与钽棒植入术治疗ARCOⅡ期非创伤性股骨头坏死的临床疗效。方法：自2012年3月至2012年9月,收集ARCOⅡ期的非创伤性股骨头坏死患者45例55髋,按照数字表法分为髓芯减压联合干细胞移植组（A组）和钽棒植入组（B组）。A组23例28髋,其中男12例,女11例;年龄23~51岁,平均（36.87±9.52）岁;病程2~28个月,平均（17.13±7.74）个月;术前Harris髋关节评分35~70分,平均（54.74±11.81）分;采用髓芯减压联合干细胞移植治疗。B组22例27髋,其中男11例,女11例;年龄26~46岁,平均（35.59±7.39）岁;病程3~26个月,平均（16.00±7.46）个月;术前Harris髋关节评分35~76分,平均（57.18±12.95）分,采用钽棒植入术治疗。观察并比较两组患者的手术时间、术中出血量、平均住院日、平均住院费用,术后采用Harris髋关节评分进行疗效评定。结果：术后45例患者获得随访,时间6~12个月,平均10.8个月。两组患者平均住院费比较差异有统计学意义（P〈0.05）;两组患者手术时间、术中出血量、住院日比较差异均无统计学意义（P〉0.05）;末次随访时A组Harris评分83.04±8.97,其中优6例,良14例,可2例,差1例;B组Harris评分84.41±9.94,其中优9例,良9例,可3例,差1例;两组比较差异均无统计学意义（P〉0.05）。结论：髓芯减压联合干细胞移植与钽棒植入术均能改善髋关节功能,髓芯减压结合干细胞移植方法费用少,具有较高的效价比,更适用于ARCOⅡ期非创伤性股骨头坏死治疗。Objective：To compare clinical effects of core decompression with stem cell transplantation and tantalum rod implanting in treating stage Ⅱnon traumatic osteonecrosis of femoral head. Methods：From March 2012 to September 2012,45patients（55 hips）with stage ARCO Ⅱnon traumatic osteonecrosis of femoral head were treated and divided into core decompression with stem cell transplantation group（group A） and tantalum rod implanting group（group B） according to number table. In group A,there were 23 cases（28 hips）,including 12 males and 11 females aged from 23 to 51 years old with an average of（36.87±9.52） years,the courses of disease ranged from 2 to 28 months with an average of（17.13±7.74） months,preoperative Harris score was for 35 to 70 with an average of（54.74±11.81）,treated with core decompression with stem cell transplantation. In group B,there were 22 cases（27 hips）,including 11 males and 11 females aged from 26 to 46 years old with an average of（35.59±7.39） years,the courses of disease ranged from 3 to 26 months with an average of（16.00±7.46） months,preoperative Harris score was for 35 to 76 with an average of（57.18±12.95）,treated with core tantalum rod implanting. Operative time,blood loss,hospital stays,hospitalization expenses were observed and compared after treatment between two groups,the clinical effects were evaluated according to Harris criteria. Results：All patients were followed up from 6 to 12 months with an average of 10.8 months. There were significant difference in hospitalization expenses between two groups（P〉0.05）,while there was no significant statistical difference in blood loss and hospital stay（P〉0.05）. At the final following up,Harris score in group A was（83.04±8.97）,6 cases obtained excellent results,14 good,2 good and 1 poor;while Harris score in group A was（84.41±9.94）,and 9 cases obtained excellent results,9 good,3 good and 1 poor; there was no statistical meaning differencesbetween two groups（P 0.05）. C

关 键 词：股骨头坏死 减压术 外科 干细胞移植 病例对照研究 ARCO分期 

分 类 号：R681.8[医药卫生—骨科学]