带股方肌蒂骨瓣移位治疗成人股骨头缺血性坏死的疗效及安全性分析  

Effect and safety analysis of treatment of ischemic necrosis of femoral head in adult patients treated with transplantation of bone flap pedicled with femoral muscle pedicle

作　　者：张健[1] 殷富裕[1] 彭吾训[1] 

机构地区：[1]贵州医科大学附属医院急诊骨科,贵阳550004

出　　处：《中国临床解剖学杂志》2017年第2期228-231,共4页Chinese Journal of Clinical Anatomy

基　　金：贵州省卫生计生委科学技术基金项目(gzwjkj2016-1-001)

摘　　要：目的研究分析带股方肌蒂骨瓣移位治疗成人股骨头缺血性坏死的疗效及安全性。方法选取2013年1月-2016年1月于我院接受带股方肌蒂骨瓣移植手术的患者96例作为研究对象,参照世界骨循环研究学会分期标准将患者分为Ⅰ期、Ⅱ期、Ⅲ期3个分期,并分别研究对比3个分期疗效及安全性情况。结果 3个不同分期的患者治疗后Harris评分均要显著高于治疗前,差异有统计学意义(P<0.05)。随着年龄的增长,愈合速度呈明显的延长趋势,差异有统计学意义(P<0.05)。随着患者临床分期的加深,患者治疗的优良率呈明显的下降趋势,差异有统计学意义(P<0.05)。观察不同分期患者并发症情况,结果无明显差异,证明带股方肌蒂骨瓣移植较为安全有效,差异有统计学意义(P<0.05)。结论带股方肌蒂骨瓣移位治疗股骨头缺血性坏死具有十分显著的疗效,患者恢复时间较快,是一种值得肯定的手术方法。Objective To explore the curative effect and safety of the transplantation of the bone flap carrying the quadratusfemoris in the treatment of ischemic necrosis of femoral head in adults. Methods From January 2013 to January 2016 in our hospital, 96 patients undergoing transplantation of the bone flap carrying quadratusfemoris was enrolled as the research object. The necrosis of the patients was divided into phase I, II and III in three stages, respectively, according to the international bone association research circulation staging criteria. The efficacy of the flap onthe necrosis of various stages three stages and safety of the situation was evaluated. Results Three patients with different stages of Harris score after treatment was significantly higher than that before treatment, the difference was statistically significant（P〈0.05）; with the increase of age, the healing rate showed significantly increasing trend, and the difference was statistically significant（P〈0.05）; in patients with senior clinical stage, the excellent and good rate of patients showed significantly decreased trend and the difference was statistically significant（P〈0.05）; observation of complications in patients with different stages showed that there was no difference concerning the incidence of the complication after flap transfer, proving the efficacy of this therapeutic approach（P〈0.05）.Conclusion Transplantation of the bone flap carrying the femoral muscle for treatment of avascular necrosis of the femoral head has a very significant effect, and the recovery time of the patients is relatively fast.

关 键 词：带股方肌蒂 移植 股骨头坏死 

分 类 号：R687[医药卫生—骨科学]