带旋髂深血管蒂髂骨瓣混合脱钙人牙基质材料治疗股骨头坏死的效果  

Effect of iliac bone flap pedicled with deep circumflex iliac artery with decalcified human dental matrix material in the treatment of osteonecrosis of the femeral head

作　　者：张乐明[1] 冯建书[1] 付强[1] 王江泳[1] 

机构地区：[1]河北省石家庄市第三医院创伤骨科,河北石家庄050011

出　　处：《中国医药导报》2017年第21期101-104,共4页China Medical Herald

基　　金：河北省石家庄市科技局项目(16146 2303)

摘　　要：目的探讨带旋髂深血管蒂髂骨瓣混合脱钙人牙基质材料(DTM)治疗股骨头坏死的效果。方法选取2013年9月~2015年10月石家庄市第三医院骨科收治的股骨头坏死患者166例,按随机数字表法分为对照组和研究组,每组各83例。对照组给予带旋髂深血管蒂髂骨瓣植入治疗,研究组给予带旋髂深血管蒂髂骨瓣混合DTM植入治疗,比较两组间髋关节症状及功能评分、血清骨钙素(BGP)、Ⅰ型原胶原N端前肽(PINP)、Ⅰ型原胶原C端肽(CTX-Ⅰ)水平、SF-36生活质量评分。结果与对照组比较,研究组治疗后疼痛视觉模拟评分(VAS)较低,日本骨科学会(JOA)髋关节功能评分、Harris髋关节功能评分较高,血清BGP、PINP、CTX-Ⅰ水平较低,SF-36生活质量评分中生理总分、心理总分较高,差异均有统计学意义(均P<0.05)。结论带旋髂深血管蒂髂骨瓣混合DTM治疗股骨头坏死的临床效果确切,能够降低血清BGP、PINP、CTX-Ⅰ水平,抑制骨吸收,促进骨形成,减轻髋关节疼痛症状,改善髋关节功能,提高患者生活质量。Objective To investigate the effect of iliac bone flap pedicled with deep circumflex iliac artery with decalcified human dental matrix material（DTM） in the treatment of osteonecrosis of the femeral head. Methods From September 2013 to October 2015, 166 patients with osteonecrosis of the femeral head from the Department of Orthopedics, Shijiazhuang the Third Hospital were selected and divided into control group and experiment group, with 83 cases in each group. The control group was treated with implantation of iliac bone flap pedicled with deep circumflex iliac artery, while the experiment group was received implantation of iliac bone flap pedicled with deep circumflex iliac artery with DTM, hip symptoms and functional score, serum osteocalcin（BGP）, type Ⅰ procollagen N propeptide（PINP）,type Ⅰ procollagen C terminal peptide（CTX-Ⅰ） levels, SF-36 quality of life score were compared. Results Compared with the control group, pain visual analogue scale（VAS） score in the experiment group was lower, Japanese Society of Department of orthopedics（JOA） hip function score and Harris hip score in the experiment group were higher after treatment, serum levels of BGP、PINP、CTX-Ⅰ were lower, phyisical component summary scale（PCS） and mental component summary scale（MCS） score in the SF-36 quality of life were higher, with significant difference（P〈0.05）. Conclusion The clinical curative effect of iliac bone flap pedicled with deep circumflex iliac artery with DTM in the treatment of osteonecrosis of the femeral head is exactly, which can reduce the levels of serum BGP, PINP, CTX-Ⅰ and hip pain symptoms, improve the function of hip joint and life quality of the patients.

关 键 词：股骨头坏死 带旋髂深血管蒂髂骨瓣 脱钙人牙基质材料 疗效 

分 类 号：R683[医药卫生—骨科学]