体外冲击波治疗股骨头缺血性坏死研究进展  

Progress in the Treatment of Osteonecrosis of the Femoral Head with Extracorporeal Shock Wave

作　　者：刘立华 孙伟[1] LIU Li-hua;SUN Wei(Centre for Osteonecrosis and Joint-preserving ＆ Reconstruction,Department of Orthopedic,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院骨科骨坏死与关节保留重建中心,北京100029

出　　处：《医学与哲学（B）》2018年第9期11-14,共4页Medicine & Philosophy(B)

基　　金：2018年国家自然科学基金面上项目(81871830);2016年国家自然科学基金面上项目(81672236);2013年国家自然科学基金面上项目(81372013);2018年北京市自然科学基金面上项目(7182146);2018年化工大学-中日友好医院联合基金项目(PYBZ1828)

摘　　要：股骨头缺血性坏死,尤其非创伤性股骨头缺血性坏死,主要累及青壮年患者,属于慢性进展致残性疾病。因此,股骨头缺血性坏死的治疗是骨科医生面临的比较棘手的问题。研究发现早期发现、诊断股骨头缺血性坏死,并进行有效的干预,有助于减轻疼痛、改善关节功能,并有可能避免股骨头病变进展、塌陷,从而保留自身关节形态与功能。目前对早/中期股骨头缺血性坏死的最佳治疗方案仍存在较大争议,而体外冲击波治疗(ESWT)源于一种高能机械波,具有多种生物学效应,并被证实有助于缺血性疾病治疗。根据股骨头缺血性坏死发生基本机制,国内外学者利用ESWT的生物力学效应治疗股骨头缺血性坏死并取得了较好的临床效果。相对于传统的治疗方式,ESWT具有非侵入性、刺激强度可调、副作用少等优势,并受到学者们越来越多的关注。本文将对ESWT在股骨头缺血性坏死中作用机制及临床应用做一综述,随着研究的深入,该疗法在治疗股骨头缺血性坏死中将具有更广阔的前景。Osteonecrosis of the femoral head （ONFH）, especially non-traumatic ONFH, is a common and debilitating disease primarily affecting younger, active populations. The treatment of ONFH to preserve the femoral head is a challenging subject. Early diagnosis and intervention prior to collapse of the femoral head are key to a successful outcome, and many conservative treatments and surgical therapies have been proposed in the literature with reliable results. However, there is no consensus on the optimal treatment. Extracorporeal shock wave （ESW） is a special form of mechanical wave, which is also an effective biomechanical stimulation. A great deal of research has approved and demonstrated the role of ESW in the prevention and treatment of ischemic diseases. According to the basic mechanism of ONFH, domestic and foreign scholars have used the biomechanical effect of ESW to treat ONFH and achieved good clinical results. Compared with traditional treatment, ESW has the advantages of non-invasive, intensity modulated and less side-effect, and is favored by more and more scholars. In this paper, the mechanism and clinical application of ESW for ONFH are briefly reviewed.

关 键 词：骨坏死 股骨头坏死 体外冲击波 

分 类 号：R454.3[医药卫生—治疗学] R68[医药卫生—临床医学]