髓芯减压并钽金属棒植入、髓芯减压并植骨术在股骨头坏死保头治疗中的短期疗效比较  

Short-term efficacy comparison of core decompression and tantalum metal rod implantation,core decompression and bone grafting in the treatment of avascular necrosis of femoral head

作　　者：强廷会[1] 周新立[1] 牟欢[1] 郭忠尚 Qiang Tinghui;Zhou Xinli;Mou Huan;Guo Zhongshang(Department of Bone and Joint Surgery,Hanzhong Central Hospital,Hanzhong 723100,China)

机构地区：[1]陕西省汉中市中心医院骨关节外科一病区,汉中723100

出　　处：《广西医科大学学报》2018年第4期513-517,共5页Journal of Guangxi Medical University

摘　　要：目的:比较髓芯减压并钽金属棒植入、髓芯减压并植骨术在股骨头坏死(ANFH)保头治疗中的短期疗效。方法:将2011年4月至2015年12月本院收治的88例ANFH患者随机分为观察组和对照组,每组44例,观察组实施髓芯减压并钽金属棒植入,对照组实施髓芯减压并植骨术。比较两组治疗有效率、手术时间、术中出血量、住院时间;记录定量参数容量转移常数(K^(trans))、速率常数(K_(ep))、血管外细胞外间隙容积比(V_e)的变化情况;采用Harris量表、疼痛视觉模拟评分(VAS)、健康调查简表(SF-36)评价髋关节功能、疼痛度及生活质量,测定其血清Ⅰ型前胶原氨基端前肽(PⅠNP)、Ⅰ型胶原C端肽(CTX)、骨钙素(OST);观察术后并发症。结果:观察组治疗有效率明显高于对照组(P<0.05);观察组手术时间、住院时间短于对照组,术中出血量少于对照组(P<0.05);观察组术后K^(trans)、K_(ep)高于对照组(P<0.05),两组Ve比较差异无统计学意义(P>0.05);观察组术后Harris评分、SF-36评分明显高于对照组,VAS评分及血清PⅠNP、CTX、OST低于对照组(P<0.05);两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:在ANFH保头治疗中髓芯减压并钽金属棒植入短期疗效较髓芯减压并植骨术好,能明显改善患者髋关节功能、定量参数、疼痛度及生活质量,降低血清PⅠNP、CTX、OST水平,且无明显并发症,值得临床推广。Objective:To compare the short-term efficacy of core decompression and tantalum metal rod implantation,core decompression and bone grafting in the treatment of avascular necrosis of the femoral head(ANFH).Methods:88 cases of ANFH patients admitted to our hospital from April 2011 to December 2015 were randomly divided into an observation group and a control group,with 44 cases in each group.The patients in the observation group were given the core decompression and tantalum metal rod implantation,and those in the control group were treated with core decompression and bone grafting.The effective rate,operative time,intraoperative blood loss and the hospital stay were recorded.The quantitative parameters including the volume transfer constant(K trans),rate constant(K ep)and extracellular extracellular space volume ratio(V e)were analyzed.The hip function,pain and quality of life were evaluated by Harris scale,pain visual analogue scale(VAS),health questionnaire(SF-36),and the levels of serum type I procollagen amino terminal propeptide(PINP),type collagen C-terminal peptide(CTX),osteocalcin(OST)were measured.The postoperative complications were observed.Results:The treatment effective rate of the observation group was higher than that of the control group(P<0.05).The operative time and the hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss volume was lower than that in the control group(P<0.05).The expression of K trans and K ep in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in the V e between the two groups(P>0.05).The scores of Harris and SF-36 in the observation group were significantly higher than those in the control group(P<0.05),and the VAS score,serum PINP,CTX,and OST levels were lower than those in the control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Core decompress

关 键 词：股骨头坏死 保头治疗 髓芯减压 植骨 钽棒植入 

分 类 号：R687.3[医药卫生—骨科学]