髋关节镜联合多次小直径钻孔减压与单独钻孔减压治疗股骨头早期缺血性坏死的效果比较  

Comparison of hip arthroscopy combined with multiple small diameter drilling decompression and single hole decompression for early ischemic necrosis of femoral head

作　　者：杨晋[1] 杨继滨 杨礼丹 余浩[1] YANG Jin;YANG Jibin;YANG Lidan;YU Hao(Department of Orthopedics,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China)

机构地区：[1]遵义医学院附属医院骨科

出　　处：《实用医学杂志》2019年第12期1957-1960,共4页The Journal of Practical Medicine

基　　金：遵义市汇川区科技计划项目[编号:遵汇科合(2016)17号]

摘　　要：目的比较髋关节镜联合多次小直径钻孔减压与单独钻孔减压治疗股骨头早期缺血性坏死的临床效果。方法回顾性分析2014年2月至2017年8月于我院因股骨头早期缺血性坏死行髋关节镜联合减压的患者(83例,116髋),根据减压方法分为多孔组(37例,51髋)和单孔组(46例,65髋),比较两组患者手术相关指标及术后住院时间,比较两组术前和术后3个月、1年的髋关节Harris评分,采用Kaplan-Meier生存曲线分析比两组患者出现股骨头塌陷的情况。结果多孔组患者其术中出血量显著少于单孔组,差异具有统计学意义(t=5.545,P <0.001),两组患者术后3个月和1年的髋关节Harris评分均较术前显著升高(P <0.05),术后1年多孔组患者其Harris评分显著高于单孔组,差异具有统计学意义(t=2.052,P=0.043)。结论髋关节镜联合多次小直径钻孔减压对比单独钻孔减压治疗股骨头早期缺血性坏死,其手术创伤更小,能进一步改善髋关节功能,其临床效果优于单独钻孔减压。Objective To compare the clinical effects of hip arthroscopy combined with multiple small diameter drilling decompression and single hole decompression for early avascular necrosis of the femoral head.Methods A total of 83 patients(116 hips)with total hip arthroscopic decompression due to early avascular necrosis of the femoral head from February 2014 to August 2017 were retrospectively analyzed. They were divided into porous groups(37 cases,51 hips)and single-hole group(46 cases,65 hips)according to the decompression method. The indexes of surgery and postoperative hospital stay were compared between the two groups. The hips of the two groups were compared. The Harris scores of the hips were analyzed before and 3 months and 1 year after surgery and Kaplan-Meier survival curves were adopted to analyze femoral head collapse in these two groups of patients. Results The amount of intraoperative blood loss was significantly lower in the porous group than that in the single-hole group(t = 5.545,P < 0.001). The hip Harris scores at 3 months and 1 year after the surgery were significantly higher than those before the operation in both two groups(P < 0.05). The Harris score of the porous group was significantly higher than that of the single-hole group at 1 year after the surgery. The difference was statistically significant(t = 2.052,P = 0.043). Conclusions Compared with single hole decompression for early avascular necrosis of the femoral head, hip arthroscopy combined with multiple small diameter drilling decompression is demonstrated smaller surgical,which can be further improved hip function,and its clinical effect is better than separate drilling stress reliever.

关 键 词：股骨头坏死 髋关节镜 多孔 单孔 减压 

分 类 号：R687.3[医药卫生—骨科学]