髋关节外科脱位头颈开窗打压植骨术联合活血补肾方治疗中晚期肾虚血瘀型股骨头坏死的临床疗效  

Clinical efficacy of impaction bone-grafting after surgical hip dislocation and head and neck fenestration combined with Huoxue Bushen formula for middle- or late-stage osteonecrosis of the femoral head with kidney deficiency and blood stasis

作　　者：杜敏东[1] 刘雄 秦刚[1] 何凯毅[1] 曾平[1] DU Min-dong;LIU Xiong;QIN Gang;HE Kai-yi;ZENG Ping(The Second Department of Orthopedics,Xianhu District,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China)

机构地区：[1]广西中医药大学第一附属医院仙葫院区骨二科

出　　处：《广西医学》2019年第22期2821-2824,共4页Guangxi Medical Journal

基　　金：国家自然科学基金(81360551、81360550、81860793);广西自然科学基金(2017GXNSFAA198296)

摘　　要：目的观察髋关节外科脱位(SHD)头颈开窗打压植骨术联合活血补肾方治疗中晚期肾虚血瘀型股骨头坏死(ONFH)的临床疗效。方法选取中晚期肾虚血瘀型ONFH患者15例(16髋),均行SHD头颈开窗打压植骨术,术后给予活血补肾中药方口服,疗程3个月。所有患者术后均获得6~25个月的随访。观察患者末次随访时髋关节Harris评分、疼痛评分、髋关节活动度评分及股骨头塌陷较术前改善情况。结果末次随访时,髋关节功能良7髋,可5髋,差4髋。患者髋关节功能Harris评分、疼痛评分、关节活动度评分均高于术前(均P<0.05)。股骨头塌陷纠正6髋,无塌陷加重5髋,继续塌陷5髋。结论 SHD头颈开窗打压植骨术联合活血补肾方治疗中晚期肾虚血瘀型ONFH患者短期疗效确切,可有效地改善髋关节活动度,减轻疼痛症状。Objective To observe the clinical efficacy of impaction bone-grafting after surgical hip dislocation(SHD) and head and neck fenestration combined with Huoxue Bushen formula for middle-or late-stage treating osteonecrosis of the femoral head(ONFH) with kidney deficiency and blood stasis.Methods Fifteen middle-or late-stage ONFH patients(16 hips) with kidney deficiency and blood stasis were selected,and all underwent impaction bone-grafting after SHD and head and neck fenestration followed by oral administration of Huoxue Bushen formula for three treatment courses.All patients obtained postoperative follow-up from 6 to 25 months.The following indicators were observed at the last follow-up:Harris score and pain score of hip function,hip joint range of motion score,and improvement of femoral head collapse compared with preoperation.Results At the last follow-up,the function was assessed as good in 7 hips,fairy in 5 hips and bad in 4 hips.Harris score and pain score of hip function,and score of hip joint range of motion were higher after operation than those before operation(all P<0.05).The collapse of femoral head was corrected in 6 hips,non-exacerbated in 5 hips and exacerbated in 5 hips.Conclusion Impaction bone-grafting after SHD and head and neck fenestration combined with Huoxue Bushen formula can achieve a definite short-term efficacy for middle-or late-stage ONFH patients with kidney deficiency and blood stasis,for it can effectively improve the hip joint range of motion,and alleviate the symptom of pain.

关 键 词：股骨头坏死 中晚期 肾虚血瘀型 髋关节外科脱位 植骨 保髋 中药疗法 活血补肾 

分 类 号：R68[医药卫生—骨科学]