带血管蒂髂骨瓣移植治疗早期股骨头坏死的临床效果  

Clinical effect of vascularized iliac bone flap transplantation in the treatment of early necrosis of femoral head

作　　者：刘冬平 姚磊 王成 刘术樟 康昭河 LIU Dong-ping;YAO Lei;WANG Cheng;LIU Shu-zhang;KANG Zhao-he(Department of Orthopaedics,Ji′an Hospital of Shanghai Oriental Hospital,Jiangxi Province,Ji′an343000,China)

机构地区：[1]上海市东方医院吉安医院骨科,江西吉安343000

出　　处：《中国当代医药》2020年第23期36-39,共4页China Modern Medicine

基　　金：江西省吉安市指导性科技计划项目(吉市科计字[2018]6号33)。

摘　　要：目的探讨带血管蒂髂骨瓣移植治疗早期股骨头坏死的临床效果及分析股外侧皮神经损伤原因,提出有效的防治方法。方法回顾性选取2016年1月~2019年1月我院早期股骨头坏死患者60例,依据治疗方法分为行带血管蒂髂骨瓣移植治疗的研究组和单纯髂骨块移植治疗的对照组,统计分析两组手术前后视觉模拟量表(VAS)评分、Harris评分、术后1年的患髋关节功能优良率、术后股外侧皮神经功能状况。结果两组患者术前的VAS评分、Harris评分比较,差异无统计学意义(P>0.05);两组患者术后第6个月、第12个月的VAS评分均逐渐降低(P<0.05),Harris评分均逐渐升高(P<0.05);术后第6个月、第12个月研究组患者的VAS评分均低于对照组,术后第12个月研究组患者的Harris评分高于对照组,差异有统计学意义(P<0.05)。两组患者术前的髋关节功能比较,差异无统计学意义(P>0.05);两组患者术后第6个月、第12个月的髋关节功能均优于术前(P<0.05);术后第6个月、第12个月研究组患者的髋关节功能均优于对照组,差异有统计学意义(P<0.05)。研究组患者第1年股外侧皮神经功能优于第1、3、6个月,差异有统计学意义(P<0.05)。结论带血管蒂髂骨瓣移植治疗早期股骨头坏死临床效果良好,但需警惕医源性股外侧皮神经损伤,一旦发生应及时诊治。Objective To explore the clinical effect of vascularized iliac bone flap transplantation in the treatment of early femoral head necrosis,analyze the causes of lateral femoral cutaneous nerve injury,and propose effective prevention and treatment methods.Methods From January 2016 to January 2019,60 patients of early necrosis of femoral head in our hospital were retrospectively selected.According to the treatment methods,they were divided into a study group undergoing vascularized iliac bone graft transplantation and a control group receiving simple iliac bone graft transplantation.The visual analogue scale(VAS)score,Harris score,the excellent rate of hip joint function in one year after surgery,and the lateral femoral cutaneous nerve injury of the two groups before and after surgery were statistically analyzed.Results There were no significant differences in VAS score and Harris score between the two groups before surgery(P>0.05);the VAS score of patients in the two groups at the 6th and 12th month after surgery was gradually reduced(P<0.05),and the Harris score was gradually increased(P<0.05).The VAS score of the study group at the 6th and 12th month after surgery was lower than that of the control group,and the Harris score was higher than that of the control group,the differences were statistically significant(P<0.05).There was no significant difference in hip joint function between the two groups before surgery(P>0.05);the hip joint function of the two groups of patients at the 6th and 12th month after surgery was better than that before surgery(P<0.05);the hip joint function of the patients in the 6th and 12th month after surgery in the study group was better than that in the control group(P<0.05).The function of the lateral femoral cutaneous nerve in the first year in the study group was better than that in the first,third,and the sixth month,the differences were statistically significant(P<0.05).Conclusion Vascularized iliac bone flap transplantation has good clinical effect in the treatment of early femoral

关 键 词：带血管蒂髂骨瓣移植 早期股骨头坏死 股外侧皮神经损伤 临床疗效 

分 类 号：R681.8[医药卫生—骨科学]