经皮扩张式铰刀髓芯减压联合注射型可再生人工骨植骨治疗一二期股骨头坏死效果分析  

Therapeutic effects of expandable reamer core decompression combined with injection artificial bone grafting bone on the first and second stage femoral head necrosis

作　　者：吴涛 李晓华 王喜 刘娜 范金鹏 刘永强 陈和伟 WU Tao;LI Xiaohua;WANG Xi(Department of Oosteology,The First Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050031,China)

机构地区：[1]河北省石家庄市人民医院骨科四病区,050031 [2]河北省军区石家庄第五离职干部休养所门诊部

出　　处：《河北医药》2020年第18期2825-2827,2831,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20191465)。

摘　　要：目的探讨扩张式铰刀髓芯减压联合注射型人工骨植骨治疗一二期股骨头坏死的临床效果。方法40例一二期股骨头坏死患者,每组20例。对照组采用髓心减压自体骨植骨治疗,观察组采用X-PEAM经皮扩张式铰刀髓芯减压+注射型人工骨植骨治疗,比较2组手术疗效、髋关节功能恢复情况和并发症。结果观察组术中出血量、首次下床活动时间、住院时间均优于对照组,差异有统计学意义(P<0.05)。观察组术后3、6、12个月的Harris评分均高于对照组,差异有统计学意义(P<0.05)。观察组术后随访并发症率低于对照组,但差异无统计学意义(P>0.05)。结论X-PEAM经皮扩张式铰刀髓芯减压+注射型人工骨植骨治疗一二期股骨头坏死创伤小,术后恢复快,安全性高,对患者髋关节功能恢复作用明显,值得推广。Objective To investigate the therapeutic effects of expandable reamer core decompression combined with injection artificial bone grafting bone on the first and second stage femoral head necrosis.Methods A total of 40 patients with stageⅠandⅡfemoral head necrosis who were treated in our hospital from January 2017 to December 2018 were enrolled in the study,who were randomly divided into control group and observation group,with 20 cases in each group.The patients in control group were treated by heart marrow decompression and autologous bone grafting,however,the patients in observation group were treated by X PEAM percutaneous expansion reamer combined with injection artificial bone grafting.The therapeutic effects,recovery status of hip joint and complications were observed and compared between the two groups.Results The intraoperative blood loss,first out-of-bed activity time and hospital stay in observation group were superior to those in control group(P<0.05).The Harris scores at 3m,6m and 12m after surgery in observation group were significantly higher than those in control group(P<0.05).The incidence rate of postoperative complication in observation group was 10.00%,which was lower than that(15.00%)in control group,but the difference between the two groups was not statistically significant(P>0.05).Conclusion X-PEAM percutaneous expansion reamer pulp core decompression combined with injection artificial bone grafting in treatment of first and second stage femoral head necrosis has the advantages of less trauma,fast postoperative recovery,high safety,obvious effects on the recovery of hip joint function of patients,thus,which is worthy of clinical application and promotion.

关 键 词：早期股骨头坏死 髓心减压自体骨植骨 扩张式铰刀髓芯减压 注射型人工骨植骨 效果 

分 类 号：R687.3[医药卫生—骨科学]