磷酸钙混合富血小板血浆置入重建股骨头治疗早期股骨头坏死  

Application of calcium phosphate mixture PRP reconstruction of necrotic areas for early metaphase osteo⁃necrosis of the femeral head

作　　者：张啸 王上增[2] 张银刚[3] 张英杰 李云朋[2] 许大勇[2] ZHANG Xiao;WANG Shangzeng;ZHANG Yingang;ZHANG Yingjie;LI Yun-peng;XU Dayong(He′nan University of Traditional Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学,郑州450003 [2]河南省中医院,郑州450002 [3]西安交通大学第一附属医院,西安710061

出　　处：《实用医学杂志》2020年第22期3116-3120,共5页The Journal of Practical Medicine

基　　金：河南省高等学校重点科研项目(编号:19B390005);河南省中医管理局专项科学研究项目(编号:2019ZY2035);河南省体育局体育课题研究项目(编号:2019024)。

摘　　要：目的探讨磷酸钙混合富血小板血浆(platelet⁃rich plasma,PRP)置入重建股骨头在早期股骨头坏死(osteonecrosis of the femoral head,ONFH)治疗中的潜在友好性。方法将河南省中医院关节外科自2016年6月至2018年1月收治的早期ONFH患者108例,依照随机数字表法将患者分为联合组与对照组,联合组52例(髋),对照组56例(髋)。对照组进行坏死骨刮除、β⁃磷酸钙颗粒填充打压、β⁃磷酸钙柱状陶瓷棒置入;联合组则将β⁃磷酸钙颗粒、柱状β⁃磷酸钙陶瓷棒浸润PRP进行填充打压置入。对两组患者进行术后不同时间位点VAS、Harris评分及影像学测评、量化指标对比。结果术后24个月多个时间位点对比,联合组置入物矿化、新生骨爬行生长替代明显优于对照组(P<0.05);联合组VAS及Harris亦优于对照组(F=30.12、17.88,P<0.05)。结论微创坏死骨刮除、磷酸钙置入对早期ONFH可修复性是客观的,微创保髋术联合PRP,可加速新生骨爬行生长矿化、促进磷酸钙置入物与自身宿主骨的融合。Objective The research tried to investigate the reliability of platelet⁃rich plasma compositesβ⁃calcium phosphate for the treatment of early Osteonecrosis of the Femoral Head.Methods 108 patients of early Osteonecrosis of the Femoral Head(unilateral lesion)were randomly divided into compound group(52 cases)and control group(56 cases).The control group was treated with osteonecrosis bone scraping,biomaterialsβ⁃calcium phosphate particles filling and pressing as well asβ⁃calcium phosphate columnar ceramic rod implantation.The composite group mixed biomaterialsβ⁃calcium phosphate particles to match platelet⁃rich plasma filling and compression and columnar calcium phosphate ceramic rod implantation.The VAS and Harris scores,imaging evalu⁃ation and quantitative indexes were compared between the two groups.Results Compared with multiple time sites in 24 months after operation,the implant mineralization and new bone crawling growth replacement in the compos⁃ite group were significantly better than those in the control group(P<0.05).The VAS and Harris in the composite group were also better than those in the control group(F=30.12,17.88,P<0.05).Conclusion Platelet⁃rich plasma compositesβ⁃calcium phosphate have a reliable advantage in the treatment of early Osteonecrosis of the Femoral Head,which could accelerate the growth and mineralization of new bone crawling,promote the fusion of calcium phosphate implants with their own host bone and facilitate functional recovery.

关 键 词：股骨头坏死 早期 β⁃磷酸钙 富血小板血浆 

分 类 号：R681.6[医药卫生—骨科学]