放散式体外冲击波治疗中晚期股骨头坏死的疗效观察  

Effect of radial extracorporeal shock wave therapy in middle-to late-Ficat stage osteonecrosis of the femoral head

作　　者：姜冬蕾[1] 张带[1] 海虹[1] 赵迎娱[1] 马跃文[1] JIANG Donglei;ZHANG Dai;HAI Hong;ZHAO Yingyu;MA Yuewen(Department of Rehabilitation,The First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院康复医学科,沈阳110001

出　　处：《中国医科大学学报》2022年第4期348-351,共4页Journal of China Medical University

摘　　要：目的回顾性分析放散式体外冲击波疗法(rESWT)治疗中晚期股骨头坏死(ONFH)的临床疗效。方法选择2016年3月至2021年3月在我院采用rESWT治疗的ONFHⅢ~Ⅳ期(Ficat分期)患者19例(25髋)。治疗时分别选用R15、D20及DI15探头,每次给予6000脉冲,频率10 Hz,2次/周,强度由2.0 bar渐增至5.0 bar,共治疗24次。分别于治疗前、治疗1个月和3个月时,评估髋关节疼痛[视觉模拟评分(VAS)]、髋关节活动(Harris评分)、髋周肌肉功能[徒手肌力检查(MMT)]。比较治疗前和治疗3个月时数字化X线摄影(DR)的变化情况。结果与治疗前相比,治疗1个月时VAS评分明显降低(P<0.001)、髋关节Harris评分及MMT评分显著增加(均P<0.001)。与治疗1个月相比,治疗3个月时VAS评分、髋关节Harris评分和MMT评分继续显著改善(P<0.01)。对比治疗前和治疗3个月时患髋DR影像学变化,未见病变进一步发展。结论rESWT能明显缓解中晚期ONFH患者髋关节疼痛,增加髋关节活动度,改善髋关节功能,对不适合手术的中晚期ONFH患者是一种无不良反应、快速止痛的治疗方式,且效果随治疗时间延长而更佳。Objective To retrospectively analyze the effect of radial extracorporeal shock wave therapy(rESWT)in middle-to late-Ficat stage osteonecrosis of the femoral head(ONFH).Methods We included 19 patients(25 hips)treated with rESWT for middleto late-Ficat stage ONFH in our hospital between March 2016 and March 2021.rESWT was applied twice weekly with 6000 pulses at a frequency of 10 Hz.The intensity increased from 2.0 bar to 5.0 bar,for a total of 24 times.Hip pain(Visual Analog Scale,VAS score),hip activity(Harris hip scale),and hip muscle function(manual muscle testing,MMT)were observed before and 1 and 3 months after treatment.Changes in digital radiography(DR)were compared before and 3 months after treatment.Results The VAS score decreased significantly(P<0.001),whereas the Harris hip and MMT scores increased significantly(both P<0.01)after 1 month of treatment.VAS,Harris hip scale,and MMT scores significantly improved further after 3 months of treatment(P<0.01).After 3 months of treatment,there was no further development of hip DR.Conclusion rESWT can significantly relieve pain and improve motor function in patients with middle-to late-stage ONFH.For patients with advanced-stage ONFH who are not suitable for surgery,rESWT is a good treatment method with almost no side effects and rapid pain relief,and the effect is better with longer treatment periods.

关 键 词：股骨头坏死 放散式体外冲击波 髋关节 

分 类 号：R493[医药卫生—康复医学]