髓芯减压后多孔钽棒联合富血小板血浆植入治疗早期股骨头坏死  

Clinical study on treatment of early necrosis of femoral head with porous tantalum rod and Platelet-rich plasma implantation after core decompression

作　　者：郭峰 宋兵 解焕鑫 章耀华[1] 张鸿悦 杨华清[1] GUO Feng;SONG Bing;XIE Huanxin;ZHANG Yaohua;ZHANG Hongyue;YANG Huaqing(Department of Orthopaedic,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China;Department of Orthopaedic,Qilu Hospital of Shandong University Dezhou Hospital,Dezhou 253000,China)

机构地区：[1]首都医科大学附属北京康复医院骨科,北京100144 [2]山东大学齐鲁医院德州医院骨科,山东德州253000

出　　处：《山东第一医科大学（山东省医学科学院）学报》2022年第8期575-579,共5页Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences

基　　金：北京市首都医学发展科研基金(2022-2-2253)。

摘　　要：目的探讨髓芯减压后多孔钽棒联合富血小板血浆植入(platelet‑rich plasma,PRP)治疗早期股骨头坏死的临床效果。方法根据纳入与排除标准,纳入2017年1月至2020年12月首都医科大学附属北京康复医院骨科和山东大学齐鲁医院德州医院骨科收治的早期股骨头坏死患者120例,随机分成单纯钽棒组、PRP联合钽棒组,2组患者均进行髓芯减压手术,比较2组患者手术时间、术后平均住院时间、术前及术后不同时间点视觉模拟(visual analogue scale,VAS)评分、髋关节Harris评分情况及术后并发症发生情况。结果两组患者手术时间、术后平均住院日及术后并发症发生率比较,差异无统计学意义(P>0.05)。两组患者术前VAS评分比较,差异无统计学意义,术后1周时PRP联合钽棒组患者疼痛评分较单纯钽棒组增高,差异有统计学意义(P<0.05);随时间增长,PRP联合钽棒组患者VAS评分较单纯钽棒组降低,差异有统计学意义(P<0.05)。两组患者术后髋关节Harris评分均较术前增加,且PRP联合钽棒组评分高于单纯钽棒组,差异有统计学意义(P<0.05)。2组患者并发症发生率差异无统计学意义(P>0.05)。结论对于早期股骨头坏死患者,髓芯减压后联合钽棒+PRP植入,可以减轻患者髋关节疼痛症状,促进患者髋关节功能恢复。Objective:To explore the clinical effect of porous tantalum bar combined with PRP in the treatment of early necrosis of femoral head.Methods:According to the into and exclusion criteria,included 120 patients,randomly divided into pure tantalum rod group,PRP combined tantalum rods,perfect perioperative examination,2 patients respectively for pulp core decompression treatment and postoperative routine perioperative management,record and compare the two groups patients average operation time,postoperative hospital stay,postoperative pain score;Harris score of hip joint before operation,1 month,3 months,6 months and 12 months after operation in 2 groups;Postoperative complications occurred in 2 groups.Results:There was no significant difference in operation time between the two groups.The patients in the tantalum bar group were(4.15±2.19)d and the patients in the PRP combined group were(4.12±2.23)d.There was no statistically significant difference in the length of hospital stay between the patients in the pure tantalum bar group and the patients in the PRP combined with tantalum bar core decompression(P>0.05).There was no statistically significant difference in preoperative VAS score between the two groups.One week after surgery,pain score of patients with PRP combined with tantalum rods was significantly higher than that of patients with tantalum rods alone;With the increase of time,VAS scores of patients with PRP combined with tantalum rods gradually decreased,which was significantly lower than that of patients with tantalum rods alone.Postoperative Harris score of the hip joint was significantly increased in both groups compared with that before surgery,and PRP combined with tantalum rod core decompression significantly improved Harris function of the hip joint compared with that of tantalum rod core alone,and the difference was statistically significant.There was no statistically significant difference in complications between the two groups.Conclusion:For patients with early necrosis of the femoral head,medull

关 键 词：股骨头坏死 缺血性坏死 钽棒 富血小板血浆 髓芯减压 

分 类 号：R687.3[医药卫生—骨科学]