体外冲击波治疗成人股骨头缺血性坏死的疗效观察  

Treatment of adult femoral head necrosis with extracorporeal shock wave therapy

作　　者：邢更彦[1] 白晓东[1] 杜明奎[1] 李禾[1] 纪惠茹[1] 姜川[1] 

机构地区：[1]中国人民武装警察部队总医院骨科,北京100039

出　　处：《中华物理医学与康复杂志》2003年第8期472-474,共3页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的 研究体外冲击波疗法治疗69例成人非创伤性股骨头缺血性坏死患者。方法 69例患者均为 Ficat分期 Ⅰ-Ⅲ期,应用高能冲击波治疗机治疗,能量密度 0.18～0.25 mJ/mm^2,以股骨头坏死区及其相邻骨质为冲击点,每个冲击点每次冲击 1 000次,共做8次治疗,患髋3个月内免负重,半年内减少负重。所有病例分别在治疗前、治疗后3,6及12个月行MRI检查(同时测量坏死区域所占股骨头体积的百分比)、髋关节Harris评分(100分)和双侧髋关节X线片检查。结果 69例患者经过1年随访发现,冲击波治疗前及治疗后 3,6及 12个月,坏死区域所占股骨头体积的百分比,分别为 49.9％,19.6％,6.8％及 5.6％,髋关节Harris评分分别为 47.2,77.9,90.2及 92.2分;双侧髋关节 X线片示治疗后各组与治疗前相比无股骨头变形及塌陷。各期病例经冲击波治疗后,各时间段坏死区域所占股骨头体积的百分比及髋关节Harris评分与冲击波治疗前比较,差异有显著性意义(P<0.01)。结论 体外冲击波治疗成人非创伤性股骨头缺血性坏死疗效显著,无创伤。我们认为该方法将成为临床治疗该类疾病的主要方法之一。Objective To study the effects of extracorporeal shock wave therapy (ESWT) for the treatment of avascular necrosis of the femoral head in adults. Methods Sixty-nine cases were collected and treated with ES- WT. The energy density of ESWT were 0. 18～0. 25mJ/mm^2, the number of shock waves delivered were 4 000～ 6 000 times in every treatment session. 8 sessions of treatment were performed in one necrosis femoral head. The MRI, X-ray, the Harris hip score were performed, respectively, before ESWT, and at 3, 6 and 12 months after ES- WT Results 69 cases were followed up through 1 year. The ratio of necrosis of the femoral head as shown by MRI averaged 49. 9% (before ESWT), 19. 6% (3 months), 6. 8% (6 months ), 5. 6% (12 months), respectively. The Harris hip score averaged 46. 2 before ESWT, 78. 9 at 3 months after ESWT, 90. 2 6 months after ESWT, 92. 2 12 months after ESWT. Significant differences were revealed after the ESWT in regard to all the evaluation outcomes as compared to those before the ESWT (P < 0. 01). No collapse of the femoral head was found on radiograph after u- sing ESWT. Conclusion It was shown that ESWT could be a very promising intervention for adult femoral head

关 键 词：体外冲击波治疗 成人 股骨头缺血性坏死 疗效观察 

分 类 号：R681.8[医药卫生—骨科学]