| 持续局部丹参和肝素灌注治疗股骨头坏死疗效分析 |
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投稿时间：2010-03-22
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| 作者 | Author | 单位 | Address | E-Mail |
| 王昌兴 |
WANG Chang-xing |
浙江中医药大学附属第二医院骨科,浙江 杭州 310005 |
Department of Orthopaedics,the Second Hospital of the Zhejiang University of TCM,Hangzhou 310005,Zhejiang,China |
wcxing@zj.com |
| 沈建国 |
SHEN Jian-guo |
浙江中医药大学附属第二医院骨科,浙江 杭州 310005 |
Department of Orthopaedics,the Second Hospital of the Zhejiang University of TCM,Hangzhou 310005,Zhejiang,China |
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| 姜滔 |
JIANG Tao |
浙江中医药大学附属第二医院骨科,浙江 杭州 310005 |
Department of Orthopaedics,the Second Hospital of the Zhejiang University of TCM,Hangzhou 310005,Zhejiang,China |
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| 吴建民 |
WU Jian-min |
浙江中医药大学附属第二医院骨科,浙江 杭州 310005 |
Department of Orthopaedics,the Second Hospital of the Zhejiang University of TCM,Hangzhou 310005,Zhejiang,China |
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| 董黎强 |
DONG Li-qiang |
浙江中医药大学附属第二医院骨科,浙江 杭州 310005 |
Department of Orthopaedics,the Second Hospital of the Zhejiang University of TCM,Hangzhou 310005,Zhejiang,China |
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| 王伟东 |
WANG Wei-dong |
浙江中医药大学附属第二医院骨科,浙江 杭州 310005 |
Department of Orthopaedics,the Second Hospital of the Zhejiang University of TCM,Hangzhou 310005,Zhejiang,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第5期，第383-385页 |
| DOI：10.3969/j.issn.1003-0034.2010.05.021 |
| 基金项目: |
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中文摘要:
目的：探讨股骨头局部持续丹参和肝素灌注治疗股骨头坏死的疗效。
方法：2004年4月至2007年6月股骨头缺血性坏死42例，男24例，女18例；年龄13～61岁，平均39.2岁。按照Ficat分期标准，Ⅱ期18例，Ⅲ期13例，Ⅳ期11例。采用持续局部丹参和肝素灌注治疗，在透视下将静脉导管置入股骨头部，用丹参和肝素局部持续灌注15 d.在术前及术后1个月进行造影评级，在术前及术后3、6和12个月分别进行Harris评分，结果使用统计软件SPSS 13.0作统计学处理，比较各型术后的Harris评分和造影评级。
结果：42例均获随访，时间32～68个月，平均42.7个月。18例Ⅱ期患者Harris评分：术后3个月(88.43±3.41)分，术后6个月(94.37±3.47)分，术后12个月(92.84±4.29)分，较术前(78.23±3.47)分提高。13例Ⅲ期患者Harris评分：术后3个月(82.94±3.31)分，术后6个月(88.60±2.31)分，术后12个月(86.09±3.17)分，较术前(66.11±4.50)分提高。11例Ⅳ期患者Harris评分：术后3个月(61.31±4.06)分，术后6个月(59.23±7.31)分，较术前(50.16±2.35)分提高；术后12个月(54.62±8.20)分，与术前比较差异无统计学意义。Ⅱ、Ⅲ期患者的股骨头静脉造影术后1个月与术前比较，股骨头静脉造影评级提高；Ⅳ期患者术后与术前比较无明显差异。
结论：持续局部丹参和肝素灌注治疗股骨头坏死具有损伤小、疗效好的优点，适用于早期(Ⅱ、Ⅲ期)的股骨头坏死患者以及尚不愿手术的Ⅳ期患者的姑息治疗。 |
| 【关键词】股骨头坏死 丹参 肝素 灌注,局部 |
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| Effective analysis of continous perfusion with Dandshen and heparin for treatment of femoral head necrosis |
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ABSTRACT
Objective: To investigate the effect of continous perfusion with Danshen and heparin for treatment of femoral head necrosis.
Methods: From April 2004 to June 2007,42 patients of femoral head necrosis were treated by contious perfusing with Dandshen and heparin,included 24 males and 18 females with an average age of 39.2 years ranging from 13 to 61 years. There were 18 patients on stageⅡ，13 patients on stage Ⅲ，11 patients on stage Ⅳaccording to Ficat standard. The venous duct were inserted into femoral head then perfused Danshen and heparin into femoral head for 15 days. Every patient was carried out opacification before treatment and 1 month after operation. Every patient was evaluated according to Harris standard before treatment and 3,6,12 months after treatment.
Results: All patients were followed-up for 32 to 68 months(means 42.7 months). The average scores of 18 patients on stageⅡon 3,6,12 months after treatment were(88.43±3.41),(94.37±3.47),(92.84±4.29),respectively,and the scores after treatment were higher than the score(78.23±3.47) after treatment. The average scores of 13 cases on stage Ⅲ on 3,6,12 after treatment were(82.94±3.31),(88.60±2.31),(86.09±3.17) respectivly,and the scrores after treatment were higher than the score(66.11±4.50) before treatment. The average scores of 11 cases on stage Ⅳon 3,6,12 months after treatment were(61.31±4.06),(59.23±7.31),(54.62±8.20) respectivly,and the scores on 3,6 months after treatment were higher than the score(50.16±2.35) before treatment,but there was no obvious difference between before treatment and 12 months after treatment. The rank of phlebography of 18 cases on stage Ⅱand 13 cases on stage Ⅲ were improved obviously 1 month after treatment,but there was no obvious difference in 11 cases of stage Ⅳ。
Conclusion: The method of contious perfusing with Danshen and heparin into femoral head has the advantage of little damage and good effect. It refers to patients in early stage(Ⅱand Ⅲ). |
| KEY WORDS Femur head necrosis Salvia miltiorrhiza Heparin Perfusion,regional |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王昌兴,沈建国,姜滔,吴建民,董黎强,王伟东.持续局部丹参和肝素灌注治疗股骨头坏死疗效分析[J].中国骨伤,2010,23(5):383~385 |
| 英文格式: | WANG Chang-xing,SHEN Jian-guo,JIANG Tao,WU Jian-min,DONG Li-qiang,WANG Wei-dong.Effective analysis of continous perfusion with Dandshen and heparin for treatment of femoral head necrosis[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(5):383~385 |
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