| 钻孔减压治疗塌陷期股骨头坏死的临床观察 |
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投稿时间：2014-10-01
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| 作者 | Author | 单位 | Address | E-Mail |
| 魏民 |
WEI Min |
中国人民解放军总医院骨科, 北京 100853 |
General Hospital of PLA, Beijing 100853, China |
weim301gk@sina.com |
| 王志刚 |
WANG Zhi-gang |
中国人民解放军总医院骨科, 北京 100853 |
General Hospital of PLA, Beijing 100853, China |
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| 刘玉杰 |
LIU Yu-jie |
中国人民解放军总医院骨科, 北京 100853 |
General Hospital of PLA, Beijing 100853, China |
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| 李众利 |
LI Zhong-li |
中国人民解放军总医院骨科, 北京 100853 |
General Hospital of PLA, Beijing 100853, China |
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| 期刊信息：《中国骨伤》2015年，第28卷，第6期，第562-566页 |
| DOI：10.3969/j.issn.1003-0034.2015.06.019 |
| 基金项目: |
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中文摘要:
目的:探讨钻孔减压治疗塌陷期股骨头坏死的临床疗效并作生存分析。
方法:收集自2006年3月至2009年2月期间治疗的22例双侧股骨头坏死病例, 其中男20例, 女2例;平均年龄38.4岁(24～52岁).所有病例一侧为Ficat Ⅲ期, 另一侧为FicatⅠ期或Ⅱ期。采用钻孔减压进行治疗, 平均随访5.4年(1～8年).以严重的髋关节疼痛(VAS≥7分)、髋关节功能障碍(Harris评分≤70分)、X线显示病变进展到Ficat Ⅳ期以及髋关节置换作为终点进行生存分析。
结果:以严重的髋关节疼痛为终点, Ficat Ⅲ期最终有13例VAS<7分, 而FicatⅠ期或Ⅱ期有18例(P>0.05);以髋关节功能障碍为终点, Ficat Ⅲ期最终有6例Harris评分>70分, 而FicatⅠ期或Ⅱ期组有18例(P<0.05);以X线显示病变进展到Ficat Ⅳ期为终点, Ficat Ⅲ期最终有2例未进展到Ficat Ⅳ期, 而FicatⅠ期或Ⅱ期组有18例(P<0.05);以髋关节置换为终点, Ficat Ⅲ期最终有13例未行髋关节置换, 而FicatⅠ期或Ⅱ期有18例(P>0.05).
结论:钻孔减压可以有效地延缓Ficat Ⅲ期的病情发展, 降低关节置换的比例。 |
| 【关键词】股骨头坏死 减压术, 外科 髋关节 |
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| Drilling decompression for femoral head necrosis at collapse stage |
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ABSTRACT
Objective:To explore clinical effects of drilling decompression for femoral head necrosis at collapse stage.
Methods:Totally 22 patients with femoral head necrosis on both side were analyzed from March 2006 to February 2009. Among them, there were 20 males and 2 females aged from 24 to 52 years old with an average of 38.4 years old. All patients were Ficat Ⅲ on one side and Ficat Ⅰ or Ⅱ on another side. Drilling decompression were performed on all patients. The average followed-up period was 5.4 years(ranged, 1 to 8 years). The endpoint of severe pain(VAS≥7), severe dysfunction(Harris≤70), radiographic progression on Ficat Ⅳ and total hip arhtroplasty(THA) was used for survivorship analysis.
Results:Severe pain as an endpoint, 13 cases were survived on Ficat Ⅲ and 18 cases on Ficat Ⅰ or Ⅱ(P>0.05). Severe dysfunction as an endpoint, 6 cases were survived on Ficat Ⅲ and 18 on Ficat Ⅰ or Ⅱ(P<0.05). Radiographic progression on Ficat Ⅳas an endpoint, 2 cases were survived on Ficat Ⅲ and 18 on Ficat Ⅰ or Ⅱ(P<0.05). THA as an endpoint, 13 cases were survived on Ficat Ⅲ and 18 cases on Ficat Ⅰ or Ⅱ(P>0.05).
Conclusion:Femoral head necrosis with Ficat Ⅲ treated with drilling decompression could prolong progression of disease, decrease percentage of THA. |
| KEY WORDS Femoral head necrosis Decompression,surgical Hip joint |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 魏民,王志刚,刘玉杰,李众利.钻孔减压治疗塌陷期股骨头坏死的临床观察[J].中国骨伤,2015,28(6):562~566 |
| 英文格式: | WEI Min,WANG Zhi-gang,LIU Yu-jie,LI Zhong-li.Drilling decompression for femoral head necrosis at collapse stage[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(6):562~566 |
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