| 富血小板血浆联合髓芯减压植骨术治疗ARCOⅡ期非创伤性股骨头坏死 |
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投稿时间：2019-12-15
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| 作者 | Author | 单位 | Address | E-Mail |
| 陈冬冬 |
CHEN Dong-dong |
陕西中医药大学第一临床医学院, 陕西 咸阳 712000 |
Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710000, Shaanxi, China |
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| 鲁超 |
LU Chao |
西安交通大学附属红会医院, 陕西 西安 710000 |
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| 宇文星 |
YUWEN Xing |
西安交通大学附属红会医院, 陕西 西安 710000 |
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| 李欢欢 |
LI Huan-huan |
陕西中医药大学第一临床医学院, 陕西 咸阳 712000 |
Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710000, Shaanxi, China |
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| 王秋霞 |
WANG Qiu-xia |
陕西中医药大学第一临床医学院, 陕西 咸阳 712000 |
Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710000, Shaanxi, China |
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| 袁雪超 |
YUAN Xue-chao |
陕西中医药大学第一临床医学院, 陕西 咸阳 712000 |
Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710000, Shaanxi, China |
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| 郝阳泉 |
HAO Yang-quan |
西安交通大学附属红会医院, 陕西 西安 710000 |
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haoyq2008@163.com |
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| 期刊信息：《中国骨伤》2020年，第33卷，第11期，第1048-1052页 |
| DOI：10.12200/j.issn.1003-0034.2020.11.012 |
| 基金项目:中国博士后科学基金（编号：2017M613179）；陕西省科技厅自然科学基础研究项目（编号：2019JM－490）；西安市卫健委科学发展项目（编号：J201803048） |
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| 中文摘要:目的：观察富血小板血浆（platelet-rich plasma，PRP）联合β-磷酸三钙生物陶瓷骨应用于髓芯减压植骨术治疗国际微循环学会股骨头坏死（Association Research Circulation Osseous，ARCO）Ⅱ期非创伤性股骨头坏死的临床疗效。方法：将2017年1月至2018年12月收治的100例（160髋）ARCOⅡ期非创伤性股骨头坏死患者分为PRP组与对照组。其中PRP组50例（80髋），男22例，女28例；年龄18~65（43.47±7.23）岁；病程4~18（15.8±2.9）个月；行髓芯减压植骨术联合PRP植入。对照组50例（80髋），男27例，女23例；年龄20~63（45.72±7.43）岁；病程6~19（14.9±3.8）个月；单纯人工骨植入。术后随访髋关节X线片，采用髋关节Harris评分、疼痛视觉模拟评分（visual analogue scale，VAS）进行疗效评价，并记录髋关节存活率。结果：术后所有患者伤口愈合良好，无感染、血栓等并发症发生，并均获得随访，时间12~14（12.0±0.4）个月。术后12个月PRP组影像表达优于对照组，差异有统计学意义（P<0.05）。术后12个月Harris髋关节评分和VAS评分，PRP组分别为89.98±6.17、1.68±1.02，对照组分别为81.62±5.62、2.52±1.13，且PRP组髋关节96.25%的存活率明显高于对照组的86.25%，两组患者术后评分均优于术前（P<0.05），但PRP组无论在任何时间点均优于对照组，组间比较差异均有统计学意义（P<0.05）。。结论：富血小板血浆与人工骨结合应用于髓芯减压植骨术，改变了以往植入单纯人工骨、疗效不确定的局面，提高了该术式的成功率，有效地降低了早中期股骨头坏死的塌陷率，延缓甚至避免髋关节的置换。 |
| 【关键词】富血小板血浆 股骨头坏死 减压术,外科 骨移植 |
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| Platelet-rich plasma combined with core decompression and bone grafting in the treatment of non traumatic necrosis of femoral head in ARCO stageⅡ |
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| ABSTRACT Objective: To observe the clinical effect of platelet-rich plasma (PRP) combined with β-tricalcium phosphate bioceramic bone in the treatment of non traumatic necrosis of the femoral head in ARCO stageⅡ. Methods: From January 2017 to December 2018,100 patients (160 hips) with ARCO stageⅡnon traumatic necrosis of the femoral head were divided into PRP group and control group. In PRP group,50 patients(80 hips),22 males and 28 females,aged from 18 to 65(43.47±7.23) years,with a course of 4 to 18(15.8±2.9) months,underwent core decompression and bone grafting combined with PRP implantation. There were 50 cases(80 hips) in the control group,including 27 males and 23 females,aged 20 to 63(45.72±7.43) years,and the course of disease was 6 to 19(14.9±3.8) months. Hip X-ray film was followed up after operation. Harris score and VAS score were used to evaluate the curative effect,and the survival rate of hip joint was recorded. Results: All patients had good wound healing,no infection,thrombosis and other complications. All patients were followed up for 12 to 14(12.0±0.4) months. Twelve months after operation,the image expression of PRP group was better than that of control group(P<0.05). Harris hip score and VAS score of pain at twelve months after operation were 89.98±6.17 and 1.68±1.02 in PRP group and 81.62±5.62 and 2.52±1.13 in control group,respectively. The survival rate of 96.25% in PRP group was significantly higher than 86.25% in control group. The postoperative score of two groups was higher than that before operation(P<0.05),but PRP group was better than control group at any time point statistical significance (P<0.05). Conclusion: Platelet-rich plasma(PRP) combined with artificial bone for core decompression and bone grafting can change the situation of simple artificial bone implantation and uncertain curative effect,improve the success rate of this operation,effectively reduce the collapse rate of femoral head necrosis in the early and middle stage,delay or even avoid hip replacement. |
| KEY WORDS Platelet-rich plasma Femur head necrosis Decompression,surgical Bone transplantation |
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| 中文格式: | 陈冬冬,鲁超,宇文星,李欢欢,王秋霞,袁雪超,郝阳泉.富血小板血浆联合髓芯减压植骨术治疗ARCOⅡ期非创伤性股骨头坏死[J].中国骨伤,2020,33(11):1048~1052 |
| 英文格式: | CHEN Dong-dong,LU Chao,YUWEN Xing,LI Huan-huan,WANG Qiu-xia,YUAN Xue-chao,HAO Yang-quan.Platelet-rich plasma combined with core decompression and bone grafting in the treatment of non traumatic necrosis of femoral head in ARCO stageⅡ[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(11):1048~1052 |
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