[1]吕文豪,董玉珍,路　坦.陶瓷棒植入与打压植骨治疗早期股骨头坏死疗效比较[J].新乡医学院学报,2020,37(4):342-346.[doi:10.7683/xxyxyxb.2020.04.009]
　LYU Wenhao,DONG Yuzhen,LU Tan.Efficacy comparison of ceramic rod implantation and bone grafting in the treatment of early necrosis of the femoral head[J].Journal of Xinxiang Medical University,2020,37(4):342-346.[doi:10.7683/xxyxyxb.2020.04.009]
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陶瓷棒植入与打压植骨治疗早期股骨头坏死疗效比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年4
页码:
342-346
栏目:
临床研究
出版日期:
2020-04-05

文章信息/Info

Title:
Efficacy comparison of ceramic rod implantation and bone grafting in the treatment of early necrosis of the femoral head
作者:
吕文豪; 董玉珍; 路　坦
(新乡医学院第一附属医院骨外二科，河南　卫辉　453100)
Author(s):
LYU Wenhao; DONG Yuzhen; LU Tan
(The Second Department of Orthopaedics,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
早期股骨头坏死; 髓芯减压; 打压植骨; 生物陶瓷棒植入; 临床疗效
Keywords:
early femoral head necrosis; pulp core decompression; bone grafting; bioceramic rod implantation; clinical efficacy
分类号:
R681.8
DOI:
10.7683/xxyxyxb.2020.04.009
文献标志码:
A
摘要:
目的　比较髓芯减压术联合打压植骨术与髓芯减压术联合生物陶瓷棒植入术治疗早期股骨头坏死的临床疗效。方法　选择2016年1月至2018年1月新乡医学院第一附属医院收治的60例早期股骨头坏死患者为研究对象，根据手术方式将患者分为对照组和观察者，每组30例。观察组患者给予髓芯减压术联合生物陶瓷棒植入术，对照组患者给予髓芯减压术联合打压植骨术。记录2组患者术前、术后Harris评分及手术情况（手术时间、术中出血量及术后早、晚期并发症）。采用X线、磁共振成像观察2组患者术后股骨头坏死的进展情况，并评估临床疗效。结果　观察组患者手术时间和术中出血量显著少于对照组 (P＜0.01)。2组患者术前Harris评分比较差异无统计学意义（P＞0.05）；术后12个月，2组患者Harris评分均显著高于术前（P＜0.01），且观察组患者Harris评分高于对照组（P＜0.01）。对照组患者治疗有效率为91.2%（31/34），优良率为70.6%（24/34）；观察组患者治疗有效率为97.0%（32/33），优良率为90.9%（30/33）；2组患者术后12个月治疗有效率比较差异无统计学意义（χ2=1.001，P＞0.05），观察组患者优良率高于对照组（χ2=4.422，P＜0.05）。结论　髓芯减压术联合生物陶瓷棒植入术治疗早期股骨头坏死可有效减轻患者的痛苦，阻止疾病进展，提高患者生活质量。
Abstract:
Objective　To explore the clinical effect of the core decompression combined with bone grafting and the core decompression combined with bioceramic rod implantation in the treatment of early femoral head necrosis.Methods　Sixty patients with early femoral head necrosis in the First Affiliated Hospital of Xinxiang Medical University from January 2016 to January 2018 were selected and divided into control group(n=30) and observation group(n=30) according to the operation method.The patients in the observation group were treated with core decompression combined with bioceramic rod implantation,while the patients in the control group were treated with core decompression combined with bone grafting.The Harris scores before and after operation,the operative time,intraoperative bleeding volume,early and late postoperative complications of patients in the two groups were recorded.X-ray and magnetic resonance examination were used to observe the progress of osteonecrosis and evaluate the clinical effect.Results　The operation time and intraoperative bleeding volume of patients in the observation group were significantly less than those in the control group (P<0.01).There was no significant difference in Harris score between the two groups before operation (P>0.05).At 12 months after operation,the Harris scores of patients in the two groups were significantly higher than those before operation (P<0.01),and the Harris score of patients in the observation group was higher than that in the control group (P<0.01).The effective rate and excellent rate of patients in the control group was 91.2% (31/34),70.6% (24/34),respectively;the effective rate and excellent rate of patients in the observation group was 97.0% (32/33),90.9% (30/33),respectively.There was no significant difference in the effective rate of patients between the two groups at 12 months after operation(χ2　=1.001,P>0.05);the excellent rate of patients in the observation group was higher than that in the control group (χ2　= 4.422,P<0.05).Conclusion　The combination of core decompression with bioceramic rod implantation in the treatment of early femoral head necrosis can effectively alleviate the pain of patients,prevent the progress of disease,and improve the quality of life of patients.

参考文献/References:

［1］　KAUSHIK A P,DAS A,CUI Q.Osteonecrosis of the femoral head:an update in year 2012［J］.World J Orthop,2012,3(5):49-57.
［2］　LIU F,WANG W,YANG L,et al.An epidemiological study of etiology and clinical characteristics in patients with nontraumatic osteonecrosis of the femoral head［J］.J Res Med Sci,2017,22(1):1-6.
［3］　ZHAO D W,YU M,HU K,et al.Prevalence of nontraumatic osteonecrosis of the femoral head and its associated risk factors in the chinese population:results from a nationally representative survey［J］.Chin Med J (Engl),2015,128(21):2843-2850.
［4］　SADILE F,BERNASCONI A,RUSSO S,et al.Core decompression versus other joint preserving treatments for osteonecrosis of the femoral head:a meta-analysis［J］.Br Med Bull,2016,118(1):33-49.
［5］　PIERCE T P,JAUREGUI J J,ELMALLAH R K,et al.A current review of core decompression in the treatment of osteonecrosis of the femoral head［J］.Curr Rev Musculoskelet Med,2015,8(3):228-232.
［6］　SHAH S N,KAPOOR C S,JHAVERI M R,et al.Analysis of outcome of avascular necrosis of femoral head treated by core decompression and bone grafting［J］.J Clin Orthop Trauma,2015,6(3):160-166.
［7］　MIAO H,YE D,LIANG W,et al.Effect of osteonecrosis intervention rod versus core decompression using multiple small drill holes on early stages of necrosis of the femoral head:a prospective study on a series of 60 patients with a minimum 1-year-follow-up［J］.Open Orthop J,2015,9(1):179-184.
［8］　季卫锋,丁伟航,马镇川,等.三通道髓芯钻孔减压加DBM、自体骨髓干细胞治疗早期股骨头坏死［J］.中国骨伤,2008,21(10):776-778.
［9］　孙景东,卢云,陈文,等.微创开窗打压植骨联合细针钻孔减压治疗塌陷前期股骨头坏死［J］.骨科,2014,5(4):206-210.
［10］　郑召民,崔力扬.髓芯减压术治疗成人股骨头坏死［J］.中国骨与关节杂志,2005,4(2):117-119.
［11］　蔡振基,邹国东,刘俊波,等.微创减压加打压植骨治疗股骨头坏死的临床应用研究［J］.世界最新医学信息文摘,2017,17(56):30-33.
［12］　ZALAVRAS C G,LIEBERMAN J R.Osteonecrosis of the femoral head:evaluation and treatment［J］.J Am Acad Orthop Surg,2014,22(7):455-464.
［13］　FERNNDEZFAIREN M,MURCIA A,IGLESIAS R,et al.Osteointegration of porous tantalum stems implanted in avascular necrosis of the hip［J］.Acta Ortop Mex,2008,22(4):215-221.
［14］　VARITIMIDIS S E,DIMITROULIAS A P,KARACHALIOS T S,et al.Outcome after tantalum rod implantation for treatment of femoral head osteonecrosis［J］.Acta Orthop,2009,80(1):20-25.
［15］　TANZER M,BOBYN J D,KRYGIER J J,et al.Histopathologic retrieval analysis of clinically failed porous tantalum osteonecrosis implants［J］.J Bone Joint Surg Am,2008,90(6):1282-1289.
［16］　毛文文,茹江英.羟基磷灰石类陶瓷在骨组织工程中的研究与更广泛应用［J］.中国组织工程研究,2018,22(30):4855-4863.
［17］　鲁亚杰,王臻,卢霄,等.生物陶瓷系统微创治疗ARCOⅡ、Ⅲ期股骨头坏死［J］.中国修复重建外科杂志,2019(10):1291-1298.
［18］　LI X,ZHAO Y,BING Y,et al.Biotemplated syntheses of macroporous materials for bone tissue engineering scaffolds and experiments in vitro and vivo［J］.ACS Appl Mater Interfaces,2013,5(12):5557-5562.
［19］　CHEN Z,WU C,YUEN J,et al.Influence of osteocytes in the in vitro and in vivo β-tricalcium phosphate-stimulated osteogenesis［J］.J Biomed Mater Res A,2014,102(8):2813-2823.
［20］　李博.β-磷酸三钙生物陶瓷棒系统治疗早期股骨头坏死的临床观察与生物力学研究［D］.南宁：广西医科大学，2017.
［21］　LU Y,LU X,LI M,et al.Minimally invasive treatment for osteonecrosis of the femoral head with angioconductive bioceramic rod［J］.Int Orthop,2018,42(4):1567-1573.

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更新日期/Last Update: 2020-04-05