本文選題：負(fù)壓吸引 + 早期股骨頭壞死�。� 參考：《河北北方學(xué)院》2016年碩士論文

【摘要】：通過動態(tài)增強(qiáng)MRI(DCE-MRI)掃描定量分析髓芯減壓聯(lián)合負(fù)壓吸引術(shù)治療早期股骨頭壞死術(shù)前術(shù)后各區(qū)域間的微循環(huán)變化,評價其療效及分析其治療機(jī)理,為臨床治療早期股骨頭壞死提供一種更為有效的方法。對納入的早期股骨頭壞死患者行髓芯減壓聯(lián)合負(fù)壓吸引術(shù),于術(shù)后1、3、6、12個月對患者進(jìn)行隨訪,行髖關(guān)節(jié)X線檢查,并記錄其Harris髖關(guān)節(jié)評分和VAS評分,以判定術(shù)后髖關(guān)節(jié)功能的改善情況;術(shù)后1、3、6個月對患者行髖關(guān)節(jié)DCE-MRI掃描,以檢測股骨頭相關(guān)血管功能定量參數(shù)Ktrans、Kep、Ve、iAUC值,以定量分析股骨頭壞死各區(qū)域術(shù)前術(shù)后微循環(huán)的變化。術(shù)后的各回訪時間點經(jīng)X線及DCE-MRI掃描未見壞死股骨頭發(fā)生塌陷或壞死區(qū)明顯擴(kuò)大的情況發(fā)生。除VAS評分在術(shù)前與術(shù)后1月相比較,差異(P0.05)無統(tǒng)計學(xué)意義外,其余術(shù)后各回訪時間點的Harris及VAS評分與術(shù)前相應(yīng)評分相比較,差異(P0.05)均有顯著統(tǒng)計學(xué)意義。在ARCOⅠ期組壞死區(qū)參數(shù)Kep術(shù)后3、6個月與術(shù)前相比較,差異(P0.05)有統(tǒng)計學(xué)意義;壞死區(qū)iAUC術(shù)后3個月與術(shù)前相比較,差異(P0.05)有統(tǒng)計學(xué)意義;在ARCOⅡ期組壞死區(qū)參數(shù)Ve術(shù)前與術(shù)后1個月相比較,差異(P0.05)有統(tǒng)計學(xué)意義。ARCOⅠ、Ⅱ期這4個參數(shù)在其他術(shù)前與術(shù)后各區(qū)各時間點相比較,差異(P0.05)無統(tǒng)計學(xué)意義。本研究初步表明髓芯減壓聯(lián)合負(fù)壓吸引術(shù)是一種新的治療早期股骨頭壞死的保頭治療方法,并表明該新的手術(shù)方法對治療早期股骨頭壞死的效果,在短期內(nèi)可有效地改善髖關(guān)節(jié)功能,減輕疼痛癥狀,并具有延緩壞死股骨頭的塌陷的作用。初步表明該新的手術(shù)方法對治療早期股骨頭壞死,對ARCOⅠ期壞死股骨頭的微循環(huán)瘀滯問題,得到一定程度的改善,但對ARCOⅡ期壞死股骨頭的微循環(huán)改善情況不明顯,并可促進(jìn)壞死區(qū)和交界區(qū)毛細(xì)血管生成。受限于實驗研究的樣本數(shù),該新的手術(shù)方法對治療早期股骨頭壞死的臨床效果及改善微循環(huán)瘀滯的情況,需要進(jìn)一步大樣本、長期隨訪觀察及病理實驗后才可得出更為確切的結(jié)論。
[Abstract]:Dynamic enhanced MRI DCE-MRI scanning was used to quantitatively analyze the changes of microcirculation between different regions before and after treatment of early femoral head necrosis by core decompression combined with negative pressure suction, and to evaluate its curative effect and analyze its therapeutic mechanism.To provide a more effective method for the treatment of early femoral head necrosis.The patients with early femoral head necrosis were treated with core decompression combined with negative pressure suction. The patients were followed up for 12 months with Harris hip score and VAS score.In order to evaluate the improvement of hip function after operation, DCE-MRI scanning was performed on the hip joint at 1 and 6 months after operation to detect the quantitative parameters of the femoral head related vascular function (KtransN), and to quantitatively analyze the changes of microcirculation in various areas of femoral head necrosis before and after operation.No collapse of the femoral head or obvious expansion of the necrotic area was observed on X-ray and DCE-MRI scans.There was no significant difference in VAS score between preoperative and postoperative month (P 0.05), but there was significant difference in Harris and VAS scores between preoperative and postoperative time points (P 0.05).There were significant differences in the parameters of necrotic zone between 3 months and 6 months after operation in ARCO stage 鈪，

本文編號：1733454