本文選題：股骨頭缺血性壞死 + 鉭��； 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討采用國(guó)產(chǎn)多孔鉭棒治療早期股骨頭缺血性壞死的臨床療效。方法:采用前瞻性自身配對(duì)設(shè)計(jì)臨床驗(yàn)證試驗(yàn),分析2014年7月~2015年12月采用國(guó)產(chǎn)多孔鉭棒治療的18例(19髖)早期股骨頭缺血性壞死患者,其中男14例,女4例;年齡30~62歲,平均44.2歲。其中病因包括:3例為激素性,7例(8髖)為酒精性,8例為特發(fā)性。根據(jù)改良Ficat分期:Ⅱa期4例,Ⅱb期14例。療效評(píng)估包括術(shù)前及術(shù)后3、6、12個(gè)月患髖的Harris、Womac評(píng)分,X線片、MRI影像學(xué)變化以及并發(fā)癥觀察。結(jié)果:所有患者均得到隨訪,隨訪時(shí)間8~24個(gè)月,平均16個(gè)月。截至最后一次隨訪,未發(fā)現(xiàn)局部感染,切口不愈合,排異反應(yīng),鉭棒斷裂,松動(dòng),移位等不良事件發(fā)生。術(shù)后各時(shí)相點(diǎn)Harris評(píng)分[(82.73±8.99)分、(84.46±10.75)分、(87.22±10.0)分]較術(shù)前[(75.51±11.91)分]均有明顯升高(P0.05),末次隨訪髖關(guān)節(jié)評(píng)分:優(yōu)為10髖,良為3髖,可為5髖,差為1髖,優(yōu)良率72%。術(shù)后各時(shí)間點(diǎn)Womac評(píng)分[(17.44±9.40)分、(12.39±7.31)分、(11.06±8.41)分],較術(shù)前[(28.28±13.10)分]均有明顯下降(P0.05)。影像學(xué)顯示,17例(18髖)股骨頭壞死無(wú)明顯加重,股骨頭生存率為95%(18/19)。其中有1例因患髖疼痛明顯加重,股骨頭塌陷,最終行人工關(guān)節(jié)置換,術(shù)后解剖患髖股骨頭,大體標(biāo)本可見(jiàn)鉭棒與周?chē)墙M織緊密結(jié)合,硬組織切片顯示新生骨組織已長(zhǎng)入材料的孔隙。結(jié)論:國(guó)產(chǎn)多孔鉭棒治療早期股骨頭缺血性壞死,能促進(jìn)骨長(zhǎng)入,有效緩解疼痛、改善髖關(guān)節(jié)功能、防止股骨頭塌陷,延緩人工全髖關(guān)節(jié)置換時(shí)間。
[Abstract]:Objective: To explore the clinical efficacy of domestic porous tantalum rods in the treatment of early avascular necrosis of the femoral head. Methods: 18 cases (19 hips) with ischemic necrosis of the femoral head were analyzed by prospective self matching design in December July 2014 ~2015, including 14 males and 4 females, aged 30~62 years, The average 44.2 years old. Among them, 3 were hormone, 7 cases (8 hips) were alcoholic and 8 were idiopathic. According to modified Ficat staging, 4 cases in stage II A and 14 cases of stage II B, the therapeutic evaluation included Harris, Womac score, X ray, MRI imaging, and complication observation before and after 3,6,12 months. All patients were followed up. The duration of the visit was 8~24 months, averaging 16 months. As of the last follow-up, no local infection, nonunion, rejection, tantalum rod fracture, loosening and displacement were found. The Harris score of each time point ((82.73 + 8.99), (84.46 + 10.75), (87.22 + 10)) after the operation were significantly higher than before ((75.51 + 11.91)) (P0.05). The total hip joint score was 10 hips with 3 hips, 5 hips and 1 hips. The good rate was 1 hips. The excellent rate was (17.44 + 9.40), (12.39 + 7.31), (11.06 + 8.41)) after 72%., and (11.06 + 8.41) points before operation (11.06 + 8.41)). Imaging showed that the necrosis of femoral head was not significantly increased in 17 cases (hip of 18), and the survival rate of femoral head was 95% (18/19). 1 of them were obviously aggravated by the pain of the hip, the femoral head collapsed, the artificial joint replacement was finally performed, and the femoral head was dissected after the operation. The gross specimens showed that the tantalum rod was closely combined with the surrounding bone tissue, and the hard tissue section showed that the new bone tissue had grown into the pore of the material. Conclusion: the domestic porous tantalum rod is used to treat the early ischemic damage of the femoral head. Death can promote bone ingrowth, relieve pain effectively, improve hip joint function, prevent femoral head collapse, and postpone total hip replacement time.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張景義;;髓芯減壓鉭棒聯(lián)合自體骨植入治療成人早期股骨頭缺血性壞死患者的短期效果分析[J];臨床醫(yī)學(xué)研究與實(shí)踐;2016年05期

2 Emilios E Pakos;Panayiotis Megas;Nikolaos K Paschos;Spyridon A Syggelos;Antonios Kouzelis;Georgios Georgiadis;Theodoros A Xenakis;;Modified porous tantalum rod technique for the treatment of femoral head osteonecrosis[J];World Journal of Orthopedics;2015年10期

3 汪亮;劉耀升;劉蜀彬;王磊;曹云岑;蘇秀云;周詩(shī)國(guó);;多孔鉭棒植入治療早中期股骨頭壞死的生存率分析和預(yù)后因素評(píng)估[J];中華骨與關(guān)節(jié)外科雜志;2015年05期

4 張忠;戴曉明;曾海濱;;髓芯減壓植骨聯(lián)合多孔鉭棒治療早期股骨頭缺血性壞死[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2013年10期

5 葉福生;倪哲吉;儲(chǔ)小兵;何幫劍;厲駒;童培建;;鉭棒置入治療早期股骨頭壞死近期療效分析[J];中國(guó)骨傷;2013年08期

6 黃文武;;髓芯減壓術(shù)與髓芯減壓并鉭棒植入術(shù)治療早期股骨頭缺血壞死的近期療效比較[J];中國(guó)現(xiàn)代醫(yī)藥雜志;2011年12期

7 夏天;楊述華;;鉭棒支撐用于股骨頭壞死研究概況[J];國(guó)際骨科學(xué)雜志;2010年01期

8 佟剛;趙鑒非;;多孔金屬鉭棒在早期股骨頭壞死治療中的應(yīng)用[J];中華骨科雜志;2010年01期

9 郭萬(wàn)首;李子榮;;股骨頭壞死的保存自身關(guān)節(jié)治療[J];中華骨科雜志;2010年01期

10 應(yīng)明;;多孔鉭及在人工關(guān)節(jié)中的應(yīng)用[J];生物骨科材料與臨床研究;2006年02期

，

本文編號(hào)：2032439