【摘要】：目的通過(guò)與單純髓芯減壓比較,探討小直徑多孔道髓芯減壓聯(lián)合髖關(guān)節(jié)鏡清理治療早期股骨頭缺血性壞死的療效。方法回顧分析2010年3月—2013年12月收治并符合選擇標(biāo)準(zhǔn)的91例早期股骨頭缺血性壞死患者臨床資料。其中,39例(53髖)采用小直徑多孔道髓芯減壓聯(lián)合髖關(guān)節(jié)鏡清理治療(A組),52例(74髖)采用單純小直徑多孔道髓芯減壓治療(B組)。兩組患者術(shù)前均有明顯髖關(guān)節(jié)疼痛、活動(dòng)受限等癥狀。兩組患者性別、年齡、病因、側(cè)別、骨壞死分期及術(shù)前Harris評(píng)分等一般資料比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。結(jié)果兩組手術(shù)均順利完成。A組手術(shù)時(shí)間為(73.3±10.6)min,較B組(41.5±7.2)min明顯延長(zhǎng)(t=8.726,P=0.000)。術(shù)后切口均Ⅰ期愈合。A組術(shù)后2例出現(xiàn)牽引造成的暫時(shí)性坐骨神經(jīng)失用,其余患者均無(wú)相關(guān)并發(fā)癥發(fā)生。兩組患者均獲隨訪,A組隨訪時(shí)間24~52個(gè)月,平均39.3個(gè)月;B組隨訪時(shí)間24~48個(gè)月,平均34.6個(gè)月。末次隨訪時(shí),兩組Harris評(píng)分均較術(shù)前明顯提高(t= 10.327,P=0.001;t= 8.216,P=0.008);且A組評(píng)分高于B組(t= 4.247,P=0.029)。X線片復(fù)查示,隨訪期間A組FicatⅠ期1髖、Ⅱ期5髖發(fā)生股骨頭塌陷,手術(shù)總有效率為88.68%(47/53);B組FicatⅠ期4髖、Ⅱ期12髖發(fā)生股骨頭塌陷,手術(shù)總有效率為78.38%(58/74);兩組手術(shù)總有效率比較,差異有統(tǒng)計(jì)學(xué)意義(χ2=5.241,P=0.041)。兩組發(fā)生股骨頭塌陷患者均行人工髖關(guān)節(jié)置換術(shù)。結(jié)論小直徑多孔道髓芯減壓聯(lián)合髖關(guān)節(jié)鏡清理治療早期股骨頭缺血性壞死能有效緩解患者關(guān)節(jié)疼痛,改善關(guān)節(jié)功能,延緩股骨頭缺血性壞死進(jìn)程。
[Abstract]:Objective to investigate the effect of small diameter multiple channel core decompression combined with hip arthroscopy in the treatment of early avascular necrosis of femoral head by comparing with simple core decompression. Methods the clinical data of 91 patients with early avascular necrosis of femoral head admitted from March 2010 to December 2013 were retrospectively analyzed. Among them, 39 cases (53 hips) were treated with small diameter perforated core decompression combined with hip arthroscopy (group A), 52 cases (74 hips) were treated with small diameter multi-channel core decompression (group B). The patients in both groups had obvious hip pain and limited movement before operation. Gender, age, etiology, side, osteonecrosis stage and preoperative Harris score were not significantly different between the two groups (P0.05). Results the operation time of group A was (73.3 鹵10.6) min, longer than that of group B (41.5 鹵7.2) min. In group A, temporary sciatic nerve loss caused by traction was found in 2 cases, and no related complications occurred in other patients. The follow-up time was 24 ~ 52 months (mean 39.3 months) in group A and 34. 6 months in group B (24 ~ 48 months). At the last follow-up, the Harris scores in both groups were significantly higher than those before operation (t = 10.327g / kg, 0.001t = 8.216m / P0. 008). The score of group A was higher than that of group B (t = 4.247). X). During the follow-up period, 1 hip of Ficat stage 鈪，

本文編號(hào)：2407293