【摘要】：目的:回顧性研究2006-2010年接受活血生骨湯聯(lián)合異體腓骨支撐術(shù)及單純異體腓骨支撐術(shù)治療的240例股骨頭壞死患者的臨床病例資料,對比分析兩種治療方法的臨床效果。方法:將股骨頭壞死病例分為兩組。治療組131例(138髖),口服活血生骨湯聯(lián)合異體腓骨支撐術(shù)治療,活血生骨湯為院內(nèi)自制湯劑,連續(xù)服用6月以上;對照組109例(118髖),單純采用異體腓骨支撐術(shù)治療。兩組病例隨訪12-72個(gè)月。術(shù)前及術(shù)后進(jìn)行Harris評分,分析兩組患者的Harris評分、優(yōu)良率及X片表現(xiàn)。結(jié)果:1.Harris評分兩組病例Harris總分較術(shù)前均有顯著改善,所有患者Harris總分由術(shù)前(67.88±8.76)分提高至術(shù)后(86.12± 11.45)分,平均提高18分(P0.05),具有統(tǒng)計(jì)學(xué)意義;治療組Harris總分由術(shù)前(67.91 ±8.92)提高至術(shù)后(88.34±9.86),對照組Harris總分由術(shù)前(67.87±8.92)提高至術(shù)后(83.47±10.36),兩組相比較具有統(tǒng)計(jì)學(xué)意義(t=6.461,P0.05);2.優(yōu)良率治療組優(yōu)良率為87.77%,對照組優(yōu)良率為73.72%,兩組病例末次隨訪時(shí)Harris評分優(yōu)良率比較具有統(tǒng)計(jì)學(xué)意義(z=3.5257,P=0.01350.05);3.X片表現(xiàn):治療組ⅡA、ⅡB、ⅡC、ⅢA、ⅢB、ⅢC的病例股骨頭形態(tài)改善率分別為 93.32%、90.45%、87.30%、72.46%、61.32%、23.52%;對照組 ⅡA、ⅡB、ⅡC、ⅢA、ⅢB、ⅢC 股骨頭形態(tài)改善率分別為 92.45%、83.64%、81.13%、67.12%、60.88%、24.67%。兩組比較ⅡB(χ2=4.637,P0.05)、ⅡC(χ2=4.025,P0.05)、ⅢA(χ2=3.889,P0.05)均有統(tǒng)計(jì)學(xué)意義,而ⅡA(χ2=1.025,P0.05)、ⅢB(χ2=0.925,P0.05)、ⅢC(χ2=0.450,P0.05)無統(tǒng)計(jì)學(xué)意義,其中ⅢC的失敗率為 63.63%,最終28髖行人工關(guān)節(jié)置換。結(jié)論:活血生骨湯聯(lián)合異體腓骨支撐術(shù)治療早、中期股骨頭壞死療效確切;活血生骨湯具有消腫止痛、活血化瘀、補(bǔ)益肝腎的功效;活血生骨湯短期內(nèi)具有促進(jìn)骨生長、緩解癥狀、改善髖關(guān)節(jié)功能作用;活血生骨湯聯(lián)合異體腓骨支撐術(shù)治療效果優(yōu)于單純采用異體腓骨支撐術(shù),可以提高保髖成功率,中、遠(yuǎn)期療效好。
[Abstract]:Aim: to retrospectively study the clinical data of 240 cases of osteonecrosis of femoral head treated with Huoxue Shenggu decoction combined with allogeneic fibula support and allogeneic fibula support from 2006 to 2010. Methods: cases of osteonecrosis of femoral head were divided into two groups. 131 cases (138 hips) in the treatment group were treated by oral administration of Huoxue Shenggu decoction combined with allogeneic fibula support, which were treated with Huoxue Shenggu decoction for more than 6 months, while 109 cases (118 hips) in the control group were treated with allogeneic fibula support alone. The patients in both groups were followed up for 12 months and 72 months. Harris score was performed before and after operation. The Harris score, excellent and good rate and X-ray findings were analyzed. Results: the total score of Harris in both groups was improved significantly. The total score of Harris in all patients increased from (67.88 鹵8.76) before operation to (86.12 鹵11.45) after operation, with an average increase of 18 points (P0.05). It has statistical significance; The total score of Harris increased from (67.91 鹵8.92) to (88.34 鹵9.86) in the treatment group and from (67.87 鹵8.92) to (83.47 鹵10.36) in the control group. There was significant difference between the two groups (t = 6.461, P < 0.01). (P 0.05); 2. The excellent and good rate was 87.77% in the treatment group and 73.72% in the control group. There was significant difference in the excellent and good rate of Harris score between the two groups at the last follow-up (z = 3.5257, P < 0.01350.05). 3. X-ray manifestations: the improvement rate of femoral head shape was 93.32%, 90.45%, 87.30%, 72.46%, 61.32%, 23.52% in treatment group 鈪，

本文編號：2444073