直接穿刺介入治疗激素性股骨头坏死的实验研究

目的　评价直接穿刺介入治疗股骨头坏死的可行性。方法　采用实验大白兔 2 4只 ,体重3.5kg ,随机分成 3组 ,A组为对照组 ;B、C两组做成激素性股骨头无菌性坏死模型 ,其中B组行直接穿刺介入治疗。直接穿刺介入治疗是将溶栓药物、改善微循环药物及骨质修复药物直接注入股骨头内 ,观察坏死股骨头的修复情况。显微镜观察包括空缺的骨陷窝数量、骨髓内脂肪细胞数量和直径、软骨下区血管数量。对 3组作统计学分析。结果　大体所见A、B、C 3组股骨头均完整 ,A组骨质坚硬 ,切开阻力大 ,但C组骨质松软 ,冠状面切开阻力很小 ,B组介于A、C两组之间。镜下显示A组空缺骨陷窝数、骨髓内脂肪细胞直径、软骨下区血管数量正常 ;B组接近A组水平 (P >0 .0 5 ) ;C组明显异常 ,与A组比较差异有显著性 (P <0 .0 5 )。结论　直接穿刺介入治疗法为临床治疗股骨头坏死打下了坚实的理论基础。

An experimental study of interventional therapy by direct puncture for the treatment of hormone-induced necrosis of femoral head

Objective To evaluate the clinical efficacy of interventional therapy by direct puncture for the treatment of avascular necrosis of the femoral head. Methods 24 experimental rabbits were undertaken and divided randomly into 3 groups, B, C groups as the models of hormone induced necrosis of femoral head, and A group as the control one. B group was followed up later with interventional therapy by direct puncture. Thromolytic agents, drugs improving microcirculation, and repairing bone tissue were infused directly into the femoral head; and then microscopic observations were conducted to study the pathology. Results The results showed: in group B, the number of vacant bony lacunae in femoral head, the average diameter of fat cells in marrow cavity and the number of blood vessel in subchondral areas showed significant improvement, approaching group A. Conclusions Treatment of femoral head necrosis through interventional method of direct puncture has commenced a solid foundation for clinical therapy.