髓心减压并自体骨髓干细胞移植治疗创伤性股骨头坏死

目的观察髓心减压并自体骨髓干细胞移植治疗股骨头坏死的临床效果。方法9例股骨头坏死患者经骨髓干细胞动员后，第2天进行骨髓干细胞采集，经髓心减压后，将干细胞悬液缓慢匀速注入。干细胞移植后随访观察患者髋关节疼痛程度、性质及持续时间变化，5个月后行股骨头供血动脉造影术观察股骨头血供情况。结果9例患者随访10个月，髋关节疼痛有不同程度缓解，关节功能改善。干细胞移植5个月后，9例患者股骨头供血动脉数字减影血管造影严查，均显示旋股内动脉及闭孔动脉管径增粗，新生血管增多，血流速度增快，股骨头血液供应明显改善。治疗中均为发生严重的并发症和不良反应。结论干细胞移植治疗股骨头坏死方法简单，安全有效，适合Ⅰ-Ⅲ期早、中期股骨头坏死患者。

Treatment of avascular necrosis of femoral head by medullary core decompression and autograft bone marrow stem cells

Objective To investigate the curative effects of medullary core decompression and autologous bone marrow stem cells transplantation in treatment of avascular necrosis of femoral head （ANFH）. Methods Nine patients of avascular necrosis of femoral head were mobilized by rhG - CSF to get bone marrow stem cells. Bone marrow were collected on the nest day, then medullary core decompression, and the stem cells suspension was injected. After transplantation, all the patients were followed up to observe the degree, property and duration of coxa joint pain. After 5 months arteriography of femoral head was carried out. Results Totally 9 patients were involved in the result analysis. Follow - up was performed for 10 months. The coxa joint pain were remissioned and the quality of life was improved. After 5 months ,9 patients had arteriography of femoral head. The caliber of the arteria circumflexa femoris medialis, laterlis and arteria obturateria were thickening,new vessels grew more and blood flow rate became faster. Conclusions The operative treatment of avascular necrosis of femoral head under medullary core decompression and sutologous bone marrow stem cell transplantation has the advantages of light damage, simplicity and effectiveness.