| 髓芯减压钽棒植入治疗成人早期股骨头坏死的疗效观察 |
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| 引用本文： | 吴敏,官建中,肖玉周,周新社,张长春,王远松,王照东. 髓芯减压钽棒植入治疗成人早期股骨头坏死的疗效观察[J]. 中华全科医学, 2016, 14(8): 1259. DOI: 10.16766/j.cnki.issn.1674-4152.2016.08.005 |
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| 作者姓名： | 吴敏 官建中 肖玉周 周新社 张长春 王远松 王照东 |
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| 作者单位： | 蚌埠医学院第一附属医院骨科, 安徽 蚌埠 233004 |
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| 基金项目： | 安徽省高校省级自然科学研究重点项目(KJ2016-A870) |
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| 摘 要： | 目的 探讨髓芯减压多孔钽棒植入治疗成人早期股骨头坏死的临床效果。 方法 采用髓芯减压多孔钽棒植入治疗成人早期股骨头坏死20例(23髋)，男性16例(18髋)，女性4例(5髋)；年龄24～60岁，平均38.2岁。依照国际骨循环研究学会骨坏死分期:ⅠB期2髋，ⅠC期1髋，ⅡA期8髋，ⅡB期9髋，ⅡC期3髋。随访时以Harris评分、影像学检查及关节生存率作为疗效评价指标。 结果 手术时间20～55 min，平均30 min；术中失血30～110 ml，平均60 ml。20例患者均获得随访，随访时间17～45个月，平均33.2个月。末次随访时Harris评分(85.4±6.8)分，与手术前(56.6±7.0)分比较差异有统计学意义(t=-43.009，P＜0.001)。以人工全髋关节置换为终点，末次随访时关节生存率为95.65％。影像学显示术后1例伴有干燥综合征长期服用激素患者术后9个月进展至Ⅳ期，其余病例没有出现股骨头囊变区扩大或头塌陷。 结论 髓芯减压多孔钽棒植入术具有简便、微创、安全、并发症少及术后患髋功能恢复良好等优点，是治疗成人早期股骨头坏死的有效方法。
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| 关 键 词： | 股骨头坏死 钽棒 减压 |
| 收稿时间： | 2016-04-18 |
Effectiveness of porous tantalum implant combined with core decompression on adult early avascular necrosis of femoral head |
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| Affiliation: | Department of Orthopaedics,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China |
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| Abstract: | Objective To evaluate the curative effectiveness of porous tantalum implant combined with core decompression in the treatment of adult early avascular necrosis of femoral head(ANFH). Methods The 23 hips of 20 patients,including 16 males(18 hips) and 4 females(5 hips),aged from 24 to 60 years old(averaged 38. 2),with femur head necrosis were treated with porous tantalum implant combined with core decompression. According to the Association Research Circulation Osteous(ARCO) classification,2,1,8,9 and 3 hips were in stage ⅠB,ⅠC,ⅡA,ⅡB and ⅡC. Harris score was average 56. 6 ±7. 0 preoperatively. The outcome measures included Harris Hip Score,radiographic outcome,and survivorship analysis with reversion to THA. Results There were 20 successful surgical procedures,with a mean operative time of 30 min(range 20- 55 min) and an average blood loss of 60 ml(ranged from 30 to 110 ml). These cases acquired follow-up,the meaning follow-up duration was 33. 2 months(17- 45 months). Harris score was average 85. 4 ±6. 8 postoperatively. As total hip arthroplasty for the endpoint,the femoral head survival rate was 95. 65%. One hip who had a hormone-using history had aggravated to femoral head collapse as stage Ⅳ,no aggravation in collapse and necrosis in other cases were found by X ray examination. Conclusion The porous tantalum implant combined with core decompression in the treatment of adult early femur head necrosis can achieve a good clinical result. The operation has the advantages of more convenient operation,minimally invasive,safe,less complications,and better hip functional recovery. It is an effective method for adult early ANFH. |
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