282例患者住院治疗股骨头坏死相关因素的分析

目的探讨非创伤性股骨头坏死的临床流行病学以及股骨头坏死发生的相关危险因素、治疗，以期对我国股骨头坏死发病及治疗现状进行分析，提高股骨头坏死早期筛查、诊断及治疗整体水平。方法设计相关调查表格，对2010年1月至2010年12月间入住四川大学华西医院骨科的282例股骨头坏死患者进行相关因素调查，包括一般情况，危险因素及诊断、治疗情况。在此基础上，对上述因素进行分析、总结。结果期间共收治非创伤性股骨头坏死患者282例，其中男210例，女72例，年龄19—80岁，平均42．6岁。股骨头坏死相关危险因素分析，激素性股骨头坏死50例，平均激素（强的松）摄入10mg／d，平均持续4年；酒精性股骨头坏死202例，平均酒精摄入量2413ml／周，饮酒时间平均20年。双侧发病142例（50．5％）。初次诊断股骨头坏死分期，FicatⅠ期17髋占4％，Ⅱ期79髋占18％，Ⅲ期123髋占29％，Ⅳ期215髋，占49％。双侧同时发生股骨头坏死142例占50．5％。78例（28％）患者既往曾接受过药物治疗；其中27例（27髋）为无症状股骨头坏死。结论四川地区股骨头坏死男：女为2．92：1；发病年龄在42．6岁。酒精摄入和大剂量糖皮质激素的应用是诱发股骨头坏死的主要原因。除关节置换术外，股骨头髓芯钻孔减压术是最常采用的保留股骨头的外科治疗措施。此股骨头坏死临床流行病学及相关研究分析，将对更好的认识我国股骨头坏死发病情况疾病因研究，对股骨头坏死早期预防、诊断和治疗提供可靠的数据和依据。

Prevalence and relative factors analysis of non-traumatic osteonecrosis of femoral head in 282 cases

Objective To analyse the prevalence, relative factors and the clinical features of the non-traumatic osteonecrosis of the femoral head （ONFH） and analyse the characteristics of the Chinese patients with osteonecrosis of the femoral head. Methods 282 patients were diagnosed as non-traumatic osteonecrosis of the femoral head and admitted to the West China Hospital of Sichuan University during Jan 2010 to Dec 2010. The medical data were collected. The prevalence, etiology and clinical features were analyzed. Results The average age of the 282 patients （201 males and 72 femals ） was 42. 6 years old; the bilateral incidence was 50. 5% （ 142 cases）. There were 202 cases （72%） with a history of alcohol abuse, 50 cases （18%） with a history of steroid use, and 30 cases of unknown causes. Before the patients were admitted to this hospital, 78 cases （28%） had received conservative treatment, including the herbal medicine, acupuncture and moxibustion. Conclusion The ratio of male and female was 2. 92：1 in Sichuan province and the average age of patients is 42. 6 years old. The non-traumatic ONFH mainly occurs in young people; the male incidence is higher than the female. The most frequently observed risk factor for ONFH is alcohol abuse in China. The most frequently performed joint-preserving procedure is coredecompression for Ficat stage Ⅰ and Ⅱ; yet the main procedure for Ficat stage Ⅲ and Ⅳ is hip arthroplasty. It is believed that the results may serve as an important baseline for understanding the disease.