髓芯减压术治疗早中期成人股骨头缺血性坏死*

[摘要]对髓芯减压术治疗成人早中期股骨头缺血性坏死（avascular necrosis of femoralhead, ANFH）的方法进行综述。查阅、总结国内外学者关于髓芯减压术（core decompression, CD）治疗早中期成人股骨头缺血性坏死的研究报告，可见细通道减压创伤小，出血少，术后卧床时间短，恢复快；大孔径单通道减压术股骨头骨折风险明显增加；对早中期的ANFH的治疗，细孔径多通道髓芯减压加骨移植加骨形态发生蛋白（BMP），或者自体骨髓干细胞注入或许效果更优。在多孔细通道CD基础上进行细胞植入，自体或异体骨加BMP植入，联合应用骨髓间质干细胞（BMSCs）植入，联合应用阿托伐他汀，双磷酸盐，甚至应用动脉插管介入治疗方法注射扩血管药、溶栓药治疗ANFH；形成以多孔细通道CD为基础的多种治疗方法联合应用的综合治疗趋势；特别是在CD基础上，应用中医药治疗方法的报告也逐年增加，值得关注。

Core decompression for adults' avascular necrosis of femoral head in early-to-mid stage

[Abstract] Review of treating early and mid-adult avascular necrosis of core decompression. Summary of domestic and foreign scholars on core decompression treatment early and mid-adult avascular necrosis of the research report: fine channel decompression has advantages of Less invasive, less bleeding, postoperative bed time is short, quick recovery; Large aperture single-channel decompression surgery significantly increased risk of fractures of the femoral head; For the treatment of early and mid-ANFH pore diameter multi-channel core decompression and bone grafting and BMP, or autologous bone marrow stem cells into effect perhaps better. Porous fine passage on the basis of core decompression cell implantation, autologous or allogeneic bone plus BMP implantation combined BMSCs implantation, the combination of atorvastatin, bisphosphonates, and even application artery interventional therapy injection vasodilators, thrombolytic drug treatment ANFH; Tendency to form a comprehensive treatment of the porous fine variety of core decompression channel based combination therapy applications; especially in the core decompression, based on the application of methods of treatment reports chinese medicine has been increasing concern