特发性股骨头缺血坏死的临床病理变化

目的:观察特发性股骨头缺血坏死(ANFH)的病理改变,根据病理特点提出临床治疗方法。方法:对34例特发性ANFH的股骨头,分别采用HE、脂肪、微血栓和弹力纤维染色,股骨头大切片、冰冻切片和石蜡切片方法,观察股骨头内各部位的坏死和修复情况,确定脂肪栓子和微血栓的形态和分布状态。结果:股骨头外上方呈"V"形坏死,与承重区负重力线相一致,坏死区周围有慢性炎细胞及新生骨小梁,脂肪组织增多,脂肪细胞肥大,血管中有大量脂肪栓子和微血栓。结论:脂肪栓塞和微血栓是AHFH重要病理改变,临床治疗中首先要减少或避免负重,并配合抗炎、降血脂和溶栓治疗。

Pathological changes of idiopathic avascular necrosis of femeral head

Objective: To observe the pathological changes in idiopathic avascular necrosis of the femeral head (ANFH) and guide clinical rehabilitative treatment according to pathological character. Methods: The necrosis and repair in different region of femoral heads were observed in 34 femoral heads with idiopathic ANFH by HE, fat, microthrombosis, elastic fiber dying of gross section, freezing section and wax section to discover the morphology and distribution of fat emboli and microthrombosis. Results: The V-shaped necrosis was observed in the outsidefemeral head. It was coincidence with the weight line of the weight-bearing area. Around necrosis zone there were chronic inflammatory cells, newly formed trabecula and large amount of hypertrophy fat cells. There was large amount of fat emboli and microthrombosis in blood vessels. Conclusion: Fat emboli and microthrombosis were important pathological changes of ANFH. In clinical treatment. the best way is to decrease and avoid the weight loading.Meanwhile, anti-inflammatory ageuts,decrease of blood adipose and thrombolytic drugs are also necessary.