手术联合复方仙灵骨葆胶囊治疗非创伤性股骨头坏死头的疗效观察

目的:观察头颈部开窗病灶清除打压植骨术联合口服复方仙灵骨葆胶囊治疗非创伤性股骨头坏死的疗效。方法:选取2017年9月至2018年3月中日友好医院住院诊治的非创伤性股骨头坏死患者46例(79髋)作为研究对象,按照回顾性资料分为观察组(n=20)和对照组(n=26)。观察组采用头颈部开窗病灶清除打压植骨术联合口服复方仙灵骨葆胶囊治疗,对照组仅行头颈部开窗病灶清除打压植骨术。随访12~20个月,临床疗效评价采用Harris髋关节评分(Harris Hip Score,HHS),手术前和随访的X线和CT资料行影像学评价。结果:HHS为优、良的髋关节分别为25髋和20髋,2组股骨头生存率分别为:75.0%和64.1%,分期为ARCOⅡb、Ⅱc髋关节的优良率分别为100%和77.8%,而ARCOⅢa期髋关节的优良率为26.9%(P<0.05)。观察组HHS、影像学表现优于对照组,2组比较差异有统计学意义(P<0.05)。结论:头颈部开窗病灶清除打压植骨术联合口服复方仙灵骨葆胶囊治疗非创伤性股骨头坏死,能促进坏死骨修复,提高临床疗效。

Efficacy Observation on Operation Combined with Compound Xianling Gubao Capsules in the Treatment of Non-traumatic Osteonecrosis of Femoral Head

Objective:To observe efficacy of impacted bone grafting through windowing at the femoral head-neck junction and focus debridement combine with Compound Xianling Gubao Capsules in the treatment of non-traumatic osteonecrosis of femoral head(NONFH).Methods:Radiological data of 46 patients(79 hips)with NONFH admitted in China-Japan Friendship Hospital between September 2017 and March 2018 were selected as study objects and retrospectively reviewed.Those treated with impacted bone grafting through windowing at the femoral head-neck junction and focus debridement combine with Compound Xianling Gubao Capsules were considered as observation group,while those only treated with impacted bone grafting through windowing at the femoral head-neck junction and focus debridement were considered as control group.The followed-up lasted for 12 months to 20 months.The clinical efficacy was evaluated by Harris Hip Score(HHS).Pre-operation and follow-up X-ray and CT data were used for radiological evaluation.Results:According to the HHS,excellent or good results were 25 hips and 20 hips,respectively.In the 2 groups,survival rates of femoral head were 75.0%and 64.1%,respectively.The survival rate of femoral head was 100.0%and 77.8%of ARCOⅡb andⅡc stage,and 26.9%of ARCOⅢa(P<0.05).Compared with the control group,the observation group had HHS and radiological results,with statistically significant difference(P<0.05).Conclusion:Impacted bone grafting through windowing at the femoral head-neck junction and focus debridement combined with Compound Xianling Gubao Capsules can promote the repair of necrotic bone and improve the clinical efficacy in the treatment of NONFH.