股骨头缺血坏死介入溶栓治疗

Interventional thrombolysic therapy of avascular necrosis in the femoral head

目的：评价介入溶栓治疗股骨头缺血坏死的临床应用价值。方法：采用Ｓｅｌｄｉｎｇｅｒ穿刺技术，经股动脉穿刺插管，直达旋股内、外动脉或闭孔动脉，先造影观察股骨头滋养动脉分布情况，然后再作介入溶栓治疗，共做１２０例１９０侧股骨头缺血坏死，其中３５例和６８例进行了２次和３次介入溶栓治疗。结果：治疗后，患侧髋关节疼痛、活动和行走改善率为９３．６８％、７５．５６％和６３％，ＦｉｅａｔⅠ、Ⅱ型患者疗效尤为显著，血管造影显示头上支、头下支和分支血管的开通率分别为８１．８２％、５８．８２％和８７．３７％。术后随访，开通血管仍保持血流通畅。结论：介入溶栓治疗具有创伤小、并发症低、血管开通率高，临床疗效显著，是治疗股骨头缺血坏死的有效方法，值得推广。

Objectives: To evaluate the clinical usefulness of interventional thrombolysic therapy for avascular necrosis of the femoral head. Methods: 120 cases with 190 avascular necrosis of femoral head were treated by interventional thrombolysic therapy. 35 cases were treated twice and 68 cases three times. Results: After the treatment, hip pain was alleviated in 93.68% of cases. Activity of joint and ability of walk were improved in 75.56% and 63% of cases. Therapeutic results in Ficat grade and were better than in Ficat grade and .Angiography demonstrated that superior branch and inferior branch in femorin medialin and their branch with stenosis or occlusion were opened respectively in 81.82%, 58.82% and 87.37%. Their branches were kept patency in 80 cases followed up by angiography in half a year after treatment. Conclusions: The results show that interventional thrombolysic therapy has an exact therapeutic effects for avascular necrosis of femoral head and is a simple