股骨头供血动脉发育变异或异常致成人股骨头缺血坏死的研究

The Study on Avascular Necrosis of Femoral Head of Adult Caused by Variation or Anomaly of Supplying Artery

目的:提高对成人股骨头缺血坏死病因诊断及临床诊断的认识。方法:选择经临床和影像检查确诊并经介入治疗的58例76个缺血坏死股骨头的血管造影资料,并与25例25个正常股骨头血管造影资料对照分析。结果:治疗组股骨头供血动脉发育变异31 例 41 支血管(53.9%),其中髂内动脉壁支变异 11 支(26.8%),旋股内侧动脉变异 26 支(63.4%),旋股外侧动脉4支(9.8%)。对照组股骨头供血动脉发育异常 3 例 3 支,两组比较差异有显著性意义(P<0.05)。结论:对本组患者发病原因及病史调查,除外病因,股骨头供血动脉发育变异是造成股骨头缺血坏死的一重要因素,在诊断及治疗中应予重视。

Objective:To improve the diagnosis and to obtain better understanding of avascular necrosis of femoral head (ANFH).Methods:Angiography of 58 patients including 76 ANFH proved clinically and radiologically were studied.The results were compared with those of the 25 normal cases.Results:The variation of feeding artery of femoral head in ANFH and interventional treatment group was seen in 31 cases.There were variations of internal iliac artery in 11 cases (26.8%), variation of medial femoral circumflex artery in 26 cases (63.4%),variation of lateral femoral circumflex artery in 4 cases (9.8%),respectively.The arterial variation of femoral head in control group was found in 3 cases.There was significant difference between the two groups (P<0.005).Conclusion:In addition to the inherent known pathogenesis,variation of the corresponding artery is one of important factors that lead to avascular necrosis of femoral head.We should pay attention to it in diagnosis and treatment.