介入治疗股骨头缺血性坏死

Interventional Therapy for Avascular Necrosis of The Femoral Head

目的:评价应用导管技术介入治疗股骨头缺血性坏死的临床作用。方法:62例临床确诊的股骨头缺血性坏死患者,采用seIdinger’s技术,分别将导管头端选择性置入病侧旋股内、外动脉,经导管灌注血管解痉药、血管扩张药及溶栓药,其中17例1次介入治疗、45例重复治疗。本组全部病例分别经介入术后1- 24个月随访观察临床症状、改善情况并行疗效评价。结果:本组62例共84只股骨头经介入治疗后,疼痛完全缓解79．04％、明显缓解12．9％、部分缓解6．45％、未缓解1．61％。全部病例经X线平片、CT或MRI复查显示不同程度骨质修复,45例重复治疗者DSA检查显示股骨头供血动脉增粗,可见新生侧支小血管增多,股骨头较前染色变浓,以Ⅰ-Ⅲ期为著。结论:介入治疗股骨头缺血性坏死可改善局部血循环、促进骨质修复,是一种安全、微创、可重复且疗效显著的新疗法,值得在临床广泛应用。

Objective： To evaluate the clinical effects of Interventional therapy for avascular necrosis of the femoral head. Methods： 62 patients （43 males, 19 females, age range from 9 to 65 years; mean age 39.72 years） were treated by seldinger＇ s technique for the avascular necrosis of the femoral head,among them, I stage of AVN in 9, Ⅱ stage in 39, Ⅲ stage in 10, Ⅳ stage in 4. the head of catheter were placed respectively in medial artery circumflex femur, lateral artery circumflex femur, to perfuse antispasmodics, vasodilators and thrombolytis through catheter,once in 17,two and more in 45. the clinical effect were evaluated for 1-24 months in all the patients. Result：62 cases （84 femoral heads）were treated by interventional therapy, the alleviation completely of local pains were 79.04 %, the alleviation apparently are 12.9 %, the alleviation partly are 6.45 %, the not relieved are 1.61 %. the bone＇s repairing were showed in varying degrees by X - rays,CT or MRI in all cases, the arteries of femoral head were showed to become wide and new collateral blood vessels to become more in 45 patients with treatment again. Conclusion：Interventional treatment for avascular necrosis femoral head is safe and effective.