股骨头缺血性坏死药物持续灌注的介入治疗

Research on medications persistent perfusion interventional radiology therapy in avascular necrosis of femoral head

目的观察经股骨头供血动脉留管持续72h药物灌注治疗股骨头缺血性坏死的临床疗效。方法32例51个缺血性坏死股骨头（治疗组）均经临床及影像学证实。采用改良Seldinger穿刺技术经股动脉穿刺。先将导管置于髂内动脉药物灌注后。再置导管于髂外动脉的股骨头主要供血动脉内留置，持续72h药物灌注。灌注完毕后。用高压注射器经导管造影，了解股骨头血供情况。30例43个缺血性坏死股骨头采取保守治疗（对照组）。结果治疗组治疗后疼痛缓解率为83．33％。活动及行走功能改善率分别为78．12％、62．54％。与对照组比较x^2值分别为9．18、10．32、6．37，P均〈0．05。结论股骨头缺血性坏死药物持续灌注介入治疗具有创伤小、迅速减轻或解除疼痛、相当程度恢复髋关节功能等优点，远期可见股骨头坏死区域骨小梁重建，适用于治疗股骨头缺血性坏死的各期病变。

Objective To observe the clinical curative effect of medications persistent perfusion interventional radiology therapy in avasculax necrosis of femoral head （ANFH）. Methods Thirty-two cases with 51 avascular necrosis head of femur（ANFH group） were diagnosed by clinical and images. The catheter was inserted and remained in the internal iliae artery by the improved Seldinger puncture method from femoral artery. After persistent medications perfusion of 72 hours, artefiography was performed to make sure the conditions of the head of femur in blood feeding. Another 30 cases with 43 avascular necrosis head of femur with conservative treatment were as control. Results 83.33% patients felt pain relaxed in ANFH group, 78.12% of the cases had movement improved; 62.54% patients walking better. Compared with the control group, x^2was 9.18, 10.32 and 6.37 respectively,there were significant difference between them （P〈0. 05）. Conclusion This method to treat ANFH has the advantage of little hurt, pain relieve fast, and adapts to all stages of ANFH.