钻孔减压植骨加中药治疗激素性股骨头缺血坏死的临床观察

DRILLING-DECOMPRESSION BONE GRAFTING AND TRADITIONAL CHINESE MEDICINE IN TREATING HORMONAL ISCHEMIC NECROSIS OF FEMORAL HEAD

目的观察钻孔减压植骨加中药治疗激素性股骨头缺血坏死的疗效。方法对90例(110髋)激素性股骨头缺血性坏死患者(治疗组),采用经粗隆下钻孔减压并植入松质骨,配合口服生新复原丸,外敷丁香骨活散进行治疗,并与90例(108髋)单纯采用经粗隆下细科氏针钻孔减压治疗(对照组)的疗效进行对比。结果以症状改善和无放射学恶变为成功评价点,治疗组90例中,Ficat1期78髋,成功率92%,Ficat 2期32髋,成功率79%,总成功率88%。对照组90例,Ficat 1期84髋,成功率65%,Ficat 2期24髋,成功率40%,总成功率54%。两组总成功率比较有显著性意义(P<0.05)。结论采用髓心减压,配合中药内服加外敷等综合疗法治疗早期股骨头坏死,具有费用低,近、远期效果好,病人易于接受等优点,值得临床推广。

Objective To observe the curative effect of drilling-decompression bone grafting and traditional Chinese medicine on hormonal ischemic necrosis of femoral head. Methods 110 hips in 90 cases were treabed with drilling-decompression cancellous bone grafting under tuberosity, oral administration of shengxinfuyuan pills and the application of Flos Caryophylli guhuosan. 108 hips in 90 cases were treated only with drilling decompression. The therapeutic effects of the two mothods were compared. Results According to evaluation system of improvement of symptoms and no radiological canceration, of the 90 cases in the treatment group, the curative effect was 92%（78 hips） in Ficat stage I and 79% （32 hips）in Ficat Stage Ⅱ respectively. The total curative rate was 88%. Of the 90 cases in the contrast group, the curative effect was 65 % （84 hips） in Ficat Stage I , and 40% （24 hips ）in Ficat Stage 11. The total curative rate was 54 %. There existed significant difference between the two groups（ P 〈0.05）. Conclusion The drilling-decompression bone grafting and the use of traditional chinese medicine deserves to be the widely used for its low cost and good short and middle term effects.