单侧穿刺介入治疗股骨头缺血性坏死

Clinical application of interventional therapy by unilateral puncture for ANFH

目的评价股骨头缺血坏死介入治疗的疗效及方法。方法对48例股骨头缺血坏死患者共70个股骨头采用seldinger技术单侧穿刺股动脉插管,造影观察血液供应情况后,超选择进入到股骨头营养血管如旋股内、外侧动脉,注入溶栓药物、扩血管药物及改善微循环药物,术后再次造影观察对比股骨头供血改变情况,并行治疗前后临床表现与影像学表现对比研究。结果治疗前后血管造影对照显示治疗后血管增多,股骨头染色增强,疼痛症状及关节功能明显改善,影像检查显示骨质不同程度修复。结论股骨头缺血坏死介入治疗是安全有效的方法,能改善重建股骨头局部微循环,促进修复。

Objective To evaluate the effect of avaseular necrosis of femoral head （ANFH） by interventional therapy. Methods Seventy femoral head in Forty eight patients of ANFH were applied with DSA by unilateral Seldinger＇s tech- nique. Thrombolytics, vasodilator and drugs improving microcirculation were injected directly into the feeding arteries of the femoral head. Clinical symptoms and imaging features were recorded and correlatively studied before and after opera- tion. Results After interventional therapy, the angiography showed the arteries supplying the femoral head increased, and the stain of the femoral head enhanced, with the pain released or disappeared, and the function improved. Various degrees of osseous repaired and new bone formation were indicated by imaging examination. Conclusion Interventional therapy is a safe and effective remedial method to ANFH, benefitting to the reconstruction of the local microcirculation and repair of the necrotic femoral head.