医用臭氧为主联合中药治疗骨股头坏死的临床观察

The Clinical Observation on the Treatment of Avascular Necrosis of Femoral Head with Comprehensive Therapy Dominated by Medical Ozone

目的探讨医用臭氧为主，辅以中药综合疗法治疗股骨头坏死的临床疗效。方法行髋关节腔阻滞，注入消炎镇痛液后观察5～10min，患者无异常反映，则用10ml的注射空针把空针乳头插入臭氧治疗仪的出气嘴，稍用力下按，臭氧顶起针栓自动进入空针，达到所需量后迅速拔出针乳头，用带冒针头快速盖住乳头，尽快向关节腔注入浓度为30％的医用臭氧8～10ml。注射后被动活动髋关节，促进药物扩散。在关节注射腔进针处，针刀的刀刃平行于神经、血管走向刺入皮肤直达关节腔，将关节囊前壁切2～3刀，以降低关节腔内压力，减压后再配合中药治疗。按照ANFH评价标准进行疗效评价。结果①135例的183个髋关节中，优20．77％（38／183）、良48．09％（881183）、可16．94％（31／183）、差14．21％（26／183），总有效率为85．79％（157／183）。②ANFH分期Ⅰ＋Ⅱ期为99．02％（101／102）、Ⅲ期为81．82％（45／55）。经Ficat分析，治疗后疗效显著（x^2=94．88，P〈0．05）。（3）Ficat法分期评价：Ⅰ期患者9髋，X线平片较难诊断，需结合MRI及ECT检查。Ⅱ期93髋、Ⅲ期56髓、Ⅳ期25髋，X线诊断较容易。结论医用臭氧为主的综合疗法治疗股骨头坏死临床疗效明显。

Objective To investigate the clinical effect of treating avascular necrosis of femoral head with comprehensive therapy dominated by medical ozone. Methods Joint cavity of femoral articulation was performed blockage and injected with fluids for eliminating inflammation and reliving pain. After 5 to 10 minutes interval, if the patients did not show any abnormal reaction, medical Ozone with the concentration of 30%, 8 to 10ml, was injected to the joint cavity. Meanwhile, needle-knife therapy was used to reduce pressure inside the cavity. Traditional Chinese medicine was also used for the treatment. Results of all 183 femoral articulations of 135 cases, the therapeutic result of 38 articulations perfect, occupying 20.8% （38/183）, 88 were good, occupying 48.1%（88/183）, 31 were normal, occupying 16.9%（31/183） and 26 were bad, occupying 14.2% （26/183）.The total effective rate was 85.8% （157/183）. Conclusion The treatment of avascular necrosis of femoral head with comprehensive therapy dominated by medical ozone had outstanding therapeutic effects.