介入法治疗股骨头缺血坏死20例

Interventional therapy for avascular necrosis of femur head:report of 20 cases

目的:探讨介入法治疗股骨头缺血性坏死(avascular necrosis of femur head,ANFH)的临床应用价值。方法:20例ANFH患者,全部病例均经X线、CT及MRI检查证实。经股动脉行Seldinger法穿刺插管,先行血管造影,再将导管超选择至病变股骨头供血动脉,灌注一定量溶栓及扩血管药物行介入治疗,术后血管造影观察病变股骨头供血情况,1周后所有病例行第2次介入治疗,方法同前,并随访临床疗效。结果:术后血管造影示股骨头供血动脉均不同程度增粗、增多,血供较术前丰富;随访发现患者关节疼痛缓解率达95%。结论:介入法是治疗ANFH的有效手段,具有重要的临床应用价值。

Objective：To explore the clinical value of interventional therapy for avaseular necrosis of femur head. Methods：The clinical data of 20 patients with avaseular necrosis of femur head confirmed by X-ray, CT and MRI were analyzed retrospeetively. Seldinger＇s technique was applied for angiography to detect the feeding arteries of the necrotic femur head. Thrombolytics and drugs for dilatating arteries were used in the interventional therapy. The blood supply of the femur head was observed by angiography after the therapy. All the patients received interventional therapy for the second time one week later with the same therapy as before. The effects were evaluated in the follow-up. Results ： The feeding arteries of the treated femur head were getting thicker, and the blood supplies became richer and inereased in number. The pain in joint was released by 95%. Conclusions： Interventional therapy is effective for treatment of avaseular necrosis of femur head,and is of a great value in clinical application.