介入治疗股骨头缺血性坏死疗效分析(附38例报告)

Effects of interventional therapy for treating avascular necrosis of femoral head:38 cases report

目的评价介入治疗股骨头缺血性坏死(ANFH)的疗效。方法对38例ANFH的患者采用介入插管的方法,先常规行股骨头的供血动脉旋股内、外动脉和闭孔动脉造影,观察血液供应情况后,每支血管分别灌注溶栓并给予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,并于1～20个月摄X线平片或\和CT及MRI随访以评估疗效。结果术后血管造影显示所有患者股骨头区血管增多,股骨头染色增强。随访1～20个月(平均10.5个月)影像检查示股骨头缺血性坏死Ⅱ期以内的患者介入治疗后股骨头得以修复。临床症状明显改善。结论介入治疗ANFH是一种安全有效的治疗方法。

Objective To evaluate the clinical therapeutic effect of interventional therapy for treating avascular necrosis of femoral head. Methods Thirty eight patients with avascular necrosis of femoral head were subjected to interventional therapy. Firstly, angiography were performed in medial artery circumflex femur, lateral artery circumflex femur and obturator artery for comprehending the blood-supply of femoral head, and then throm- bolytic drug, vasodilators and antispasmodics were perfused through catheter respectively. Angiography was adopted by all patients after several days in order to compare blood-supply of femoral head with first procedure. The clinical effect were evaluated for 1 to 20 months by X-ray, CT or MRI. Results The arteries of femoral head were showed to become more in all patients with angiography again. The median survival time was 10.5 months with a range of 1 to 20 months. The bone＇s repairing were showed in patients within II stage by X-ray; CT or MRI, and all of them had symptomatic relief. Conclusions The interventional therapy is a safe and effective procedure for treating avascular necrosis of femoral head.