股骨头缺血坏死介入治疗及近期疗效

Interventional therapy in the treatment of avascular necrosis of femoral head and short-term efficacy

目的:探讨介入性治疗股骨头缺血坏死的近期疗效。方法:自2006年至2008年,对28例(男19例,女9例,年龄14～70岁,平均38岁)股骨头缺血坏死患者采用介入插管的方法,超选择进入到股骨头营养血管旋股内外侧动脉和闭孔动脉,造影观察其血液供给情况后,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;治疗后12～36个月摄X线片观察股骨头骨密度改变情况;并分析其临床症状(疼痛及关节活动度)的改变情况。结果:28例患者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,12～36个月后X线片显示病骨密度和形态逐渐恢复或接近正常者占97.2%(35/36),患髋疼痛程度及关节活动度临床症状明显改善。结论:介入方法治疗股骨头缺血坏死是一种简便、无痛苦、安全、疗效可靠的治疗方法,能在临床上广泛应用。

Objective：To evaluate the clinical effect of avascular necrosis of femoral head（ANFH） with interventional therapy in the near future. Methods：Twenty eight patients （19 males,9 females,the age was from 14 to 70 years old with an average of 38 years） with ANFH were treated by catheterization. The thrombolytic drugs,vasodilator drugs and improving microirculative drugs were respectively injected directly into the arteries supplying the femoral head after ultraselection. Contrasted the changing of the arteries suppplying the femoral head between pretreatment and posttreatment,and observed the bone density of the femoral head at 12-36 months after treatment,and analyzed clinical symptoms （hip pain and joint range of motion） improving. Results： The angiography showed the arteries supplying the femoral head were manifold,the coloration or the femoral head were enhanced after interventional therapy. The X-ray showed the bone density of the femoral head gradually recovered of nearly common by 97.2%（35 / 36）. And hip pain and joint range of motion significantly improved than that of before treatment. Conclusion：Interventiomal therapy is a safe and effective method to ANFH,which seems to be promising for wide clinical application.