髓芯减压植骨干细胞移植联合中药治疗股骨头坏死

Treatment of femoral head necrosis by core decompression and stem cells transplantation combined with Traditional Chinese Medicine

目的 探讨髓芯减压植骨自体骨髓干细胞移植联合中药治疗股骨头坏死（ANFH）的的疗效.方法 股骨头坏死患者30例按治疗方法不同分为三组：髓芯减压植骨组（A组）10例,12髋;髓芯减压自体骨髓干细胞移植组（B组）10例,13髋;髓芯减压自体骨髓干细胞移植联合中药组（C组）10例,10髋.观察三组X线平片、CT及M砌检查、Harris评分（HHS）、疗效.结果 三组接受治疗的Ⅰ、Ⅱ、Ⅲ期病例,3、6、12个月未出现股骨头变形及塌陷等病情恶化;术后12个月Harriss评分为93分明显高于术前57.5分（X2=5.81,P〈0.05）;术前MRI检查,测量低信号区所占股骨头体积比为42%.术后股骨头坏死区消失;B、C组总有效率高于A组（X2=3.81,X2=3.98,均P〈0.05）.结论髓芯减压植骨自体骨髓干细胞移植联合中药治疗股骨头坏死具有损伤小、简便、准确、有效的优点.

Objective To study curative effect of core decompression and autologous bone marrow stem cell transplantation combined with traditional Chinese medicine in the treatment of early femoral head necrosis （ANFH）.Methods 30 patients with femoral head necrosis treated by different methods were divided into 3 groups： core decompression A group） 10 cases（12 hips） ;core decompression pus stem cells transplantation（B group） 10 cases（13 hips） ;core decompression pus stem cells transplantation combined with traditional Chinese medicine（C group） 10 ca-ses（ 10 hips） ;The X-ray 、CT MRI、Harris score（ HHS） .curative effect were observed.Results The phase of Ⅰ,Ⅱ,Ⅲ,in 3 groups didn＇t appear deformation and collapse at 3,6,12 months;The score of Harris after 12 months 93 points were higher than that preoperatively 57.5 points（χ 2= 5.81 ,P〈0.05） ;The signal ratio of femoral head volume in MRI was 42% before treatment,disappearance of femoral head necrosis after treatment;Total curative effect of B,C group,werehighter than that Agroup（χ2 =3.81,χ2 =3.98,P〈0.05）.Conclusion The operative treatment of ANFH with core decompression and stem cells transplantation combined with traditional Chinese medicine had the advantage of minimal damage,simplicity,accuracy,and effectiveness.