股骨头圆韧带动脉血供的相关研究

Related Research on Round Ligament Artery Blood Supply of Femoral Head

目的：评测股骨颈骨折后股骨头圆韧带动脉血供情况,探讨其临床治疗方法,为可以采用闭合复位内固定保留股骨头治疗股骨颈骨折取得理论依据.方法：70例行人工髋关节置换术的患者,按年龄分为A、B、C 3组,A组＜60岁（21例）,B组为60～70岁（26例）,C组＞70岁（23例）.断头取出后,肉眼直视下观察干净纱布擦拭前后髋臼窝圆韧带动脉的出血情况.术后切除的圆韧带送病理检查,横断圆韧带制作病理切片观察圆韧带动脉通畅情况.结果：70例观察对象,干净纱布擦拭前可见圆韧带动脉出血而擦拭后仍有出血共有44例;擦拭前可见圆韧带动脉出血而擦拭后未见出血共有13例;擦拭前后均未见出血13例.术后送检圆韧带行病理切片提示圆韧带动脉通畅38例,不通畅者32例.A组圆韧带动脉通畅率高于另外两组,差异有统计学意义P＜0.0167.结论：综合评估股骨颈骨折后股骨头圆韧带动脉血供情况,60岁以下年龄组股骨颈骨折后患者股骨头圆韧带动脉总体通畅情况良好,Garden III型及以下股骨颈骨折可行保留股骨头治疗;Garden IV型及60岁以上股骨颈骨折患者建议一期行人工假体置换术.

Objective ：To evaluate the round ligament artery blood supply of the femoral head after femoral neck fracture, discuss the clinical therapy, and get the theoretical basis for the closed reduction and internal fixation. Methods ：70 cases in the THA with the round ligament artery bleeding before and after swabbing were observed , the pathological inspection of the round ligament was conducted to make the transection of the round ligament and make sure whether the round ligament artery was smooth or not. Results：Among these 70 cases, 44 cases of round ligament artery were observed bleeding before and after swabbing. 13 cases of round ligament artery were observed bleeding before swabbing. 13 cases of round ligament artery were not observed bleeding before and after swabbing. 38 cases of round ligament artery were smooth, while 32 cases of round ligament artery were narrow or unseen. Compared with the other two groups, there was statistical significance in those who were below 60 years old according to the SPSS 18.0 Software （P 〈0.0167）. Conclusions： Based on the assessment of blood supply in femoral head after femoral neck fracture in those who are below 60, the femoral head of femoral neck fracture can be retained in the treating of the Garden Ⅰ, Ⅱ, Ⅲ. Garden Ⅳ - type and people above 60 with femoral neck fracture are recommended to take the THA.