骨髓干细胞移植结合介入疗法治疗股骨头缺血性坏死

Treatment of avascular necrosis of femoral head by combination of bone marrow stem cell transplantation and interventional therapy

目的观察经动脉骨髓干细胞移植联合介入治疗股骨头缺血性坏死的疗效。方法选择经临床和影像学诊断为股骨头缺血性坏死患者32例(54髋),采用Seldinger技术穿刺股动脉插管,将导管插入患侧髂内动脉,造影观察股骨头区血供情况,随后在髂内动脉注入溶栓药物、扩血管药物、改善微循环药物及自体干细胞悬液,治疗后随访观察临床症状变化及影像学表现。结果治疗后6个月,28例髋关节疼痛、功能障碍等不适得到缓解或消失,6例行髂内动脉造影显示股骨头区供血血管增粗,分支增多;2例X线片复查坏死骨质有不同程度新骨形成及修复。结论通过髂内动脉骨髓干细胞移植联合介入疗法治疗股骨头缺血性坏死是安全、有效、简便的方法。

Objective To observe the effects of the combination of bone marrow stem cell transplantation and interventional therapy on avascular necrosis of femoral head（ANFH）.Methods 32 patients with ANFH（54 hips）diagnosed by clinical and radiological examinations underwent femoral arterial puncture with Seldinger＇s technique.The catheter was inserted into the affected side of internal iliac artery,and then the angiography was conducted to detect blood supply to the necrotic femoral head.Thrombolytics,vasodilators,drugs that improve microcirculation and the suspension of bone marrow stem cells were directly injected into internal iliac artery subsequently.Clinical symptoms and imaging features after treatment were followed up and observed.Results 6 months after treatment,the pain and dysfunctions of hip joints in 28 cases released or disappeared.Internal iliac artery angiograph of 6 cases showed enlarged blood vessels supplying to femoral head with more branches.X-ray review showed that the recovery of necrotic bone and the formation of new bone at various degrees were found in 2 cases.Conclusion Bone marrow stem cell transplantation combined with interventional therapy through internal iliac artery is a safe,effective and simple method for the treatment of ANFH.