多条血管束植入治疗成人股骨头坏死的远期疗效观察(附190例203髋分析)

Long-term Effects of Implantation of Multi-Bundles for Adult Avascular Necrosis of Femoral Head

目的 分析多条血管束植入术对于治疗成人股骨头缺血性坏死的远期疗效 ,总结多条血管束植入手术的技术要求与成败经验 ,探讨多条血管束植入在股骨头坏死治疗过程中的作用。方法 自 1982年 2月至 1993年 2月应用旋股外侧动静脉的升支、横支组成多条血管束 ,经“V”形骨隧道植入股骨头治疗各种病因导致的成人股骨头缺血性坏死 30 0余例 ,对其中获得长期随访的 190例 2 0 3髋进行了分析和总结 ,最长随访时间为 13. 7年 ,最短为 5年 ,平均 7. 4年。从X线、临床表现按成人股骨头缺血性坏死百分评分法进行评分 ,并将各指标得分及总分进行统计学处理。结果 手术前与随访时的X线表现、疼痛、行走距离、关节功能、总分比较均有显著性差异 (P <0 . 0 1) ,死骨完全吸收时间最短为 3个月 ,最长为 5 3个月 ,平均为12 8个月。结论 多条血管束植入术对于成人股骨头缺血性坏死具有确切的治疗作用 ,远期效果优良 。

Objective To analyze the long-term follow-up results of the treatment of implantation of multi-blood bundles for adult avascular necrosis of femoral head, to summarize the operation's technical requirement and our clinical experiences, and to investigate it's mechanism in the process of treatment of ANFH.Methods The multi-blood bundles derived from a.v. circumflexa femoris lateralis were implanted to femoral head through the "V" shape bone tunnels to treat ANFH.More than 300 cases whose pathogenies were different had been treated from February 1982 to December 1993,from whom 190 cases and 203 hips were analyzed and summarized.The longest follow-up time is 13.7 years, the shortest follow-up time is 5 years, average time is 7.4 years. We gave marks to patients'X-rays, clinic symptoms(pain, walk distance, expansion of joint movement),and analyzed them by the methods of statistics.Results The result has showed that there are significant difference on x-rays,pain,walk distance, expansion of joint movement, total mark between marks before operation and at the time of follow-up(P<0.01).The shortest time which necrotic bones were absorbed wholly is 3 months, the longest time is 53 months, average 12.78 months.Conclusion The effects of the implantation of multi-blood bundles for ANFH is certain. The long-term follow-up results of the treatment is excellent and the applied future is good.