骨髓干细胞移植治疗股骨头坏死疗效分析

The research towards Bone marrow stem cell transplantation on femoral head necrosis

目的:观察经动脉自体骨髓干细胞移植治疗股骨头坏死的临床疗效。方法:40例股骨头坏死患者在干细胞动员后,从髂后上嵴处抽取自体骨髓血200～400 ml,经沉淀、离心、分离等处理后制备20～30 ml干细胞悬浊液。并用流式细胞仪检测CD34+,在数字减影血管造影术下(DSA)行股动脉穿刺,将导管超选插入闭孔动脉、旋股内外动脉,将细胞悬液缓慢灌注入动脉内。移植后随访观察患者髋关节疼痛程度、行走距离、髋关节活动度及影像学改变。结果:全部患者观察随访6～18个月(平均3.6个月),髋关节疼痛有不同程度的缓解37例(92.5%),行走间距延长23例(57.5%),关节功能改善13例(32.5%)。结论:骨髓干细胞移植治疗创伤性股骨头坏死是一种创伤小、疗效高、安全有效的治疗方法。

Objective To observe the clinical effects of Bone Marrow Stem Cell（BMSC） transplantation via artery on femoral head necrosis. Methods 40 patients with femoral head necrosis chose the BMSC treatment.every patient drew 200 - 400 ml autologous bone marrow blood from their own posterior superior spine,which made 20 - 30 ml Stem CeU suspensions by precipitation,separation,centrifugal and so forth,and given CD34＋ test by flow cytometry.Under Digital Subtraction Angiography（DSA）,the patients were conducted femoral artery puncture in which the tubes were inserted into medial femoral circumflex artery lateral femoral circumflex artery and obturator artery with the cell suspensions were gradually poured into the arteries.The level character time change of coxa paining and walking distance gait change change of abduction and medial rotation in patients were observed in the follow-ups after BMSC transplantations.Results In the following 3 N 18 months（3.6 months on average）,there were 37 patients（92.5%） showing the remission of coxa joint paining on different degrees,23（57.5%） showing the longer walking distance,and 13（32.5%） showing the improvement of joint fimctions.Conclusion The BMSC transplantation is convenient safe and effective in the treatment of the femoral head necrosis with fewer traumas.