动脉药物灌注治疗股骨头骨骺无菌性坏死及治疗前后动脉造影压力测定比较分析(附19例报告)

The Treatment of Arterial Medicine Infusion in Accordance with Epiphysis Aseptic Necrosis of Caput Femoris and Analysis of Arteriogram and Pressure Measurement in Comparision with Pre-treatment(Report on 19 Patients)

目的 :对股骨头骨骺无菌性坏死行髂外动脉溶纤、扩管药物灌注治疗 ,通过血管造影和局部动脉压力监测来评价该治疗对股骨头及关节供血改善程度。资料和方法 :治疗患儿 19例 ,术中应用 4～ 5Fcobra导管分别置于左右髂总动脉、髂内和髂外动脉 ,通过HP 12 90C型多参数监护仪进行动脉压力测量 ,随后行患侧髂外动脉造影同时向髂外动脉灌注尿激酶、低分子右旋糖酐和皮质激素 ,治疗结束后重复监测以上动脉压力变化并再次血管造影 ,同治疗前作比较。结果 :16例 (84% )患儿在治疗后患侧髂总、髂外动脉压力较治疗前升高 3～ 16mmHg ,平均升高 6 .5mmHg。 15例 (78% )治疗后髂外动脉造影显示旋股内、外动脉血管轮廓不同程度增粗并分支数目增加。结论 :通过影像学和血液动力学观察 ,髂外动脉灌注溶纤、扩管药物能有效增加股骨头和关节的供血。

Objective: The purpose of this study was to evaluate the improvement degree of caput femoris and physiological blood supply by angiography and monitor to local pressure of artery with the treatment of iliaca externa arteriae fibrinolysis and dilate medical infusion.In accordance with epiphysis aseptic necrosis of caput femoris.Subjectives:19 patients with epiphysis aseptic necrosis of caput femoris.Measures:Operators placed 4-5F cobra conducts respectively on the left and right iliaca communis arteriae and iliaca interna and externa arteriae,measuring the pressure of artery by HP1290C marametre monitor instrument.Then iliaca extema arteriae arteriogram in illness part followed.Meanwhile they were injected with urokinase、dextran-40 and cortical hormone to iliaca externa arteriae.After treatment ended,it was neccessary to monitor the changes of arterial pressure and make angiography once again.There was a comparision with pre-treatment.Resulls:For 84%(16/19)patients,the pressure of interna and externa arteriae in illness part rose from 3 to 16 mmHg,average 6.5mmHg.The posttreatment iliaca externa arteriogram showed 78%(15/19)patients thickened the blood vessel frame of circumflex femoris medialis and lateralis arteriae at different level and had a larger number of branches.Conclusions:iliaca externa arteriae infusion of fibrinolysis and dilate medical treatment can efficiently increase caput femorics and physioloical blood-supplied by observation of iconography and hemodynamics.