介入治疗成人非创伤性股骨头缺血性坏死的疗效分析

Clinical Effect Assessment of the Interventional Therapy for the Adult Non-Traumatic Ischemic Necrosis of Femoral Head

目的:分析介入治疗对于成人非创伤性股骨头缺血性坏死的疗效。方法:采用介入方法治疗95例共117髋非创伤性股骨头缺血性坏死。对比介入治疗前后DSA造影分型结果及血供异常例数。结果:117患髋中,Ⅰa型的31病髋中,11髋(35.48%)介入治疗后动脉主干再通;Ⅰb型的27髋中,24髋(88.89%)介入治疗后分支再通;Ⅱ型的11髋中,5髋(45.45%)实质期股骨头缺损面积缩小;Ⅲ型的10髋中,8髋(80.00%)静脉期见股骨头浓密染色明显减轻;Ⅳ型的33髋中,28髋(84.85%)可见动脉主干再通、分支增粗、实质期股骨头缺损面积缩小和静脉期股骨头染色减轻等。治疗前117病髋异常率为95.73%。经过介入治疗后,异常率为30.77%。治疗后异常率明显低于治疗前异常率(P<0.01)。结论:介入治疗可有效改善非创伤性股骨头缺血性坏死血供异常,增加股骨头血供,具有操作简单、创伤小、疗效确切等优点。

Objective： To analyse the effect of the interventional therapy for the Adult non-traumatic ischemic necrosis of femoral head （ANFH）. Methods： 95 cases of ANFH, 117 sick hips were treated by the interventional therapy and compared the imaging classification results by DSA before and after the interventional therapy and the amounts whose blood supply was abnormal. Results： In the 31 sick hips of the I a type, 11 sick hips（35.48%） had main artery recanalization after the therapy; in the 27 sick hips of the I b type, 24 sick hips （88.89%） had branch artery recanalization after the therapy; in the 11 sick hips of II type, femoral head defect area of 5 sick hips （45.45%） were cut down in the nephrographic phase after the therapy; in the 10 sick hips ofllI type, femoral head dyeing of 8 sick hips （80.00%） was lightened in the venous phase after the therapy; in the 33 sick hips of 1V type, 28 sick hips （84.85%） showed the change including the main artery recanalization, femoral head defect area reduing in the nephrographic phase and femoral head dyeing lightening in the venous phase. The abnormal rate of the 117 sick hips was 95.73% before the treatment and it was 30.77% after the therapy. The abnormal rate after the treatment was obviously lower than that before the treatment （P〈0.01）. Conclusion： The interventional therapy can change the abnormal blood supply of ANFH,increasing the blood supply of the head offemur. It has the advantages of simplicity of operator, small wound and good effect.