细针钻孔减压术治疗早期股骨头坏死76例疗效观察

Effects of Thin Needle Drilling Decompression on 76 Patients with Early Osteonecrosis of Femoral Head

目的:探讨研究细针钻孔减压术治疗早期股骨头坏死的临床治疗效果。方法:选取本院骨科2009年3月-2011年3月收治的股骨头坏死患者76例,按照国际骨循环研究会关于股骨头坏死分期标准(ARCO分期),其中Ⅰ期40例46髋,Ⅱ期36例42髋;按病因分类:酒精性36例41髋,激素性27例30髋,酒精加激素性13例17髋。按入院先后顺序将患者分为观察组和对照组,分别采取细针钻孔减压术治疗和保守治疗,观察分析患者Harris评分、并发症以及临床疗效的相关情况。结果:观察组患者治疗后的Harris评分明显高于治疗前,且比较差异有统计学意义(P<0.05)。观察组Ⅰ期患者中ⅠA、ⅠB和ⅠC临床治疗的优良率分别为100%、90.0%和66.7%,Ⅱ期患者中ⅡA、ⅡB和ⅡC临床治疗的优良率分别为71.4%、44.4%和33.3%。Ⅰ期患者临床治疗效果明显优于Ⅱ期,且观察组治疗的优良率明显高于对照组,比较差异均有统计学意义(P<0.05)。结论:对于早期股骨头坏死患者而言,应用细针钻孔减压术治疗的临床疗效显著,且股骨头坏死分期越早治疗的效果越好。

Objective：To investigate the clinical therapeutic effect of thin needle drilling decompression for the early osteonecrosis of femoral head.Method： 76 patients with osteonecrosis of femoral head were selected in our hospital from 2009 March to 2011 March. According to association research circulation osseous（ARCO） classifying, 40 patients with 46 hips and 36 patients with 42 hips were in stage Ⅰ and Ⅱ. According to classifying from etiological factors, the alcohol-induced was in 36 patients with 41 hips, steroid-induced was in 27 patients with 30 hips, alcohol and steroid-induced was in 13 patients with 17 hips. The patients were divided into observation group and control group according to the order of admission, two groups were respectively treated with thin needle drilling decompression and conservative treatment. The Harris Score and complications and clinical efficacy were observed and analyzed.Result： The Harris Score of all the patients was significantly higher after treatment than that before treatment, and the difference was statistically significant （P〈0.05）. The excellent and good results in stage ⅠA, ⅠB and ⅠC was obtained 100%, 90.0%, and 66.7% respectively, in stage ⅡA, ⅡB and ⅡC was 71.4%, 44.4%, and 33.3%, the clinical therapeutic effect was better in stage Ⅰ than in stage Ⅱ, and the clinical therapeutic effect was better in the observation group than in the control group, the difference was statistically significant （P〈0.05）.Conclusion： The clinical therapeutic effect of thin needle drilling decompression for the early osteonecrosis of femoral head is very significant, and the earlier, the better.