中药联合微创打压植骨腓骨支撑术治疗围塌陷期股骨头坏死32例

Clinical Effect of Minimal-invasive Fibula Supporting Method Combined with TCM in Treating Peri-collapse Stage Femoral Head Necrosis

目的：探讨中药联合微创打压植骨腓骨支撑术治疗围塌陷期股骨头坏死的临床疗效。方法：2009年3月-2012年8月采用微创打压植骨腓骨支撑术治疗32例围塌陷期股骨头坏死患者，术后配合仙灵骨葆和川芎嗪片口服；全部病例获得随访；以Harris评分评价关节功能，股骨头生存率作为疗效评价指标。结果：术后所有病例均无感染、神经损伤等并发症；术后随访16～52个月，平均26．4个月，Harris评分从术前平均（78．6±5．5）分提高到末次随访平均（91.0±5．9）分；以髋关节置换作为终点事件，末次随访时股骨头生存率为90．63％。结论：微创打压植骨腓骨支撑术创伤小、恢复快，可改善股骨头内生物力学稳定，改善关节功能，延缓甚至避免关节置换；术后配合仙灵骨葆胶囊、川芎嗪片口服促进股骨头修复；联合使用近期临床疗效确切。

Objective：To discuss the clinical effect of minimal-invasive fibula supporting method combined with TCM in treating peri-collapse stage femoral head necrosis. Methods： Thirty-two patients with femoral head necrosis in peri-collapse stage were treated by means of minimal-invasive fibula supporting method combined with TCM of Xianlinggubao Capsule and ligustrazine Pill from March 2009 to August 2012. The clinical effect was evaluated by Harris Hip Score and femoral survival rate. Results：All the patients were followed up for 26.4 months on average. There was no complication at the end of follow-up, meanwhile, the mean preoperative Harris hip score of （ 78.6.1±5.5 ） points was improved to （91.0±5.9） and the femoral survival rate was 90.63%. Conclusion： Minimal-invasive fibula supporting method has the advantages of small trauma, quicker recovery, biomechanical stability for the femoral head, improving joint function, and delaying or even avoiding joint replacement. Combination of minimal-invasive fibula supporting method with TCM can promote the repair of femoral head, and has assured efficacy in treating osteonecrosis of the femoral head.