三联序贯疗法治疗早中期股骨头缺血性坏死

The clinical research on application of triple sequential therapy to treat early-to-middle femoral head avascular necrosis

目的：回顾分析研究三联序贯疗法、单纯钻孔减压、单纯介入、单纯口服药物、减压＋介入、减压＋口服药物治的疗312髋成人早中期股骨头缺血性坏死患者。方法182例312髋均为Ficat Ⅰ-Ⅲ期患者，分别应用三联序贯疗法、单纯钻孔减压、单纯介入、单纯口服药物、减压＋介入、减压＋口服药物治疗，所有病例在治疗前，治疗后0.5年，治疗后1年，治疗后1.5年，治疗后2年进行Harris评分。结果治疗后0.5年，Ⅰ期内6组计量资料比较，无统计学意义（P〉0.05）；Ⅱ期、Ⅲ期6组内三联疗法组优于其他治疗组，有统计学意义（P〈0.05）；治疗后1年，Ⅰ期组内6组计量资料比较，无统计学意义（P〉0.05），Ⅱ期、Ⅲ期6组内三联疗法组优于其它治疗组，有统计学意义（P〈0.05）；治疗后1.5年，Ⅰ期、Ⅱ期、Ⅲ期6组内三联疗法组优于其它治疗组，有统计学意义（P〈0.05）。治疗后2年，Ⅰ期、Ⅱ期、Ⅲ期6组内三联疗法组优于其它治疗组，有统计学意义（ P〈0.05）。结论三联疗法对早中期成人股骨头缺血坏死的疗效显著高于单一治疗，是临床治疗早中期成人股骨头缺血性坏死的有效方法。

Objective：To retrospectively analyze and research the applications of triple sequential therapy,simple drill-ing decompression,simple intervention,simple oral drugs,decompression and intervention,decompression and oral medi-cation to treat 312 hip of adult patients with early-to-middle femoral head avascular necrosis. Methods：182 patients with 312 hips were all in Ficat Ⅰ-Ⅲ stage,and received the applications of triple sequential therapy,simple drilling decom-pression,simple intervention,simple oral drugs,decompression and intervention,decompression and oral medication re-spectively,the Harris scoring was carried out among all cases before treatment,0. 5 year after treatment,1 year after treat-ment,1. 5 years after treatment and 2 years after treatment. Results：In 0. 5 year after treatmen,the 6 groups were com-pared,and measuring data of stageⅠhad no statistical significance（P〉0. 05）;triple sequential therapy were better than the other treatment methods among 6 groups,and measuring data between the stages Ⅱand Ⅲ had statistical significance （P〈0. 05）;1 year after treatment,6 groups were compared and measuring data of stageⅠhad no statistical significance （P〉0. 05）;triple sequential therapy were better than the other treatment methods among 6 groups and measuring data of stageⅡ,stage Ⅲ had statistical significance（P〈0. 05）;1. 5 years after the treatment,triple sequential therapy were better than the other treatment methods among 6 groups measuring data of stageⅠ,Ⅱ,Ⅲhad statistical significance（ P〈0. 05）;2 years after the treatment,triple sequential therapy were better than the other treatment methods among 6 groups measuring data of stageⅠ,Ⅱ,Ⅲhad statistical significance（P〈0. 05）. Conclusion：The curative effect of triple sequen-tial therapy for adult with early-to-middle femoral head avascular necrosis is significantly higher than the single treat-ment,and triple sequential therapy is an effective clinical treatment for adults with early-to-middle femoral head avascular necrosis.