微创减压植骨术配合活血养骨汤治疗早中期股骨头坏死32例

Using Minimally Invasive Decompression Bone Grafting combined with Huoxue Yanggu Decoction in the Treatment of Early Osteonecrosis of the Femoral Head for 32 Cases

目的探讨微创减压植骨术配合活血养骨汤治疗早中期股骨头坏死的临床疗效。方法对从2012年3月—2014年1月间收治的32例50髋股骨头坏死进行保髋治疗,ARCO分期ⅡA-ⅢA期,行微创减压植骨术配合使用中药活血养骨汤治疗,术前术后分别行Harris疼痛评分以评估疗效。结果随访11-29个月,平均18.2个月,术前Harris总评分（60.65±3.56）分,术后12个月为（83.39±10.21）分。治疗前后存在统计学差异（P〈0.05）。在32例患者的50个患髋中3例4髋因股骨头塌陷行人工全髋关节置换,保髋率为92.00%;其余46髋中,末次随访时Harris评分平均（84.26±4.17）分,其中优者（≥90.0分）19髋,良者（80.0-89.9分）17髋,中者（70.0-79.9分）8髋,差者（〈70.0分）2髋。结论微创减压植骨术配合中药活血养骨汤治疗股骨头坏死有效。

Objective To observe the curative effect of minimally invasive decompression bone grafting combined with Huoxue Yanggu decoction in the treatment of early osteonecrosis of the femoral head（ ONFH）. Methods 32 cases of patients with ONFH patients 50 hips were treated for hip-preserving from March 2012 to January 2014, ARCO staging from ⅡA to ⅢA period. They received minimally invasive decompression bone grafting and internal bracket implanting surgery and oralcombined with Huxue Yanggu decoction. The curative effect was assessed by the Harris score. Results The average duration of follow-up was 18.2 months（rangs from 11 months to29 months）. The preoperative Harris score increased averagely from preoperative（ 60.65 ± 3.56） points to postoperative 12 months（83.39±10.21） points. In contrast with preoperation and postoperative, the difference was statistically significant（ P〈0.05）. The 3ONFH patients 4 hips conduct the total hip arthroplasty because of the femoral head collapsed and disappeared completely in 32 ONFH patients 50 hips. The rat of hip-preservation was 92.00%. In other 46 hips, the last follow-up Harris score was（84.26 ± 4.17） points,including gifted person（≥90.0 points） 19 hips, good person（80.0 to 89.9 points） 17 hips, medium person（70.0 to 79.9 points） in8 hips, and poor（〈70.0 points） 2 hips. Conclusion The minimally invasive decompression bone grafting combined with Huoxue Yanggu decoction in the treatment of early ONFH had effect.