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小直径多孔道髓芯减压术治疗早期股骨头坏死的临床研究 被引量:2

Clinical study of micro-diameter and multiple-drilling core decompression in treatment of early femur head necrosis
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摘要 目的探讨小直径多孔道髓芯减压术治疗早期股骨头坏死的疗效。方法将68例早期股骨头坏死患者采用随机数字表法分为两组,试验组35例使用3.0~4.0mm克氏针或钻头行小直径多孔道髓芯减压术治疗,对照组33例行传统器械刮匙去除死骨治疗。结果试验组手术时间、住院时间、术后髋关节Harris评分的疼痛评分均优于对照组[(41.2±7.4)min比(74.3±10.2)min、(9.7±2.3)d比(14.3±4.2)d、(43.56±2.12)分比(37.21±1.19)分],差异有统计学意义(P〈0.01或〈0.05)。两组术中出血量和住院费用比较差异无统计学意义(P〉0.05)。两组术后3和6个月髋关节Harris总分比较差异无统计学意义(P〉0.05);试验组术后12和24个月髋关节Harris总分明显高于对照组[(93.11±2.43)分比(91.23±2.89)分、(85.23±2.43)分比(73.54±2.89)分],差异有统计学意义(P〈0.05)。结论应用小直径多孔道髓芯减压术治疗早期股骨头坏死较传统器械具有创伤小、手术时间短、坏死骨清除率高和减缓疾病进展等优点,具有一定的临床应用价值。 Objective To discuss the efficacy of micro-diameter and multiple-drilling core decompression in treatment of early femur head necrosis. Methods Sixty-eight patients with early femur head necrosis were selected, and they were divided into 2 groups by random digits table method. The experiment group (35 cases) underwent the micro-diameter and multiple-drilling core decompression (3.0 - 4.0 mm Kirschner wire or drill), and the control group (33 cases) underwent traditional instruments surgery. Results The operative time, hospital stay and pain score of postoperative hip joint Harris score in experiment group were better than those in control group: (41.2 ± 7.4) rain vs. (74.3 ± 10.2) rain, (9.7 ± 2.3) d vs. (14.3 ± 4.2) d and (43.56± 2.12) scores vs. (37.21 ± 1.19) scores, and there were statistical differences (P 〈 0.01 or 〈 0.05). There were no statistical differences in blood loss and overall hospital costs between 2 groups (P 〉 0.05). There were no statistical differences in the total score of hip joint Harris score at 3 and 6 months after surgery (P 〉 0.05). The total scores of hip joint Harris score at 12 and 24 month after surgery in experiment group were significantly higher than those in control group: (93.11 ± 2.43) scores vs. (91.23 ± 2.89) scores and (85.23 ± 2.43) scores vs. (73.54 ±2.89) scores, and there were statistical differences (P 〈 0.05). Conclusions The micro-diameter and multiple-drilling core decompression is applied to the early femur head necrosis with less trauma, shorter operative time, higher clearance rate of necrotic bone and slower disease progression compared with traditional instruments. The micro-diameter and multiple-drilling core decompression makes patients' hip function get a satisfactory recovery with certain clinical applications.
作者 许超 陈永志
出处 《中国医师进修杂志》 2015年第10期754-757,共4页 Chinese Journal of Postgraduates of Medicine
关键词 股骨头坏死 减压术 外科 治疗结果 Femur head necrosis Decompression, surgical Treatment outcome
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