美多巴治疗早期非创伤性股骨头坏死的临床研究

Clinical Research of Treatment for Early Non-Traumatic Osteonecrosis of the Femoral Head with Madopar

目的：探讨美多巴治疗非创伤性股骨头坏死的近期疗效。方法收集2002年10月—2009年11月在苏州大学附属第一医院骨科确诊为早期非创伤性股骨头坏死的患者进行临床随访研究。所有病例治疗过程中均定期行双髋前后位X片及MRI检查，采用Charnley改良Merle D＆#39; Aubigne临床综合评分方法评估疗效，应用MRI坏死指数验证美多巴的治疗作用。结果所有入选病例均积极配合治疗，并获完整随访，随访13～74个月，平均随访时间32.34个月。治疗组口服美多巴治疗后，多数患者临床症状得到改善，X线显示股骨头内密度均增高，坏死指数降低，临床满意率75.34%，临床改善率60.27%，治疗成功率68.49%。结论美多巴在治疗早期非创伤性股骨头坏死中有积极的作用，大多数患者经治疗后能够避免或推迟坏死股骨头的塌陷。

Objective To observe the preliminary effects of the treatment for early non-traumatic osteonecrosis of the femoral head with Madopar.MethodsPatients with non-traumatic avascular necrosis with early diagnosis in orthopaedic clinic of the First Afifliated Hospital of Soochow University from October 2002 to November 2009 were collected for the follow-up study. All cases get regular check of double X-ray and MRI examination before and after the treatment process, adopting Charnley Merle D＆#39; Aubigne comprehensive score method to evaluate clinical curative effect, with MRI necrotic index to verify therapeutical effect of Madopar. Result All patients were actively cooperate with treatment, followed up 13~74 months （average 32.34 months）. The clinical symptoms improved in all cases in treatment group after taking Madopar; X-ray iflms showed that bone density increased in nearly all the femoral heads, the followed-up MRI showed their necrotic indices had decreased. The rate of clinical satisfaction was 75.34%, the rate of clinical improvement was 60.27%, and the successful rate of treatment was 68.49%.Conclusion The Madopar treatment of early stage of osteonecrosis of femoral head has a positive effect, and most of the patients after Madopar treatment could prevent or delay collapse of the femoral head in early stage of osteonecrosis.