髓芯减压联合负压吸引术治疗早期股骨头坏死的临床疗效

Efficacy on the Treatment of Early Stage Necrosis of Femoral Head with Core Decompression Combined with Negative Pressure

目的:评价髓芯减压联合负压吸引术治疗早期股骨头坏死的疗效。方法:术前术后记录患者的Harris评分、VAS评分及检测其股骨头血管功能定量参数,以评价术前术后髋关节功能及股骨头微循环的变化情况。结果:术后经影像学检查未见股骨头发生塌陷或坏死区明显扩大。除术后1个月(P>0.05)外,术后其余的VAS评分均低于术前(P<0.05);术后的Harris评分均高于术前(P<0.05)。在ARCOⅠ期组坏死区Kep值于术后3、6个月均低于术前(P<0.05);坏死区iAUC值于术后3个月低于术前(P<0.05)。在ARCOⅡ期组坏死区Ve值于术后1个月低于术前(P<0.05)。结论:这种新的手术方法在短期内可有效地改善髋关节功能,减轻疼痛症状,并具有延缓坏死股骨头塌陷的作用。可在一定程度上改善ARCOⅠ期股骨头坏死的微循环瘀滞问题,但对ARCOⅡ期股骨头坏死的改善情况不明显。

Objective：To evaluating efficacy on treatment of early stage necrosis of femoral head with core decompression combined with negative pressure.Methods：The changes of hip＇s function and femoral head＇s microcirculation were evaluated by recording their scales of hip Harris and VAS and detect the quantitative parameters of vascular function in femoral head at the end of 1,3,6months post-operation respectively.Results：No collapse or significant advances in necrosis region of femoral head were found by imaging examination.All postoperative VAS scores decreased significantly（all P〈0.05）,except for the VAS score after month（P〉0.05）.And all postoperative Harris scores increase（all P〈0.05）.After 3months,the Kep value and iAUC value of ARCO stageⅠgroup decreased（all P〈0.05）.The Ve value of ARCO stageⅡgroup decreased at the end of one month after operation（P〈0.05）.Conclusion：The new surgical method can effectively improve the hip function,alleviate the symptom,and delay the collapsing of necrosis of femoral head in the short term.The surgical method can improve the microcirculation stasis of the ARCO stageⅠnecrosis of femoral head to a certain extent,but for the ARCO stageⅡ,its effect is not obvious.