锝亚甲基二膦酸盐注射液治疗距骨骨软骨损伤的临床研究

Clinical research on the treatment of osteochondral lesions of the talus with ^(99m)Tc-MDP

目的:总结锝亚甲基二膦酸盐注射液(^(99m)Tc-MDP)对距骨骨软骨损伤(OLT)的治疗效果。方法:收集45例OLT的MRI、SPECT-CT资料,根据病程分期对32例符合保守治疗患者的治疗效果进行回顾性分析,依据美国足与踝关节外科协会(AOFAS)踝与后足功能评分标准及视觉模拟评分法(VAS)评定患者的临床疗效。结果:所有患者MRI见距骨滑车关节面不规则条状、带状异常长T_1、长T_2信号,连续或不连续,部分呈地图样或囊变影,Ⅰ期5例,Ⅱ期13例,Ⅲ期14例,Ⅳ期8例,Ⅴ期5例;SPECT-CT治疗前后病灶核素浓聚范围缩小,显效11例,有效18例,无效3例。AOFAS评分显著高于治疗前(P<0.05);VAS评分显著低于治疗前(P<0.05)。随访临床疗效优良率为73.33%。结论:MRI对OLT诊断明确,^(99m)Tc-MDP注射液治疗OLT效果良好。

Objective：To conclusion the treatment effect of osteochondral lesions of the talus with 99mTc-MDP. Methods：Collection of 45 patients with cartilage lesions of the talus and analysis all of the MR performance. According to the course of the stage32 cases of patients who would conducted conservative treatment. Then their treatment effect were retrospectively analysis . The patients＇ clinical curative effect were assessed by the American association of foot and ankle surgery （American orthopaedic foot and ankle society,AOFAS） after the ankle and foot function grading standard and method of visual analogue scale （visual analogue scale ,VAS）. Result：（1）The imaging findings ：all the patients showed bone cartilage injury in MRI and SPECT-CT signs, 8 cases had small flake of long T1 long T2 signal above talus, clear boundaries were seen between injury and host bone, according to the different shape of lesions to determine the stage. After treatment,ll patients got a good resuh,18 fair and 3 poor. （2）The clinical therapeutic effect evaluation：AOFAS score significantly higher than that before treatment （P〈0.05）. VAS score significantly lower than before treatment （P〈0.05）. （3）The rate of good clinical curative effect was 73.33%. Conclusion： Magnetic resonance imaging （MRI） provides diagnosis value on the staging of talus cartilage lesions,99mTc-MDP has a good effect on treatment of osteoehondral lesions of the talus.