新型七孔分区减压法治疗成人早期股骨头坏死的疗效观察

Clinical observation on treatment of early osteonecrosis of the femeral head in adults by a new seven-hole decompression method

目的探讨分析新型七孔分区减压法对成人早期股骨头坏死的临床疗效。方法采用前瞻性病例对照分析方法,选取2015-05~2016-10收治该院的成人早期股骨头坏死患者55例,Ⅰ期(ARCO标准) 26例30髋,Ⅱ期29例35髋。采用新型七孔分区减压治疗者(新型组) 20髋,传统三孔减压治疗(传统组) 25髋,药物保守治疗者(保守组) 20髋。随访1年,评估并比较各组临床疗效。结果三组患者均完成治疗并获得有效随访。至末次随访,新型组、传统组及保守组Harris评分均较治疗前获得明显改善,差异有统计学意义(P <0. 001),且新型组Harris评分优于传统组及保守组,差异有统计学意义(P <0. 001)。末次随访X线检查,新型组股骨头塌陷发生率低于传统组及保守组,差异有统计学意义(P <0. 05)。结论新型七孔分区减压法治疗成年人早期股骨头坏死具有明显优势,有助于改善髋关节功能,延缓股骨头坏死塌陷。

Objective To investigate the clinical effect of a new seven-hole decompression method on treatment of early osteonecrosis of the femeral head in adults. Methods A prospective case-control study was performed. 55 patients with early osteonecrosis of the femoral head were treated in our hospital from May 2015 to October 2016, including 26 patients（30 hips） with stage I（ARCO standard） and 29 patients（35 hips） with stage Ⅱ. The new seven-hole decompression was performed on 20 hips（the new type group） and traditional three-hole decompression therapy on 25 hips（the traditional group） and conservative medication on 20 hips（the conservative group）. All the patients were followed up for 1 year to evaluate the clinical efficacy and the clinical effects were compared among the three groups. Results All the patients in the three groups completed the treatments and obtained effective treatments. At the last follow-up after treatment, Harris scores were significantly improved in all the three groups compared with those before treatment（P〈0.001）. Harris scores in the new type group were improved better than those in the traditional group and the conservative group（P〈0. 001）. The incidence of the femoral head collapse in the new type group was lower than that in the traditional group or in the conservative group（P〈0.05）. Conclusion The new seven-hole decompression method has obvious advantages in the treatment of early femoral head necrosis in adults. It can improve the hip function and delay the collapse of the femoral head necrosis.