针刀疗法对股骨头坏死患者关节功能的影响及相关因素分析

Clinical Observation on the Treatment of Osteonecrosis of the Femoral Head by Needle Knife and The Related Factors

目的:观察针刀疗法对股骨头坏死患者关节功能的影响并分析其影响因素。方法:采用针刀治疗46例股骨头坏死患者,根据Harris髋关节功能评分、视觉模拟(VAS)评分、髋关节活动度评价临床疗效并分析职业、病因、病程、影像分期等相关影响因素的疗效差异。结果:针刀治疗后各随访点VAS评分、Harris评分及髋关节活动度均优于治疗前(P<0.05)。不同职业、病因的VAS评分、Harris评分、髋关节活动度比较,差异无统计学意义(P>0.05)。病程6个月至1年患者治疗后1周的VAS评分小于病程1年以上的患者(P<0.05)。不同影像分期患者各随访点VAS评分比较,差异无统计学意义(P>0.05),治疗后1周Ⅱ期患者的Harris优良率高于Ⅲ期和Ⅳ期(P<0.05);治疗后1周Ⅱ期患者的髋关节活动度高于Ⅲ期和Ⅳ期(P<0.05),Ⅲ期患者的髋关节活动度高于Ⅳ期(P<0.05),治疗后6个月Ⅱ期患者的髋关节活动度高于Ⅳ期(P<0.05)。结论:针刀疗法可明显缓解股骨头坏死患者疼痛,改善关节功能,具有疼痛与功能改善迅速、适用人群广泛等特点。

Objective： To observe the curative effect and related factors of function by using the needle knife for treating osteonecrosis of the femoral head. Methods： Harris hip score, visual analogue scales（VAS）,range of motion（ROM） of joints were recorded in different follow-up times to evaluate the effect, and etiology,duration, occupation, image classification were chosen as related factors. Results： Efficacy results： the Harris,VAS and ROM of every follow-up time after needle knife treatment were better than pre-treatment, the differences were statistically significant（P〈0.05）. Result of related factors analysis： there were no statistically differences in the Harris,VAS and ROM among the etiology, occupation（P〉0.05）; The VAS of course of the disease between six months and a year after needle knife treatment was better than course of the disease over 1 year, the differences were statistically significant（P〈0.05）, the rest of follow-up time in different courses of the disease had no statistically differences in the Harris,VAS and ROM（P〉0.05）; The Harris of ARCO Ⅱ 7 days after needle knife treatment was better than ARCO Ⅲ and ARCO Ⅳ, the differences were statistically significant（P〈0.05）.The ROM of ARCOⅡ7 days after needle knife treatment was better than ARCO Ⅲ and ARCO Ⅳ, ARCO Ⅲbetter than ARCO Ⅳ, the differences were statistically significant（P〈0.05）. The ROM of ARCO Ⅱsix months after needle knife treatment was better than ARCOⅣ, the differences were statistically significant（P〈0.05）. Conclusion： Needle knife therapy can relieve pain, and improve joint function quickly.