中西医结合保髋治疗ARCOⅢ期股骨头缺血性坏死疗效及生存质量分析

Curative effect of hip preservation treatment of ARCOⅢ avascular necrosis of femoral head in western medicine combined with traditional Chinese medicine and analysis on its quality of life

目的:探讨带血管蒂大转子骨瓣联合游离髂骨移植打压植骨术结合中药对股骨头缺血性坏死ARCOⅢ期保髋治疗的临床疗效及对生存质量的影响。方法:选取2015年9月至2016年12月骨伤科收治的92例ARCOⅢ期股骨头缺血性坏死患者,随机分为观察组和对照组,观察组患者进行带血管蒂大转子骨瓣联合游离髂骨移植打压植骨术结合中药保髋治疗,对照组患者仅进行带血管蒂大转子骨瓣联合游离髂骨移植打压植骨术保髋治疗,比较两组患者临床疗效,术前、术后3个月Harris、SF-36量表评分。结果:观察组患者临床疗效优良率为76.09%,比对照组患者的60.87%提高(P<0.05);术前两组患者Harris、SF-36量表评分差异无统计学意义(P>0.05);术后3个月观察组患者Harris、PF、RP、BP、GH、VT、SF、RE、MH评分上升高于对照组(P<0.05)。结论:带血管蒂大转子骨瓣联合游离髂骨移植打压植骨术结合中药可提高股骨头缺血性坏死ARCOⅢ期保髋治疗的临床疗效,促进髋关节功能的恢复,提高患者生存质量,建议在临床上推广。

Objective:To investigate the clinical efficacy and impact on the quality of life in hip preservation treatment of ARCOⅢ avascular necrosis of femoral head with vascular pedicled large trochanter bone flap combined with free iliac bone grafting and bone grafting.Methods:92 patients with ARCO III femoral head avascular necrosis admitted from September 2015 to December 2016 were selected and divided into observation group and control group randomly.Patients in the observation group were treated with vascular pedicled large trochanter bone flap combined with free iliac bone graft and bone grafting combined with traditional Chinese medicine for hip protection.The control group was treated with vascularized trochanteric bone flap combined with free iliac bone graft for bone grafting.The clinical efficacy of the two groups was compared,and Harris and SF-36 scales were scored preoperatively and 3 months postoperatively.Results:The excellent and good rate of clinical efficacy was 76.09%in the observation group compared with that of 60.87%in the control group.The difference was statistically significant(P<0.05).There was no significant difference in the scores of Harris and SF-36 between the two groups before operation(P>0.05).The scores of Harris,physiological function(PF),physiological role(RP),body pain(BP),general health(GH),vitality(VT),social function(SF),role of emotion(RE)and mental health(MH)in the observation group were higher than those in the control group after operation(P<0.05).Conclusion:The vascular pedicled large trochanter bone flap combined with free iliac bone graft combined with traditional Chinese medicine can improve the clinical efficacy of ARCO III hip-preserving treatment for avascular necrosis of the femoral head,promote the recovery of hip function and improve the quality of life of patients.It is recommended to promote in the clinical practice.