髓芯减压硫酸钙人工骨植入治疗早期非创伤性股骨头缺血坏死安全性及远期疗效

Safety and long-term Effect of Core Decompression and Calcium Sulfate artificial Bone Implantation in the Treatment of early Nontraumatic Avascular Necrosis of the femoral Head

目的评价非创伤性股骨头缺血坏死的早期病例在接受髓芯减压手术联合接受硫酸钙人工骨植入术治疗的手术安全性以及该术式远期疗效情况。方法研究开展于2015年3月—2018年1月郑州市第一人民医院收治60例早期非创伤性股骨头缺血坏死患者,均接受髓芯减压硫酸钙人工骨植入术治疗。观察并记录患者手术治疗时长、术中出血量以及术后并发症发生情况,对患者进行持续12个月随访调查(末期随访2020年1月),评估患者术后优良率、术后疼痛视觉模拟评分(VAS)及影像学检查结果。结果患者手术均顺利完成;患者术后3个月、术后12个月、术后24个月优良率渐趋提高,术后12个月、24个月相较术前3个月,差异显著(P<0.05);患者术后3个月、术后12个月的髋关节稳定率相比术前明显更高,差异显著(P<0.05);患者术后VAS疼痛评分逐渐降低,患者术后12个月的VAS疼痛评分相比术前明显更低,差异显著(P<0.05)。结论非创伤性股骨头缺血坏死的早期病例在接受髓芯减压手术联合接受人工骨植入术治疗的效果明确、手术安全性高且该术式的远期疗效好,具有临床与应用价值。

Objective To evaluate the safety and long-term effect of core decompression combined with calcium sulfate artificial bone implantation in early non-traumatic avascular necrosis of the femoral head.Methods A total of 60 patients with early non-traumatic avascular necrosis of the femoral head were admitted to the first people’s hospital of Zhengzhou from March 2015 to January 2018.The duration of surgical treatment,intraoperative bleeding and postoperative complications were observed and recorded.The patients were followed up for 12 months(end-stage follow-up in January 2020),the postoperative excellent and good rate,visual analogue scale(VAS)of postoperative pain and imaging examination were evaluated.Results All the operations were completed successfully,and the excellent and good rates were gradually increased at 3 months,12 months and 24 months postoperatively compared with 3 months pre-operatively(P<0.05);The HIP stability rate at 3 months and 12 months after operation was significantly higher than that before operation(P<0.05),the VAS pain score decreased gradually and the VAS pain score at 12 months after operation was significantly lower than that before operation,the difference was significant(P<0.05).Conclusion The early non-traumatic avascular necrosis of the femoral head can be effectively treated by core decompression combined with artificial bone implantation.The operation is safe and the long-term effect is good,it has clinical and applied value.