富血小板血浆联合脉冲射频治疗ARCOⅠ~Ⅲa期股骨头坏死的临床应用研究

Clinical application of PRP combined with pulsed radiofrequency in the treatment of femoral head necrosis at stage of ARCOⅠ-Ⅲa

目的探讨富血小板血浆(PRP)联合脉冲射频治疗国际骨循环学会分期(ARCO)Ⅰ~Ⅲa期股骨头坏死的临床应用。方法选取80例ARCOⅠ~Ⅲa期股骨头坏死患者作为研究对象,按照随机数字表法分为观察组(n=40)和对照组(n=40),对照组给予口服仙灵骨葆胶囊治疗,观察组采用PRP联合脉冲射频治疗。比较两组临床疗效、治疗前后Harris髋关节评分、影像学评分。结果观察组临床治疗有效率95.00%高于对照组80.00%,差异有统计学意义(χ^2=4.11,P<0.05);两组治疗后7 d、1个月、2个月、6个月、12个月Harris髋关节评分、影像学评分均高于治疗前,差异均有统计学意义(t分别=4.91、8.28、11.57、19.68、22.62、2.65、5.59、9.20、13.86、18.05、4.06、7.03、10.74、13.43、15.97、2.09、5.46、7.30、8.51、12.72,P均<0.05);观察组治疗后7 d、1个月、2个月、6个月、12个月Harris髋关节评分、影像学评分均高于对照组,差异均有统计学意义(t分别=2.19、2.16、2.36、3.25、4.17、2.02、2.18、2.58、3.53、4.11,P均<0.05)。结论PRP联合脉冲射频治疗ARCOⅠ~Ⅲa期股骨头坏死的效果确切,能够有效改善患者髋关节功能,减缓、终止、改善股骨头坏死进展。

Objective To explore the clinical application of platelet-rich plasma(PRP)combined with pulsed radiofrequency in the treatment of femoral head necrosis at stage of association research circulation osseous(ARCO)Ⅰ-Ⅲa.Methods Eighty patients with femoral head necrosis at stage of ARCOⅠ-Ⅲa were enrolled as the research subjects.They were divided into observation group(n=40)and control group(n=40)by random number table method.The control group was treated with oral Xianning Gubao capsules,while observation group was treated with PRP and pulsed radiofrequency.The clinical curative effect,scores of Harris and imaging before and after treatment were compared between the two groups.Results The clinical curative efficiency of clinical treatment in observation group was higher than that in control group(95.00%vs 80.00%)(χ^2=4.11,P<0.05).After 7 d,1 month,2 months,6 months and 12 months of treatment,scores of Harris and imaging in both groups were higher than those before treatment(t=4.91,8.28,11.57,19.68,22.62,2.65,5.59,9.20,13.86,18.05,4.06,7.03,10.74,13.43,15.97,2.09,5.46,7.30,8.51,12.72,P<0.05).After 7 d,1 month,2 months,6 months and 12 months of treatment,scores of Harris and imaging in observation group were higher than those in control group(t=2.19,2.16,2.36,3.25,4.17,2.02,2.18,2.58,3.53,4.11,P<0.05).Conclusion The curative effect of PRP combined with pulsed radiofrequency is significant on femoral head necrosis at stage ARCOⅠ-Ⅲa.It can effectively improve hip function,alleviate,improve and even terminate the progress of femoral head necrosis.