麻醉下手法松解结合针刀改善股骨头坏死关节功能的临床研究

Clinical Study on Improving Joint Function of ONFH by Manual Release Combined with Acupotomy Under Anesthesia

目的:探讨椎管内麻醉下髋关节闭合手法松解结合针刀松解对股骨头坏死关节功能的影响,方法:选取经过椎管内麻醉下髋关节闭合手法松解结合针刀松解治疗的患者为治疗组45例(63髋),选取经过针刀松解治疗的患者为对照组43例(60髋)。两组患者均获得半年随访。以VAS评分、Harris评分和髋关节活动度(ROM)为疗效评价指标,对治疗后半年的疗效指标进行统计学分析。结果:治疗后半年随访,两组患者的VAS评分、Harris评分和髋关节活动度均优于治疗前,差异有统计学意义(P<0.05)。治疗组治疗后半年的VAS评分、Harris评分、髋关节活动度均优于对照组,差异有统计学意义(P<0.05)。结论:两组患者均取得较良好的疗效,但采用椎管内麻醉下髋关节闭合手法松解结合针刀松解治疗可更明显缓解股骨头坏死患者髋关节疼痛、改善髋关节功能,是一种值得推广的保髋疗法。

Objective:To explore the effect of closed hip joint release combined with acupotomy release on joint function of osteonecrosis of femoral head(ONFH)under spinal anesthesia,so as to provide an effective method for hip preservation treatment of ONFH.Methods:Patients met the inclusion criteria were randomly divided into the treatment group(n=45,63 hips)and the control group(n=43,60 hips).The treatment group was treated with closed hip joint manual release combined with acupotomy release under spinal anesthesia,whereas the control group was only treated with acupotomy release.Both groups were followed up for half a year.VAS score,Harris score and range of motion(ROM)were used as evaluation indexes to assess the curative effect.Results:Six months after the treatment,VAS score,Harris score and ROM of hip joint were significantly improved compared to those before the treatment in the two groups(P<0.05);of which the improvements in the treatment group were more significant(P<0.05).Conclusion:The therapy of closed hip joint release combined with acupotomy release by using intraspinal anesthesia can significantly relieve hip joint pain and improve hip joint function in patients with ONFH,which is a kind of hip preservation therapy worthy of promotion.