介入治疗股骨头缺血坏死(附28例报告)

Interventional therapy for the avascular necrosis of femoral head:a report of 28 cases

目的评价经股动脉插管溶通术对股骨头缺血坏死的治疗效果。方法28例经临床和血管造影证实的股骨头缺血坏死患者均接受了经股动脉插管溶通术治疗。该介入治疗操作是以Seldinger技术将5Fcobra导管经股动脉超选送至内、外侧旋股动脉后,进行血管造影与溶通治疗。结果溶通治疗后,血管造影及DSA显示,股骨头缺血坏死病变区的血管计数明显增多,伴临床症状改善见于全部病例,其中,22例(79%)的疗效尤为显著。结论经股动脉插管溶通术能明显改善股骨头血供状况,它是目前治疗股骨头缺血坏死最安全、有效、可靠的方法。

Objective To evaluate the efficacy of interventional therapy by transfemoral artery infusion and vascular recanalization (TFAIVR) for the avascular necrosis of femoral head(ANFH).Methods Twenty- eight patients with clinically and angiographically proved ANFH underwent TFAIVR.During the procedure,a 5F catheter was introduced into femoral artery with Seldinger's technique, thereafter,the catheter was introduced ultra- selectively into medial and lateral circumflex femoral arteries and then angiography and vascular recanalization were performed.Results Following TFAIVR,angiography and DAS revealed that the significant increasis of the vessel count in the regions of ANFH and the improvement of clinical symptoms were found in all patients, of them,22 cases (79 % ) were especially obvious improvements. Conclusion TFAIVR can improve significantly the blood supply of femoral head and at present it is a the most safe, effective and reliable means for treating ANFH.