摘要
目的:介绍自制股骨头骨髓置管器的构造及评价治疗股骨头缺血性坏死的疗效。方法:自制股骨头骨髓置管器治疗股骨头缺血性坏死38例和Legg-Perthes病3例。按Ficat分期,Ⅰ期4例,Ⅱ期26例,Ⅲ期7例,IV期1例;Legg-Perthes病3例,按Herring标准分型均为C型。临床诊断根据症状、体征、X线片及CT或MRI,最后由病理检查确诊。治疗1周,以治疗前后临床症状、骨髓对比、骨髓压力的变化及X线随访作为疗效观察指标,评价其疗效。结果:33例(Ⅰ-Ⅱ期及3例Legg-Perthes病)疼痛明显改善,髋关节功能提高,8例缓解;治疗前的骨髓压都大于50 cm H2O,经治疗后骨髓压都降到10 cm H2O以下;股骨头骨髓对比显示33例(Ⅰ-Ⅱ期及3例Legg-Perthes病)股骨头病灶区域对比剂弥散良好,8例弥散稍好,所有患者静脉回流都有改善;31例治疗后随访3年,其中23例(20例为Ⅰ-Ⅱ期和3例为Legg-Perthes病)X线片显示有不同程度的骨质修复,Ⅲ-Ⅳ期的8例未见明显修复征象,与术前比较情况相仿。结论:自制股骨头骨髓置管器是治疗Ⅰ、Ⅱ期股骨头缺血性坏死及Legg-Perthes病的有效方法,对Ⅲ、Ⅳ期股骨头缺血性坏死在缓解症状及延缓病程上具有明显的效果。
Objective： To introduce the construction of placing tube instrument and evaluate the effect of treating ANFH with it. Methods：38 patients of ANFH and 3 patients of Legg Perthes disease were treated with this instrument. According to Ficat staging,4 cases were in stage Ⅰ, 26 cases in stage Ⅱ, 7 cases in stage Ⅲ, l case in stage Ⅳ, 3 patients of Legg Perthes disease belonged to group C according to Herring stage. The clinical diagnosis depended on clinical symptoms, X-ray film,CT/MRI and was confirmed by pathological examination. Criteria of curative effect depended on the change of clinical symptoms,bone marrow＇s venography, bone marrow pressure,and X-ray examination after treatment for one week. Results：As compared with the conditions before therapy ,bone-marrow venography showed that contrast agent spread in the bone marrow extensively and venous return volume improved obviously for 33 cases （stage Ⅰ , stage Ⅱ and Legg-Perthes disease）, whose pain was diminished and 8 patients alleviated after therapy. The bone marrow pressure decreased from 50 cm H2O before therapy to 10 cm H2O after therapy in all patients. 31 patients were followed up with X-ray examination for 3 years,X-ray film of which showed resorption of dead bone and formatioris of new bone in 23 patients （20 cases of stage Ⅰ and Ⅱ , 3 cases of the Legg-Perthes disease）. There was no change in 8 patients of stage Ⅲ and Ⅳ. Conclusion：This technique was suitable for the treatment of ANFH of stage Ⅰ to Ⅱ ,because it was a safe method with exact therapeutic effects,but it could only alleviate clinical symptoms and delay pathological process for ANFH of stage Ⅲ and Ⅳ.
出处
《放射学实践》
2005年第12期1066-1069,共4页
Radiologic Practice
关键词
股骨头坏死
放射学
介入性
骨生成
Femur head necrosis
Radiology,interventional
Osteogenesis
