摘要
目的探讨组织工程化人工陶瓷骨联合富血小板血浆治疗早期股骨头坏死的临床有效性及安全性,为保头髋疗法提供一个新思路、新方向。方法选取2016年1月~2018年12月陕西中医药大学附属医院及西安市红会医院收治的70例早期股骨头坏死(ARCOⅠ-Ⅱ期)患者为研究对象,按照数字表法随机分为观察组(n=35)和对照组(n=35)。观察组采用组织工程化人工陶瓷骨联合自体富血小板血浆打压植骨治疗,对照组采用人工陶瓷骨打压植骨治疗。记录治疗前后两组患者的一般资料、髋关节功能Harris评分、髋部疼痛VAS评分及影像学资料。结果①髋关节功能Harris评分:术前两组髋关节功能Harris评分比较,差异无统计学意义(P>0.05);术后12个月,观察组髋关节功能Harris评分与对照组相比,差异有统计学意义(P<0.05)。②髋部疼痛VAS评分:术前两组髋部疼痛VAS评分比较,差异无统计学意义(P>0.05);术后12个月,观察组较对照组明显减轻(P<0.05)。③影像学结果:术后6、12个月,观察组髋部X线、CT及MRI检查可见植入的陶瓷骨及新生骨长入倾向,且影像学资料未见股骨头坏死进一步进展;而对照组可见植入的陶瓷骨但未见明显新生骨长入,虽然影像学资料未显示股骨头坏死进一步进展,但MRI可见股骨头内T2高信号。结论陶瓷骨打压植骨联合富血小板血浆可以有效改善股骨头坏死患者症状,延缓股骨头塌陷时间,为治疗早期股骨头坏死的保头疗法提供了一种新方法、新思路。
Objective To observe the clinical effectiveness and safety of tissue-engineered artificial ceramic bone combined with platelet-rich plasma in the treatment of early femoral head necrosis,providing a new idea and direction for head and hip therapy.Methods 70 early osteonecrosis of the femoral head patients included in this study were randomly divided into test group(35 cases)and control group(35 cases),according to the digital table method.The test group was treated with tissue-engineered artificial ceramic bone combined with autologous platelet-rich plasma for bone grafting.The control group was treated with artificial ceramic bone compression and bone grafting.The general information,Harris score,hip pain VAS score and imaging data of the two groups of patients were recorded before and after treatment.Results The Harris score of hip joint function of the two groups of patients before surgery was not statistically significant(P>0.05).The Harris score of hip joint function of the test group was 12 months after surgery compared with the control group.The difference was statistically significant(P<0.05).The hip pain VAS scores of the two groups of patients before surgery were not statistically significant(P>0.05),and the hip pain of the experimental group was significantly reduced 12 months after surgery,compared with the control group.There was a significant difference(P<0.05).X-rays,CT,and MRI examinations of the experimental group at 6 and 12 months after surgery showed implanted ceramic bone and neonatal bone growth tendency,and the imaging data showed no further progress of femoral head necrosis.In the control group,the implanted ceramic bone was seen,but no obvious new bone growth was observed.Although the imaging data did not show further progress of femoral head necrosis,MRI showed a high T2 signal in the femoral head.Conclusion Ceramic bone compression and bone grafting combined with platelet-rich plasma can effectively improve the symptoms of patients,delay the time of femoral head collapse,and provide a n
作者
李安明
史国号
刘德玉
欧国峰
王国柱
肖斌
郝阳泉
LI Anming;SHI Guohao;LIU Deyu;OU Guofeng;WANG Guozhu;XIAO Bin;HAO Yangquan(Central Hospital of Ankang Hengkou Demonstration Zone,Ankang 725000,Shanxi,China;Department of Orthopedics,The Second Affiliated Hospital of Shanxi University of Traditional Chinese Medicine,Xianyang 712000,Shanxi,China;Department of Orthopaedics,The Affiliated Hospital of Shanxi University of Traditional Chinese Medicine,Xianyang 712000,Shanxi,China;Department of Orthopaedics,Xi'an Red Cross Hospital,Xi'an 710054,China)
出处
《西部医学》
2020年第12期1778-1783,共6页
Medical Journal of West China
基金
全国名老中医药专家传承工作室建设项目(国中医药人教发[2018]134号)
关中李氏骨伤流派传承工作室项目(陕中医药发[2018]40号)。
关键词
股骨头坏死
打压植骨
富血小板血浆
疗效
Osteonecrosis of the femoral head
Compression of bone graft
Platelet-rich plasma
Clinical research
