摘要
目的:探讨桃仁通痹丸联合经髋关节外科脱位入路打压植骨治疗中青年ARCOⅡ~Ⅲ期股骨头缺血性坏死的临床疗效。方法:选取2015年9月至2019年6月就诊的中青年ARCOⅡ~Ⅲ期股骨头缺血性坏死患者52例,其中男41例、女11例,采用随机数字法分为对照组和治疗组;两组均采用经髋关节外科脱位入路股骨头坏死病灶清理、打压植骨支撑术配合术后对症处理及康复治疗,治疗组在对照组基础上于术后第1天开始口服桃仁通痹丸,3个月为1个疗程。记录患者术后并发症及肝肾功异常情况;记录两组术前、术后6个月、术后12个月及末次随访时Harris评分评价髋关节功能;采用双髋关节正位X线片进行股骨头影像学评价从而评估股骨头坏死修复情况,以股骨头负重面高度塌陷大于4 mm作为研究终点事件评价股骨头生存率。结果:两组患者均顺利完成手术及术后随访,未出现切口感染、下肢深静脉血栓形成、骨折等严重并发症。对照组随访15~38个月,平均随访时间为(24.88±6.74)个月;治疗组随访16~35个月,平均随访时间为(24.74±4.94)个月。两组术前Harris评分比较,差异无统计学意义(P>0.05);与术前相比,两组术后各随访时间节点Harris评分结果均明显提高,差异有统计学意义(P<0.01);比较两组患者术后6个月Harris评分,差异无统计学意义(P>0.05);术后12个月及末次随访时,治疗组Harris评分优于对照组,差异有统计学意义(P<0.05);比较两组末次随访Harris评分优良率、股骨头稳定率、股骨头生存率,治疗组均优于对照组,差异有统计学意义(P<0.05)。结论:采用桃仁通痹丸口服联合经髋关节外科脱位入路打压植骨治疗中青年ARCOⅡ~Ⅲ期股骨头缺血性坏死,整体与局部兼顾,能有效改善髋关节功能、修复坏死股骨头、提高股骨头生存率,可作为ONFH保髋术后辅助用药,值得临床推广。
Objective:To investigate the clinical efficacy of Taoren Tongbi pill combined with surgical hip dislocation approach with pressure bone graft on the treatment of ARCO stageⅡandⅢosteonecrosis of the femoral head in middle-aged and young patients.Methods:52 middle-aged and young patients with ARCO stageⅡandⅢosteonecrosis of the femoral head from September 2015 to June 2019 were divided into control group and treatment group by random number method,including 41 males and 11 females who were hospitalized in hospital.Both groups were treated with osteonecrosis of the femoral head focus cleaning and pressure bone graft through surgical hip dislocation approach,combined with postoperative symptomatic treatment and rehabilitation treatm-ent.The treatment group began to take Taoren Tongbi pill orally on the first day after surgery on the basis of the control group,and 3 months as a course of treatment.Postoperative complications and abnormal liver and kidney function were recorded.The hip function was evaluated by Harris score before surgery,6 months after operation,12 months after operation and the last follow-up time.Radiographic evaluation was carried out by orthophotography of both hip joints to evaluate the repair of femoral head,and the survival rate of femoral head was evaluated by the end point event of femoral head collapse height greater than 4 mm.Results:The surgery and postoperative follow-up of both groups of patients were successfully completed,without incision infection,deep venous thrombosis of lower limbs,fracture and other serious complications.The control group was followed up for 15 to 38 months with an average follow-up time of(24.88±6.74)months.The treatment group was followed up for 16 to 35 months,with an average follow-up time of(24.74±4.94)months.There was no significant difference in preoperative Harris score between the two groups(P>0.05).The Harris score at each follow-up time node of postoperation was better than preoperative with statistically significant difference(P<0.01).There w
作者
张焕堂
吴昭克
张前进
谢庆华
龚志兵
郭金花
王婉霞
ZHANG Huantang;WU Zhaoke;ZHANG Qianjin;XIE Qinghua;GONG Zhibing;GUO Jinhua;WANG Wanxia(Quanzhou Orthopedic-Traumatological Hospital,Quanzhou,362000,Fujian China)
出处
《中国中医骨伤科杂志》
CAS
2023年第6期41-45,51,共6页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
福建中医药大学校管课题临床专项(XB2018111)。
关键词
股骨头坏死
桃仁通痹丸
髋关节外科脱位入路
植骨术
osteonecrosis of the femoral head
Taoren Tongbi pill
surgical hip dislocation approach
pressure bone graft
