摘要
目的分析髓芯减压术联合同种异体骨移植或人工椎板置入在股骨头坏死保髋关节的临床疗效差异。方法2018年1月~2019年12月间收治的股骨头坏死病人80例,按治疗方法分为A组和B组,每组各40例。A组采用髓芯减压术联合同种异体骨移植术治疗,B组采用髓芯减压术联合人工椎板置入治疗;治疗前后采用HHS和VAS评分系统进行评估,并对治疗的成功率进行评估;治疗前及随访时行X光扫描检查,参照ARCO分期对影像学改变进行评估。结果治疗后A组HHS评分为(84.83±2.18)分,B组为(89.49±2.39)分,治疗前HHS评分分别为(57.11±8.32)分和(56.38±7.97)分,治疗前后比较差异有统计学意义(P<0.05),治疗后B组HHS评分为(89.49±2.39)分,高于A组的(84.83±2.18)分,差异有统计学意义(P<0.05);治疗后A组VAS评分为(4.65±1.03)分,B组为(3.02±0.87)分,治疗前VAS评分分别为(6.55±2.18)分和(6.47±1.95)分,治疗前后比较差异有统计学意义(P<0.05)。治疗后B组病人VAS评分(3.02±0.87)低于A组(4.65±1.03),差异有统计学意义(P<0.05);B组治疗成功率(97.50%)高于A组(80.00%),差异有统计学意义(P<0.05)。结论相较于髓芯减压术联合同种异体骨移植,髓芯减压术人工椎板置入可提高股骨头坏死病人髋关节功能,改善临床疗效。
Objective To analyze the clinical effect of core decompression combined with allogeneic bone grafting or artificial lamina implantation in the treatment of femoral head necrosis and hip joint preservation.Methods Eighty patients with femoral head necrosis admitted to our hospital from January 2018 to December 2019 were divided into group A and group B;group A was treated with core decompression combined with allograft,and group B was treated Core decompression combined with artificial lamina implantation;HHS and VAS scoring systems were used to evaluate patients before and after treatment,and the success rate of patients’treatment was evaluated.The patients were examined by X-ray before treatment and during follow-up,and the imaging changes were evaluated according to Arco staging.Results After treatment,the HHS score of group A(84.83±2.18)and group B(89.49±2.39)were higher than those of before the treatment of group A(57.11±8.32)and group B(56.38±7.97)(P<0.05).After treatment,the HHS score of group B(89.49±2.39)was significantly higher than that of group A(84.83±2.18)(P<0.05);the VAS score of group A(4.65±1.03)were significantly higher than those of before the treatment of group A(6.55±2.18)(P<0.05).After treatment,the VAS score of group B(3.02±0.87)was significantly lower than that of before the treatment of group B(6.47±1.95)(P<0.05).After treatment,the VAS score of group B(3.02±0.87)was significantly lower than that of group A(P<0.05).The treatment success rate of group B(97.50%)was significantly higher than that of group A(80.00%)(P<0.05).Conclusion Compared with core decompression combined with allogeneic bone transplantation,core decompression with artificial lamina implantation can more effectively improve hip joint function in patients with femoral head necrosis and improve clinical efficacy.
作者
敖阳
张猛
AO Yang;ZHANG Meng(Department of Orthopedics,Fuxin Traditional Chinese Medicine Hospital,Liaoning,Fuxin 123000,China)
出处
《临床外科杂志》
2021年第10期967-970,共4页
Journal of Clinical Surgery
关键词
髓芯减压术
同种异体骨移植
人工椎板置入
股骨头坏死
保髋关节
core decompression
allogeneic bone transplantation
artificial laminar implantation
femoral head necrosis
hip joint preservation
