三种不同方法治疗Perthes病的疗效比较研究

发布时间：2018-08-07 17:24

【摘要】：目的比较三种不同方法治疗儿童Perthes病的疗效,进一步探讨适合儿童Perthes病的治疗手段。方法回顾性收集我院1999年12月至2012年10月收治的99例(99髋)儿童Perthes病,将其分为4组进行疗效观察,A组(保守治疗1组,年龄5岁,Herring A.B型)33髋;B组(保守治疗2组,年龄5岁,Herring B/C.C型)21髋;C组(股骨粗隆间或粗隆下内翻截骨组,不论年龄,Herring B/C.C型)24髋;D组(Salter骨盆截骨组,不论年龄,Herring B/C.C型)21髋。采用临床和X线片动态随访,按Stulberg标准进行疗效评价。结果经2～10年随访,4组的优良率分别为:A组66.7%,B组38.1%,C组62.5%,D组61.9%;A组、C组和D组的疗效均优于B组,差异均有统计学意义(P0.05);同样为保守治疗,A组的疗效明显优于B组,差异有统计学意义(P0.05);A组、C组和D组的优良率虽以A组最高,但三组间比较差异无统计学意义(P0.05);B组、C组和D组同为Herring B/C.C型,优良率以B组最差,差异有统计学意义(P0.05)。结论增加股骨头的包容是治疗Perthes病的有效方法,病情轻、发病年龄小的Herring A.B型患儿宜保守包容治疗,病情重、发病年龄大的Herring B/C.C型患儿宜手术包容治疗。
[Abstract]:Objective to compare the efficacy of three different methods in the treatment of Perthes's disease in children and to explore the treatment methods suitable for Perthes's disease in children. Methods 99 cases (99 hips) with Perthes's disease were collected retrospectively from December 1999 to October 2012 in our hospital. The patients were divided into 4 groups: group A (conservative treatment group 1, aged 5 years, Herring A.B), group B (33 hips), group B (conservative treatment group 2). Group C (intertrochanteric femoral intertrochanteric or subtrochanteric varus osteotomy, regardless of age, Herring B/C.C type), group D (Salter pelvis osteotomy, regardless of age). Clinical and X-ray follow-up was used to evaluate the efficacy according to Stulberg criteria. Results after 2 ~ 10 years follow-up, the excellent and good rates of group B and B were 66.7and 38.1% respectively. The curative effects of group C and group D were better than those of group B (P0.05), and the curative effect of group A was better than that of group B (P 0.05), and the curative effect of group A was better than that of group B (P 0.05), and the curative effect of group A was significantly better than that of group B (P 0.05), and the curative effect of group A was better than that of group B (P 0.05). The difference was statistically significant (P0.05) although the excellent and good rates of group A and D were the highest in group A, there was no significant difference among the three groups (P0.05). The excellent and good rates were the worst in group B and the worst in group B (P0.05). Conclusion increasing the tolerance of femoral head is an effective method for the treatment of Perthes disease. It is appropriate for the children with Herring A.B type who have a mild illness and the younger age to be treated with conservative inclusive therapy. The patients with severe disease and the older Herring B/C.C type children with the disease should be treated with surgical inclusion therapy.
【作者单位】：中南大学湘雅二医院创伤骨科;中南大学湘雅医学院附属海口医院骨科中心;
【分类号】：R687.3

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