关节镜配合打压植骨腓骨支撑术治疗围塌陷期股骨头坏死效果观察

发布时间：2018-01-21 16:24

  本文关键词： 股骨头坏死 围塌陷期 打压植骨 关节镜 腓骨支撑术　出处：《山东医药》2017年05期 　论文类型：期刊论文

【摘要】：目的观察关节镜配合打压植骨腓骨支撑术治疗围塌陷期股骨头坏死的效果。方法将122例围塌陷期非创伤性股骨头坏死患者根据手术方式分为观察组57例(57髋)与对照组65例(65髋)。观察组于关节镜监视下行打压植骨腓骨支撑术治疗,对照组行打压植骨腓骨支撑术治疗。对比两组切口长度、手术时间、术中出血量、拆线时间;术前及术后12、24、36个月采用Harris评分评价髋关节功能恢复情况;术后36个月比较两组ACRO分期;术后36个月根据股骨头坏死修复和塌陷程度对患者进行分级,Ⅰ级为好转,计算好转率。结果与对照组比较,观察组失血量大、手术时间长(P均0.05),两组切口长度、拆线时间比较差异无统计学意义(P均0.05)。术后36个月,观察组Harris评分较对照组升高(P均0.05)。术后36个月两组ACRO分期比较差异无统计学意义(P0.05)。两组好转率比较差异无统计学意义(P0.05),两组ⅡB期、ⅡC期好转率高于ⅢB期(P均0.05);观察组ⅢB期好转率高于对照组(P0.05)。结论关节镜配合打压植骨腓骨支撑术治疗围塌陷期股骨头坏死有效,尤其对治疗ⅢB期围塌陷期股骨头坏死有优势。
[Abstract]:Objective to observe the effect of arthroscopy combined with bone grafting and fibula support in the treatment of peri-collapse osteonecrosis of femoral head. Methods 122 cases of non-traumatic femoral head necrosis in peri-collapse period were divided into observation group (n = 57) (n = 57). 57 hips) and 65 cases (65 hips) in the control group. The treatment group was treated by fibula and bone grafting under arthroscopic monitoring. In the control group, the length of incision, the time of operation, the amount of blood lost during operation and the time of thread removal were compared between the two groups. Harris score was used to evaluate the recovery of hip function before and after operation at 12: 24 and 36 months after operation. 36 months after operation, ACRO staging was compared between the two groups. 36 months after operation, the patients were graded according to the degree of repair and collapse of femoral head necrosis, grade I was improved and the rate of improvement was calculated. Results compared with the control group, the blood loss in the observation group was larger than that in the control group. There was no significant difference in incision length and thread removal time between the two groups (P < 0.05). 36 months after operation, there was no significant difference between the two groups. The Harris score in the observation group was significantly higher than that in the control group (P < 0.05). There was no significant difference in the ACRO staging between the two groups at 36 months after operation (P 0.05). There was no significant difference in the improvement rate between the two groups (P 0.05). The improvement rate of stage 鈪，

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