国产多孔钽棒治疗早期股骨头缺血性坏死的临床疗效

发布时间：2018-06-17 21:02

本文选题：股骨头缺血性坏死 + 钽　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的:探讨采用国产多孔钽棒治疗早期股骨头缺血性坏死的临床疗效。方法:采用前瞻性自身配对设计临床验证试验,分析2014年7月~2015年12月采用国产多孔钽棒治疗的18例(19髋)早期股骨头缺血性坏死患者,其中男14例,女4例;年龄30~62岁,平均44.2岁。其中病因包括:3例为激素性,7例(8髋)为酒精性,8例为特发性。根据改良Ficat分期:Ⅱa期4例,Ⅱb期14例。疗效评估包括术前及术后3、6、12个月患髋的Harris、Womac评分,X线片、MRI影像学变化以及并发症观察。结果:所有患者均得到随访,随访时间8~24个月,平均16个月。截至最后一次随访,未发现局部感染,切口不愈合,排异反应,钽棒断裂,松动,移位等不良事件发生。术后各时相点Harris评分[(82.73±8.99)分、(84.46±10.75)分、(87.22±10.0)分]较术前[(75.51±11.91)分]均有明显升高(P0.05),末次随访髋关节评分:优为10髋,良为3髋,可为5髋,差为1髋,优良率72%。术后各时间点Womac评分[(17.44±9.40)分、(12.39±7.31)分、(11.06±8.41)分],较术前[(28.28±13.10)分]均有明显下降(P0.05)。影像学显示,17例(18髋)股骨头坏死无明显加重,股骨头生存率为95%(18/19)。其中有1例因患髋疼痛明显加重,股骨头塌陷,最终行人工关节置换,术后解剖患髋股骨头,大体标本可见钽棒与周围骨组织紧密结合,硬组织切片显示新生骨组织已长入材料的孔隙。结论:国产多孔钽棒治疗早期股骨头缺血性坏死,能促进骨长入,有效缓解疼痛、改善髋关节功能、防止股骨头塌陷,延缓人工全髋关节置换时间。
[Abstract]:Objective: To explore the clinical efficacy of domestic porous tantalum rods in the treatment of early avascular necrosis of the femoral head. Methods: 18 cases (19 hips) with ischemic necrosis of the femoral head were analyzed by prospective self matching design in December July 2014 ~2015, including 14 males and 4 females, aged 30~62 years, The average 44.2 years old. Among them, 3 were hormone, 7 cases (8 hips) were alcoholic and 8 were idiopathic. According to modified Ficat staging, 4 cases in stage II A and 14 cases of stage II B, the therapeutic evaluation included Harris, Womac score, X ray, MRI imaging, and complication observation before and after 3,6,12 months. All patients were followed up. The duration of the visit was 8~24 months, averaging 16 months. As of the last follow-up, no local infection, nonunion, rejection, tantalum rod fracture, loosening and displacement were found. The Harris score of each time point ((82.73 + 8.99), (84.46 + 10.75), (87.22 + 10)) after the operation were significantly higher than before ((75.51 + 11.91)) (P0.05). The total hip joint score was 10 hips with 3 hips, 5 hips and 1 hips. The good rate was 1 hips. The excellent rate was (17.44 + 9.40), (12.39 + 7.31), (11.06 + 8.41)) after 72%., and (11.06 + 8.41) points before operation (11.06 + 8.41)). Imaging showed that the necrosis of femoral head was not significantly increased in 17 cases (hip of 18), and the survival rate of femoral head was 95% (18/19). 1 of them were obviously aggravated by the pain of the hip, the femoral head collapsed, the artificial joint replacement was finally performed, and the femoral head was dissected after the operation. The gross specimens showed that the tantalum rod was closely combined with the surrounding bone tissue, and the hard tissue section showed that the new bone tissue had grown into the pore of the material. Conclusion: the domestic porous tantalum rod is used to treat the early ischemic damage of the femoral head. Death can promote bone ingrowth, relieve pain effectively, improve hip joint function, prevent femoral head collapse, and postpone total hip replacement time.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

【参考文献】