活血生骨汤联合异体腓骨支撑术治疗股骨头坏死疗效观察

发布时间：2019-03-20 09:18

【摘要】：目的:回顾性研究2006-2010年接受活血生骨汤联合异体腓骨支撑术及单纯异体腓骨支撑术治疗的240例股骨头坏死患者的临床病例资料,对比分析两种治疗方法的临床效果。方法:将股骨头坏死病例分为两组。治疗组131例(138髋),口服活血生骨汤联合异体腓骨支撑术治疗,活血生骨汤为院内自制汤剂,连续服用6月以上;对照组109例(118髋),单纯采用异体腓骨支撑术治疗。两组病例随访12-72个月。术前及术后进行Harris评分,分析两组患者的Harris评分、优良率及X片表现。结果:1.Harris评分两组病例Harris总分较术前均有显著改善,所有患者Harris总分由术前(67.88±8.76)分提高至术后(86.12± 11.45)分,平均提高18分(P0.05),具有统计学意义;治疗组Harris总分由术前(67.91 ±8.92)提高至术后(88.34±9.86),对照组Harris总分由术前(67.87±8.92)提高至术后(83.47±10.36),两组相比较具有统计学意义(t=6.461,P0.05);2.优良率治疗组优良率为87.77%,对照组优良率为73.72%,两组病例末次随访时Harris评分优良率比较具有统计学意义(z=3.5257,P=0.01350.05);3.X片表现:治疗组ⅡA、ⅡB、ⅡC、ⅢA、ⅢB、ⅢC的病例股骨头形态改善率分别为 93.32%、90.45%、87.30%、72.46%、61.32%、23.52%;对照组 ⅡA、ⅡB、ⅡC、ⅢA、ⅢB、ⅢC 股骨头形态改善率分别为 92.45%、83.64%、81.13%、67.12%、60.88%、24.67%。两组比较ⅡB(χ2=4.637,P0.05)、ⅡC(χ2=4.025,P0.05)、ⅢA(χ2=3.889,P0.05)均有统计学意义,而ⅡA(χ2=1.025,P0.05)、ⅢB(χ2=0.925,P0.05)、ⅢC(χ2=0.450,P0.05)无统计学意义,其中ⅢC的失败率为 63.63%,最终28髋行人工关节置换。结论:活血生骨汤联合异体腓骨支撑术治疗早、中期股骨头坏死疗效确切;活血生骨汤具有消肿止痛、活血化瘀、补益肝肾的功效;活血生骨汤短期内具有促进骨生长、缓解症状、改善髋关节功能作用;活血生骨汤联合异体腓骨支撑术治疗效果优于单纯采用异体腓骨支撑术,可以提高保髋成功率,中、远期疗效好。
[Abstract]:Aim: to retrospectively study the clinical data of 240 cases of osteonecrosis of femoral head treated with Huoxue Shenggu decoction combined with allogeneic fibula support and allogeneic fibula support from 2006 to 2010. Methods: cases of osteonecrosis of femoral head were divided into two groups. 131 cases (138 hips) in the treatment group were treated by oral administration of Huoxue Shenggu decoction combined with allogeneic fibula support, which were treated with Huoxue Shenggu decoction for more than 6 months, while 109 cases (118 hips) in the control group were treated with allogeneic fibula support alone. The patients in both groups were followed up for 12 months and 72 months. Harris score was performed before and after operation. The Harris score, excellent and good rate and X-ray findings were analyzed. Results: the total score of Harris in both groups was improved significantly. The total score of Harris in all patients increased from (67.88 卤8.76) before operation to (86.12 卤11.45) after operation, with an average increase of 18 points (P0.05). It has statistical significance; The total score of Harris increased from (67.91 卤8.92) to (88.34 卤9.86) in the treatment group and from (67.87 卤8.92) to (83.47 卤10.36) in the control group. There was significant difference between the two groups (t = 6.461, P < 0.01). (P 0.05); 2. The excellent and good rate was 87.77% in the treatment group and 73.72% in the control group. There was significant difference in the excellent and good rate of Harris score between the two groups at the last follow-up (z = 3.5257, P < 0.01350.05). 3. X-ray manifestations: the improvement rate of femoral head shape was 93.32%, 90.45%, 87.30%, 72.46%, 61.32%, 23.52% in treatment group 鈪，

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