【摘要】 目的探讨股骨头无菌坏死介入治疗的临床价值。方法经临床、X线、CT或MRI检查证实的54例患者,按股骨头坏死的ARCO分期:Ⅰ期6例,Ⅱ期38例,Ⅲ期9例,Ⅳ期1例。其中有外伤史39例,长期应用激素史9例,原因不明者6例。采用Seldinger穿刺技术,将4～5FCobra导管超选择插入旋股内、外动脉,注入溶栓、扩血管及骨营养药物。结果a)本组54例中有52例股骨头无菌坏死患者疼痛缓解或减轻,约占96.3%;髋关节活动范围均有不同程度改善。b)旋股内、外动脉经介入治疗后血管管径增粗,分支增多,显影时间缩短,骨坏死囊变区染色变浅,回流加速。c)介入治疗后54例患者随访3个月～2a,其中,Ⅰ期患者6例、Ⅱ期患者30例、Ⅲ期患者3例,在X线、CT或MRI片上显示坏死骨有不同程度吸收,伴不同程度的新骨形成。结论本组大多数病例经溶栓、扩血管及骨营养药物的联合使用,临床症状明显改善,X线、CT及MRI片见坏死骨吸收、新骨形成,说明此法对改善股骨头血液供应具有明显效果。更多还原

【Abstract】 Objective To investigate the clinical value of interventional therapy for avascular necrosis of the femoral head(ANFH).Methods According to ARCO staging of ANFH,54 patients with ANFH proved by X-ray,CT and/or MRI included 6 cases of stage I,38 cases of stage Ⅱ,9 cases of stage Ⅲ,and 1 cases of stage Ⅳ.Among all patients,39 cases had traumatic history,9 case had long term administration of hormone history,and 6 cases were unknown etiology.The interventional therapy was performed by Seldinger’s technique i.e.4-5 F cobra catheter was inserted superselectively into the arteriae circumflexa femoris medialis and arteriae circumflexa femoris lateral and then thromolytic agents,vasodilator drugs and drugs improving microcirculation were injected directly into above arteries.Results Following interventional therapy,52 of 54 patients presented the relieve of hip pain,relieve rate was 96.3 %.The disorder of hip joint function were improved in different degrees.The angiography showed thickening diameter and increasing bronch of arteriae circumflexa femoris medialis and lateral.During follow-up for 3 months to 2 years,X-ray,CT or MRI showed that the absorption of necrotic bone and formation of neo bone in different degrees were found in 6 cases of stage 1,30 cases of stage Ⅱ,and 3 cases of stage Ⅲ. Conclusion The combined applications of thromolytic agent,vasodilator drugs and improving microcirculation drugs have apparent efficacy for treating ANFH.更多还原