【摘要】 目的评估股骨头缺血性坏死(ONFH)带旋股外血管升支髂骨瓣转移治疗后,股骨头内血运变化情况。方法 24例单侧股骨头缺血性坏死患者,男19例,女5例,ARCO分期标准Ⅱ期20髋,Ⅲ期4髋,应用带旋股外血管升支髂骨瓣转移术治,术后行患侧DSA检查。全部患者在术后6周～5年再次行患侧DSA复查。结果 24例术前股动脉DSA造影均显示股骨头供血的异常改变,旋股外侧动脉升支血管充盈良好。术后6周DSA显示22侧转移骨瓣血管蒂充盈良好,股骨头内供血明显改善;2例术后DSA显示转移骨瓣血管蒂充盈不佳或股骨头内无造影剂充盈,其中1例术后12个月复查DSA显示血管蒂充盈满意,股骨头血供良好。1例术后2年随访,DSA造影显示股骨头内无造影剂充盈,行人工关节置换。本组病例临床成功率为91%,影像学成功率为85%。结论①旋股外血管升支解剖位置恒定,无较大变异,适于切取带血管骨瓣进行移植。②带旋股外血管升支髂骨瓣转移术治疗股骨头缺血性坏死能有效重建股骨头内血运更多还原

【Abstract】 Objective To assess the effectiveness of digital subtraction angiography (DSA) in evaluation of the hemodynamic changes after the treatment of avascular osteonecrosis of femoral head (ONFH) with ascending branch of lateral femoral circumflex artery bone flaps. Methods Totally 24 patients including 19 males and 5 females with 20 hips of stage Ⅱ and 4 hips of stage Ⅲ, were treated by using Iliac bone flaps pedicled with ascending branch of lateral femoral circumflex artery.Selective DSA was performed on all 24 patients preoperatively and 6 months to 5 years postoperatively. Results Six months after operation reconstruction of blood supply on the femoral head was seen in 22 cases.2 patients showed poor filling or failure of filling of the vessel pedicles in transplanted bone flaps and re-examination of DSA conducted at 12 months after operation showed satisfactory filling in one of those 2 cases.1 cases failure filling after 2 years postoperative。Total hip arthroplasty were performed in the 1 patients. The clinical success rate of this procedure was 91%, and the radiological success rate was 85%. Conclusion ① The anatomical position of ascending branch of lateral femoral circumflex artery is constant,and beseem to use as vascularised bone flaps.② the treatment of avascular osteonecrosis of femoral head using Iliac bone flaps pedicled with ascending branch of lateral femoral circumflex artery is a effective method.更多还原