[1]吴良金,孙风凡△,倪慧英,等.单孔与多孔道髓芯减压联合富血小板血浆治疗早期股骨头缺血性坏死的临床观察[J].中国中医骨伤科杂志,2023,31(10):12-17+22.[doi:10.20085/j.cnki.issn1005-0205.231003]
　WU Liangjin,SUN Fengfan,NI Huiying,et al.Comparative Study of Single-Pore and Multi-Pore Decompression Combined with Platelet-Rich Plasma on the Treatment of Early Femoral Head Necrosis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(10):12-17+22.[doi:10.20085/j.cnki.issn1005-0205.231003]
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单孔与多孔道髓芯减压联合富血小板血浆治疗早期股骨头缺血性坏死的临床观察()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年10期
页码:
12-17+22
栏目:
临床研究
出版日期:
2023-10-15

文章信息/Info

Title:
Comparative Study of Single-Pore and Multi-Pore Decompression Combined with Platelet-Rich Plasma on the Treatment of Early Femoral Head Necrosis
文章编号:
1005-0205(2023)10-0012-06
作者:
吴良金1; 孙风凡1△; 倪慧英1; 谭浩林1; 夏晓斌1; 项杰1; 周晓成1
1杭州市富阳中医骨伤医院关节科(杭州,311000)
Author(s):
WU Liangjin1; SUN Fengfan1△; NI Huiying1; TAN Haolin1; XIA Xiaobin1; XIANG Jie1; ZHOU Xiaocheng1
1Hangzhou Fuyang Orthopaedic Hospital of Traditional Chinese Medicine,Hangzhou 311000,China.
关键词:
小直径多孔道减压;  大直径单孔道减压;  富血小板血浆;  早期股骨头坏死
Keywords:
small diameter multi-pore decompression;  large diameter single-pore decompression;  platelet-rich plasma(PRP);  early femoral head necrosis
分类号:
R681.8
DOI:
10.20085/j.cnki.issn1005-0205.231003
文献标志码:
A
摘要:
目的:比较单孔与多孔道髓芯减压联合富血小板血浆(PRP)治疗早期股骨头坏死的临床疗效。方法:选取2015年至2022年诊断为早期股骨头坏死并行保髋手术治疗的患者80例,将其分成A组(采取髋关节镜辅助下小直径多孔道髓芯减压)20例,B组(采取髋关节镜辅助下小直径多孔道髓芯减压联合富血小板血浆局部应用)20例,C组(采取髋关节镜辅助下大直径单孔道髓芯减压)20例,D组(采取髋关节镜辅助下大直径单孔道髓芯减压联合富血小板血浆局部应用)20例。术后1个月、3个月、1年及1.5年分别随访,并记录4组病例所有患者的术前、术后髋关节功能Harris 评分、疼痛视觉模拟量表(VAS)评分及手术侧股骨头的MRI影像学改变,对数据进行统计分析,以评估股骨头内局部应用富血小板血浆和小直径多孔道/大直径单孔道髓芯减压的临床疗效。结果:VAS 评分组内比较,治疗后4组VAS评分均低于治疗前,差异有统计学意义(P<0.05)。组间比较,治疗后VAS 评分D组<C组<B组<A组,差异有统计学意义(P<0.05)。Harris评分组内比较,治疗后4组 Harris评分均高于治疗前,差异有统计学意义(P<0.05); 组间比较,治疗后Harris评分A组<B组<C组<D组,差异有统计学意义(P<0.05)。末次随访时MRI评估提示A、B、C、D组患者的优良率分别为45%,50%,70%和75%。结论:与单纯孔道髓芯减压技术相比,髓芯减压联合局部富血小板血浆注射疗效更佳; 而且从孔道直径比较,大直径单孔道髓芯减压技术治疗股骨头缺血性坏死优于小直径多孔道髓芯减压技术。
Abstract:
Objective:To compare the clinical efficacy of single-pore and multi-pore decompression combined with platelet-rich plasma(PRP)on the treatment of early femoral head necrosis.Methods:A total of 80 patients diagnosed with early femoral head necrosis and treated with coxy-preserving surgery were selected from 2015 to 2022.The patients were divided into group A(small diameter and multi-pore decompression assisted by hip arthroscope)20 cases,group B(small diameter and multi-pore decompression assisted by hip arthroscope combined with local application of PRP)20 cases,group C(large diameter and single-pore decompression assisted by hip arthroscope)20 cases,group D(receiving large-diameter single-pore decompression with hip arthroscopy combined with local application of PRP)20 cases.Regular follow-up visits were performed 1 month,3 months,1 year and 1.5 years after surgery.Preoperative and postoperative Harris hip function scores,visual analog scale(VAS)scores of pain and MRI imaging changes of femoral head were recorded in all patients in the 4 groups,and the data were statistically and contrastigally analyzed to evaluate the internal local application of femoral head clinical efficacy of PRP and small diameter multi-pore/large diameter single-pore cardiac decompression.Results:VAS scores:Intra-group comparison,VAS scores after treatment were lower than before treatment(P<0.05).Comparison between groups,VAS scores after treatment in group D<group C<group B<group A,the difference was statistically significant(P<0.05).Harris scores:Intra-group comparison,the Harris scores after treatment of 4 groups were higher than that before treatment(P<0.05).Comparison between groups,Harris scores after treatment in group A<group B<group C<group D,the difference was statistically significant(P<0.05).At the last follow-up,MRI evaluation suggested that the excellent and good rates of patients in group A,B,C and D were 45%,50%,70% and 75%,respectively.Conclusion:Compared with simple channel decompression technique,PRP injection combined with medullary decompression is more effective.Moreover,from the comparison of pore diameter,large-diameter single-pore decompression technique is superior to small-diameter multi-pore decompression technique in the treatment of avascular necrosis of femoral head.

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备注/Memo

备注/Memo:
基金项目:浙江省卫生科技计划项目(2022KY1068)
杭州市卫生科技计划项目(B20220051)
△通信作者 E-mail:936294580@qq.com
更新日期/Last Update: 2023-10-01