动脉灌注髓芯减压干细胞移植治疗股骨头坏死_临床医学论文.docVIP

动脉灌注髓芯减压干细胞移植治疗股骨头坏死_临床医学论文 动脉灌注髓芯减压干细胞移植治疗股骨头坏死_临床医学论文 作者：万宇，赵富胜，陈施展，张文华，姚一民 【摘要】 目的 评价动脉灌注加股骨头髓芯减压后注射干细胞治疗成人股骨头缺血性坏死的疗效。方法 对30 例成人股骨头缺血性坏死(ARCO分期ⅠA～ⅢA期)分别采用单纯动脉灌注、动脉灌注加股骨头髓芯减压、动脉灌注加股骨头髓芯减压后行干细胞移植三种方法治疗。术后采用髋关节Harris评分及影像学(主要为MRI)情况评定疗效。结果 动脉灌注加股骨头髓芯减压后注射干细胞较另外两组在MRI表现上有明显差异(P＜0.05)。结论 通过对早期股骨头缺血性坏死进行血管灌注、股骨头髓芯减压及自体骨髓干细胞注射的治疗，可以延缓或阻止股骨头缺血坏死、塌陷、变形的病理过程。 【关键词】 股骨头缺血性坏死；自体骨髓干细胞；髓芯减压；动脉灌注 Abstract：Objective Evaluate the curative effect of the treatment of the avascular necrosis of the adult femoral head with stem cell injection after the arterial perfusion plus pith decompression of the femoral head.Methods 30 cases of the adult avascular necrosis of the femoral head(ARCO Phase：PhaseⅠA～ⅢA) were treated with respectively 3 methods，namely：the sole arterial perfusion the arterial perfusion combined with pitch decompression of the femoral head the injection of stem cell after the arterial perfusion combined with pitch decompression of the femoral head.And after the operation，the curative effects were evaluated with Harris Scoring system and medical imaging system(mainly MRI)in dealing with hip joint.Results There was significant difference between the cases treated with the injection of stem cell after the arterial perfusion combined with pitch decompression of the femoral head with those cases treated with the rest two kind of treatments(P＜0.05).Conclusion With the treatment of vascular perfusion，pith decompression of the femoral head and the injection of autologous marrow stem cell，the pathological process of the earlyphase femoral head avascular necrosis could be mitigated or prevented from being ischemia，collapsed and deformed. Key words：avascular necrosis of the femoral head；autologous bone marrow stem cells；pith decompression；intra 股骨头缺血性坏死(avascular necrosis of the femoral head，ANFH)是一种骨科常见病、多发病，致残率较高，而且病因不明，一般认为其发病机制与脂肪栓塞、血管内凝血、骨内高压和骨细胞脂肪性坏死有关。由于人工关节置换存在使用寿命问题，青壮年患者不宜积极或过早行关节置换。我们将自2002年以来我院先后治疗的病情相近的30 例股骨头缺血坏死病例分为三组，分别采用单纯动脉灌注、动脉灌注加股骨头髓芯减压、动脉灌注加股骨头髓芯减压后干细胞移植