髓心减压植骨与钽棒植入治疗股骨头缺血性坏死的比较分析-comparative analysis of intramedullary decompression and bone grafting and tantalum rod implantation in the treatment of avascular necrosis of femoral head.docxVIP

山西医科大学硕士学位论文 山西医科大学硕士学位论文 PAGE PAGE 2 髓心减压植骨与钽棒植入治疗股骨头缺血性坏死的比较研究 摘 要 目的：研究比较髓心减压植骨与钽棒植入治疗股骨头缺血性坏死的临床疗效。 方法：选择2008年5月至2010年3月我院收治的成人股骨头缺血坏死患者(均为Ficat Ⅱ期)26例（31髋），男19例，女7例，年龄24～63岁（平均41.3岁），其中15例（19 髋）采用髓心减压植骨术治疗，11例（12髋）采用髓心减压钽棒植入术治疗。记 录两种术式的失血量、手术时间、输血量、住院天数、Harris评分和镇痛泵的使用 天数。 结果：所有病例均获得术后随访4～24个月，两组术中失血量、手术时间、输血量、 镇痛泵的使用天数和随访时间比较差异无统计学意义，而住院天数髓心减压钽棒 植入组明显长于髓心减压植骨组（P0.05）。两组术前Harris评分比较无明显差异， 两组术后Harris评分较术前均有明显提高（P0.05），术后Harris评分髓心减压钽棒 植入组（88.24分）高于髓心减压植骨组（71.84分），提高22.8%，数据差异显著有 统计学意义（P0.05）。 结论：髓心减压钽棒植入术对早期成人股骨头坏死髋关节功能的改善明显优于髓 心减压植骨术，但住院天数较长。 关键词：股骨头缺血坏死；钽金属；髓心减压植骨术 A comparative study for treatment of necrosis of the femoral head of core decompress with bone graft and tantalum screw Abstact Objective- To study the clinical outcome of core decompress with bone graft and tantalum screw insertion for the treatment of necrosis of the femoral head. Methods- 26 cases (31 hips) of Ficat stage Ⅱ necrosis of the femoral head, from May 2008 to March 2010,were studied,including 19 males and 7 females.The average age was 41.3 (24～63) years.15 cases (19 hips) underwent core decompress with bone graft while 11 cases (12 hips) received tantalum screw insertion.The Harris score 、 intraoperative blood loss、surgical time、blood transfusions、PCA pump usage and hospital days were evaluated. Results- All cases were followed up 4 to 24 months (average 15 months),there was no statistical difference between two gro up in intraoperative blood loss、surgical time、 blood transfusions 、 follow-up time 、 PCA pump usage and Harris score of preoperative.There was statistical difference between two group in hospital days(P0.05),but in-hospital time of tantalum screw insertion is longer than those of core decompress with bone graft.The Harris score of both groups was obviously increased postoperatively(P0.05).The average Harris score of tantalum screw insertion group(88.24) was increased by 22.8% than that of core decompress with bone graft (71.84), there was statistical diff