腓骨移植治疗股骨头缺血性坏死临床观察.docVIP

腓骨移植治疗股骨头缺血性坏死临床观察 　　[摘要] 目的 观察腓骨移植治疗股骨头缺血性坏死的临床疗效。 方法 选取90例股骨头缺血性坏死患者，随机分为观察组与对照组，每组45例。观察组采取腓骨移植治疗，对照组采取肌骨瓣移植治疗。比较两组手术时间、术中失血量、住院时间、术前及术后不同时间点的髋关节Harris评分、髋关节优良率与股骨头塌陷率。 结果 两组住院时间差异无统计学意义（P0.05）。观察组手术时间、术中失血量均高于对照组（P0.05）。观察组术后6个月与12个月的Harris评分均高于对照组（P0.05）。 结论 腓骨移植治疗股骨头缺血性坏死有利于彻底清除病变组织，并提供软骨下骨力学支撑，为髋关节功能的恢复奠定基础，值得临床推广应用。 　　[关键词] 腓骨；股骨头坏死；缺血性坏死；移植 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2017）28-0055-03 　　[Abstract] Objective To observe the clinical effect of fibular transplantation in the treatment of avascular necrosis of femoral head. Methods A total of 90 patients with avascular necrosis of the femoral head were randomly divided into observation group and control group， with 45 cases in each group. The observation group was treated with fibular transplantation and the control group was treated with musculocutaneous flap transplantation. The operation time， intraoperative blood loss， hospitalization time， hip joint Harris score at preoperative and postoperative different time points， hip excellent rate and femoral head collapse rate between the two groups were compared. Results There was no significant difference in hospitalization time between the two groups（P0.05）. The operation time and intraoperative blood loss were higher in the observation group than those in the control group（P0.05）. The Harris scores were higher in the observation group than those in the control group at 6 months and 12 months after surgery（P0.05）. Conclusion Fibular transplantation for the treatment of avascular necrosis of the femoral head is conducive to the complete removal of diseased tissue， and provides subchondral bone mechanics support， which lays the foundation for the recovery of hip joint function， and is worthy of clinical application. 　　[Key words] Fibula； Femoral head necrosis； Avascular necrosis； Transplantation 　　股骨?^坏死是因多种因素导致的股骨头结构改变、塌陷、关节功能障碍。据报道[1]，该病在30～50岁人群中较为高发，且男性发病率高于女性。有研究[2]显示股骨头缺血性坏死若不及时治疗与干预，约70%患者在4年内会出现塌陷甚至致残。非创伤性股骨头坏死多因酗酒、皮质激素治疗等原因诱发，且以缺血性坏死最为