目的 探讨介入结合经皮髓芯减压植骨治疗股骨头缺血性坏死的临床效果.方法 对32例股骨头缺血性坏死患者(36髋)行股骨头的供血动脉旋股内、外动脉和闭孔动脉造影,分别每支血管灌注溶栓、扩血管药物,治疗后行供血动脉造影检查;介入治疗后1周行股骨头经皮髓芯减压植骨.结果 术后血管造影显示,所有患者股骨头区血管计数较治疗前均有不同程度的血管增粗、血管数目增多改变.32例均获随访,时间9～18个月.患髋疼痛症状消失或明显减轻,关节功能不同程度改善.疗效按Harris评分:优22例,良5例,可3例,差2例.结论 介入结合经皮髓芯减压植骨操作简单、安全,创伤小,并发症少,疗效肯定,是一种治疗股骨头缺血性坏死的新方法.%Objective To evaluate the clinical effects of the avascular necrosis of femoral head ( ANFH ) treated by intervention combined with percutaneous core decompression and bone graft. Methods 32 cases with 36 hips of ANFH were treated with the method of thrombolysis and open catheterizing and perfusing medial and lateral circumflex arteries. To evaluate therapeutic effect, a week after interventional therapy of percutaneous femoral head core decompression and bone graft. Results Angiography of the cases demonstrated an increase in vessel count in the region of femoral head after treatment as compared with that before treatment. All cases were followed up for 9 ~ 18 months. Disorders of joint function were improved in some degree. Hip pain was alleviated significantly in all patients after treatment. Effect of treatment by Hams score: excellent in 22 cases, good in, fair in 3, and poor in 2 cases. Conclusions Intervention combined with percutaneous core decompression and bone grafting is simple, safe, trauma, less complications and efficacy of certain. It is a treatment for avascular necrosis of the new method.
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