体外高能震波治疗股骨头坏死中远期MRI评价

摘要

Objective To evaluate the correlation between the improvement of hip clinic scoring (VAS and Harris) and the change of necrosis lesion (lesion size and hip effusion) in patients with femoral head necrosis treated by the extracorpo‐real shock wave therapy (ESWT) .Methods The trial included 46 patients (Oct 2004 to Jan 2011) with 82 osteonecrotic femoral head .Pain symptom and hip function were evaluated by VAS and Harris score before and after ESWT respective‐ly .Femoral head necrosis was evaluated using MRI before ESWT and at various stages after ESWT .Results In follow‐up of 79 hips ,MRI showed a decrease of necrotic zone size in 40 hips (50 .6% ) ,and a decrease of hip effusion in 48 hips (60.6% ) .Significant difference was found between the VAS and Harris scores before ESWT .There was no statistical correlation ( P >0 .05) between the hip clinic scores and the change of lesion size .There was a statistical correlation ( P<0 .05) between hip clinic scores and hip effusion .Conclusion The improvement of hip comprehensive functional and pain correlated with hip effusion ,no correlation was found with the change of lesion size .%目的：探讨MRI随访研究ESWT治疗股骨头坏死的 Harris评分、VAS评分与病灶变化的相关性。方法选取2004年～2011年在我院采用ESWT 治疗股骨头缺血性坏死的46例82髋。评价疼痛VAS评分、Harris评分改善与MRI显示股骨头内病灶大小和髋关节腔积液变化相关性。结果总随访髋数79髋，ESWT治疗后MRI显示病灶缩小共40髋（50．6％）、髋关节腔积液减少48髋（60．6％）。髋关节综合功能改善、疼痛症状变化与关节腔积液分级、积液变化有统计相关性（ P ＜0．05），与病灶大小变化无统计相关性（ P ＞0．05）。结论 ESWT治疗股骨头坏死患者临床评价改善与关节腔积液分级、积液变化具有相关性，与病灶大小变化无相关性。