早期股骨头坏死采用陶瓷棒支架植入术及富血小板血浆治疗的应用研究
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国家自然科学基金项目(52171244);陕西省重点研发计划项目(S2021-YF-YBSF-0576)


Application of ceramic rod stent implantation and platelet rich plasma in the treatment of early femoral head necrosis
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    摘要:

    目的 探析早期股骨头坏死(ONFH)采用陶瓷棒支架植入术、富血小板血浆(PRP)治疗的应用效果。方法 选择2021年1月—2022年10月本院就诊的30例早期ONFH患者,均行陶瓷棒支架植入术联合PRP治疗。记录患者手术时间、出血量及并发症相关情况,对比治疗前、治疗后2月临床疗效[保髋评分(RHS)]、生存质量[SF-12 生存质量量表(SF-12)]、疼痛程度[视觉模拟评分量表(VAS)评分]以及影像学复诊结果。结果 30例早期ONFH患者切口均为一期愈合,顺利完成手术。手术时间1.92~3.33 h,平均(2.36±0.47)h,术中出血量50~267 mL,平均(68.57±10.25)mL;所有患者术中、术后均未发生感染、大转子滑囊炎、骨折等并发症。治疗后RHS评分优良率(83.33%)及评分等级明显优于治疗前(10.00%)(χ2=32.411,Z=32.943,P<0.05)。治疗后早期ONFH患者SF -12评分明显高于治疗前,且VAS评分明显低于治疗前(t=7.937、11.119,P<0.05)。患者术后经X线、MRI、CT等影像学技术显示陶瓷棒植入组织融合状况良好,髋关节表现较为稳定,且股骨头坏死未见进一步进展,病变区域有所减小。结论 陶瓷棒支架具有较理想的力学强度、较好亲水性能、可被人体降解吸收、较高提及孔隙率优势,PRP属于自体血小板浓缩物,内部含有大量生长因子;陶瓷棒支架植入术联合PRP应用于早期ONFH治疗中临床效果显著,保髋评分较高,可有效改善患者疼痛程度及生活质量,值得临床推广

    Abstract:

    Objective To explore the therapeutic effect of ceramic rod stent implantation and platelet rich plasma (PRP) on early osteonecrosis of the femoral head (ONFH). Methods 30 patients with early ONFH from January 2021 to October 2022 in our hospital were selected, all of whom were treated with ceramic rod stent implantation combined with PRP. Record the operation time, blood loss and complications of patients, and compare the clinical efficacy [Reconstruction Hip Scores (RHS)], quality of life [MOS 12 item Short Form Health Survey (SF 12)), pain degree (Visual Analog Score (VAS)], and imaging return visit results before and 2 months after treatment. Results The incisions of 30 patients with early ONFH healed in one stage and the operation was successfully completed. The operation time was 1.92-3.33 h (2.36 ± 0.47) h, and the intraoperative blood loss was 50-267 mL (68.57 ± 10.25) mL. No infection, trochanteric bursitis, fracture and other complications occurred in all patients during and after the operation. After treatment, the excellent and good rate of RHS score (83.33%) and score grade were significantly higher than those before treatment (10.00%)(χ2=32.411,Z=32.943,P<0.05). SF-12 score of ONFH patients after treatment was significantly higher than that before treatment, and VAS score was significantly lower than that before treatment (t=7.937, 11.119, P<0.05). After operation, X-ray, MRI, CT and other imaging techniques showed that the implanted ceramic rods were in good fusion condition, the hip joint performance was relatively stable, and femoral head necrosis did not progress further, and the lesion area was reduced. Conclusion The ceramic rod scaffold has the advantages of ideal mechanical strength, good hydrophilicity, being degradable and absorbed by human body, and high porosity. PRP is an autologous platelet concentrate containing a large number of growth factors. The application of ceramic rod stent implantation combined with PRP in the early ONFH treatment has significant clinical effect, high hip preservation score, and can effectively improve the pain degree and quality of life of patients, which is worthy of clinical promotion

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  • 在线发布日期: 2025-01-17
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