富血小板血浆联合高位股骨头颈开窗植骨支撑术治疗早期股骨头坏死的研究

姜良斌; 肖伯莲; 刘松; 韦标方

doi:10.13418/j.issn.1001-165x.2018.04.021

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (4) : 449-452. DOI: 10.13418/j.issn.1001-165x.2018.04.021

临床研究

富血小板血浆联合高位股骨头颈开窗植骨支撑术治疗早期股骨头坏死的研究

姜良斌^1，2，　肖伯莲^1，2，　刘松^{1, 2}，　韦标方²

作者信息 +

Early research of the platelet-rich plasma (PRP) combined with the bone grafting through a femoral neck window at high location for the treatment of the osteonecrosis of the femoral head

JIANG Liang-bin ^1,2, XIAO Bo-lian ^1,2，LIU Song^1,2, WEI Biao-fang ²

Author information +

文章历史 +

摘要

目的　探讨富血小板血浆（platelet-rich plasma ，PRP）联合高位股骨头颈开窗植骨支撑术治疗早期股骨头坏死（osteonecrosis of the femoral head，ONFH）的作用效果。方法　2015年7月至2017年7月，将采用改良二次离心法制作的 PRP 用于治疗早期ONFH18 例（27髋）作为PRP 组，采用非PRP治疗的治疗早期ONFH16例（24髋）作为对照组，两组进行疗效比较，术后1、3、6个月行X线片复查，观察病情变化，用髋关节Harris评分及VAS评分进行疗效评价,观察比较两组股骨头修复情况以及坏死进展并加以分析。结果　两组患者均获随访，随访时间6个月。①术后6个月影像学检查显示，PRP组患者股骨头外形良好，均未发生变形及塌陷，自体髂骨整合良好，股骨头密度增加。对照组7例发生塌陷，自体髂骨与股骨头界限明显，整合差。末次随访PRP组效果明显优于对照组。②PRP组Harris髋关节评分由术前（67.85 ± 9.72）分提高至末次随访的（88.51 ±6.13）分，对照组Harris髋关节评分由术前（69.85 ± 8.15）分提高至末次随访的（78.42 ± 6.28）分；PRP组疼痛VAS评分由术前（4.5±1.3）分下降至末次随访的（1.6±1.1）分，对照组疼痛VAS评分由术前（4.2±0.8）分下降至末次随访的（2.4±0.9）分。两组治疗前后比较差异均有统计学意义（P < 0.05），术后两组间比较差异有统计学意义（P< 0.05）。结论　临床使用PRP后可以减轻患者髋部疼痛，改善关节功能，促进骨长入，具有显著的临床应用价值。

Abstract

Objective　To investigate the potency of the platelet-rich plasma（PRP）combined with the bone grafting through a femoral neck window at high location for the treatment of the osteonecrosis of the femoral head.　Methods　From July 2015 to July 2017, 18 cases（27 hips）of osteonecrosis of the femoral head were treated with platelet-rich plasma combined with core decompression and ilium support（PRP group）and 16 cases（24 hips）with core decompression and ilium support only（control group）. At 1, 3，and 6 months after operation, patients were followed up for Harris hip score，VAS score and radiographic measures.　Results　All the patients were followed up thoroughly and the follow-up periods were 6 months. At 6 months after operation, the shape of the femoral heads in the PRP groups was good, showing no deformation and collapse. The ilium made integration with the surrounding bone without infection. Harris score of PRP group before and after treatment increased from（67.85±9.72）points to（88.51±6.13）points. Harris score of control group before and after treatment increased from（69.85±8.15）points to（78.42±6.28）points. VAS score of PRP group before and after treatment increased from（4.5±1.3）points to（1.6±1.1）points. VAS score of control group before and after treatment increased from（4.2±0.8）points to（2.4±0.9） points. There were statistically significant differences between two groups. There were statistically significant differences in the pre-therapy and post-treatment (P<0.05). There were statistically significant differences in the post-operation between two groups (P<0.05).　Conclusions　Use the platelet-rich plasma（PRP）in clinical can relieve hip pain and improve joint function, and is thus highly valuable in clinical use．

导出引用

姜良斌,肖伯莲,刘松,韦标方. 富血小板血浆联合高位股骨头颈开窗植骨支撑术治疗早期股骨头坏死的研究[J]. 中国临床解剖学杂志. 2018, 36(4): 449-452 https://doi.org/10.13418/j.issn.1001-165x.2018.04.021

JIANG Liang-bin, XIAO Bo-lian，LIU Song, WEI Biao-fang. Early research of the platelet-rich plasma (PRP) combined with the bone grafting through a femoral neck window at high location for the treatment of the osteonecrosis of the femoral head[J]. Chinese Journal of Clinical Anatomy. 2018, 36(4): 449-452 https://doi.org/10.13418/j.issn.1001-165x.2018.04.021

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