[1]潘风雨,张涌泉.青壮年人群早期股骨头坏死治疗策略的选择[J].医学信息,2018,31(08):10-13.[doi:10.3969/j.issn.1006-1959.2018.08.003]
　PAN Feng-yu,ZHANG Yong-quan.Selection of Treatment Strategy for Early Femoral Head Necrosis in Young and Middle-aged Population[J].Journal of Medical Information,2018,31(08):10-13.[doi:10.3969/j.issn.1006-1959.2018.08.003]
点击复制

青壮年人群早期股骨头坏死治疗策略的选择()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
31卷
期数:
2018年08期
页码:
10-13
栏目:
出版日期:
2018-04-15

文章信息/Info

Title:
Selection of Treatment Strategy for Early Femoral Head Necrosis in Young and Middle-aged Population
文章编号:
1006-1959（2018）08-0010-04
作者:
潘风雨; 张涌泉
解放军第一〇七医院关节外科，山东 烟台 264002
Author(s):
PAN Feng-yu; ZHANG Yong-quan
Department of Joint Surgical,107th PLA Hospital,Yantai 264002,Shandong,China
关键词:
股骨头坏死; 青壮年; 保髋治疗; 带蒂髂骨块移植
Keywords:
Key words：Osteonecrosis of femoral head; Young adults; Hip preservation therapy; Iliac bone graft with pedicle
分类号:
R687.3
DOI:
10.3969/j.issn.1006-1959.2018.08.003
文献标志码:
A
摘要:
股骨头坏死是一种常发生于青壮年人群的高致残性疾病。在股骨头塌陷前的早期阶段，通常选用保留髋关节的手术治疗，但保髋治疗的手术方式很多，如何恰当的选择治疗方式是医生必须面对的难题。“血液循环障碍”是股骨头坏死的共同病理特征，保髋手术的出发点就是要解决这一问题，其理想的手术方式需要实现以下四个治疗目标：去除死骨和纤维肉芽组织，改善股骨头血液循环，提供结构支撑，促进新骨生成。在当前的技术条件下，“病灶清除+有血运的骨移植术”能够同时实现这四个治疗目标，成为治疗青壮年人群早期股骨头坏死的理想方式，其中又以“病灶清除+带血管蒂的髂骨移植术”为最佳。
Abstract:
Abstract：Femoral head necrosis is a highly disabling disease that often occurs in young and middle-aged people.In the early stage before the collapse of the femoral head,the hip preservation surgery is usually used,but there are many ways to treat the hip preservation.How to choose the appropriate treatment is a difficult problem that the doctor must face."Blood circulation disorder"is the common pathological characteristic of femoral head necrosis.The starting point of hip preservation surgery is to solve this problem.The ideal operation method needs to achieve the following four treatment objectives:removing dead bone and fibrous granulation tissue,improving femoral head blood circulation,providing structural support,promoting new bone formation.Under current technical conditions,bone transplantation with debridement and blood delivery can achieve these four treatment goals simultaneously and become an ideal way to treat early femoral head necrosis in young and middle-aged people.Among them,iliac bone transplantation with vascular pedicle was the best.

参考文献/References:

[1]Mont MA,Jones LC,Hungerford DS.Nontraumatic osteonecrosis of the femoral head:ten years later[J].J Bone Joint Surg Am,2006,88(5):1117-1132.
[2]Mont MA,Zywiel MG,Marker DR,et al.The natural history of untreated asymptomatic osteonecrosis of the femoral head:a systematic literature review[J].J Bone Joint Surg Am,2010,92(12):2165-2170.
[3]卢晓强,于星鹏,张一龙.成人股骨头坏死治疗的方法[J].医学综述,2008,14(17):2674-2676.
[4]刘耀升,刘蜀彬.早中期股骨头坏死保留关节的手术治疗进展[J].中华损伤与修复杂志(电子版),2012,7(05):528-531.
[5]Marker DR,Seyler TM,McGrath MS,et al.Treatment of early stage osteonecrosis of the femoral head[J].J Bone Joint Surg Am,2008,90(Suppl 4):175-187.
[6]Pakos EE,Tsiampas D,Xenakis T.Long term outcomes of Charnley THA in patients under the age of 50:an editorial comment on recently published article by Warth et al[J].Ann Transl Med,2015,3(Suppl 1):S9.
[7]Warth LC,Callaghan JJ,Liu SS,et al.Thirty-five-year results after Charnley total hip arthroplasty in patients less than fifty years old.A concise follow-up of previous reports[J].J Bone Joint Surg Am,2014,96(21):1814-1819.
[8]王成琪,范启申,王剑利,等.带血管蒂髂骨膜瓣移植术治疗股骨头缺血性坏死[J].中华显微外科杂志,1995,18(02):149.
[9]Urbaniak JR,Coogan PG,Gunneson EB,et al.Treatment of osteonecrosis of the femoral head with free vascularized fibular grafting.A long-term follow-up study of one hundred and three hips[J].J Bone Joint Surg Am,1995,77(5):681-694.
[10]Urbaniak JR,Harvey EJ.Revascularization of the femoral head in osteonecrosis[J].J Am Acad Orthop Surg,1998,6(1):44-54.
[11]王坤正,同志勤,王春生.吻合血管游离腓骨移植治疗股骨头坏死[J].中华显微外科杂志,2000,23(4):254.
[12]薛锋,张长青,柴雷子,等.吻合血管游离腓骨移植治疗股骨头坏死的系统回顾[J].中国骨与关节损伤杂志,2014,29(4):322-324.
[13]戴士峰,刘昆鹏,刘德群.自体松质骨及带血管蒂髂骨瓣移植治疗青壮年股骨头坏死的疗效观察[J].中国骨与关节损伤杂志,2011,26(12):1101-1102.
[14]隋吉生,蒋纯志,王黎明,等.带旋股外动脉升支血管蒂髂骨瓣移植治疗Ⅱ、Ⅲ期股骨头坏死的临床观察[J].临床医学工程,2009,16(09):62-63.
[15]吉向民.带旋股外动脉升支血管蒂髂骨瓣移植治疗成人股骨头坏死的临床观察[J].中国现代医生,2010,48(02):125-126.
[16]罗成辉,股骨头坏死患者保留关节治疗效果分析[J].临床合理用药杂志,2012,5(34):31-32.

相似文献/References:

[1]黄幼玲.中药配合鹿瓜多肽治疗股骨头坏死临床效果观察[J].医学信息,2018,31(06):141.[doi:10.3969/j.issn.1006-1959.2018.06.049]
　HUANG You-ling.Clinical Observation on Treatment of Femoral Head Necrosis with Chinese Medicine Combined with Lugua Polypeptide[J].Journal of Medical Information,2018,31(08):141.[doi:10.3969/j.issn.1006-1959.2018.06.049]
[2]王添兴,李国庆,汪 洋,等.空心加压螺钉与动力髋螺钉治疗股骨颈骨折术后股骨头坏死相关并发症的Meta分析[J].医学信息,2019,32(02):83.[doi:10.3969/j.issn.1006-1959.2019.02.024]
　WANG Tian-xing,LI Guo-qing,WANG Yang,et al.Meta-analysis of Complications Associated with Hollow Compression Screws and Dynamic Hip Screws in the Treatment of Femoral Head Necrosis after Femoral Neck Fracture[J].Journal of Medical Information,2019,32(08):83.[doi:10.3969/j.issn.1006-1959.2019.02.024]
[3]陈恒安,胡 海,刘金龙,等.股骨头坏死骨髓IL-6表达与骨髓水肿分级的相关性研究[J].医学信息,2019,32(03):65.[doi:10.3969/j.issn.1006-1959.2019.03.021]
　CHEN Heng-an,HU Hai,LIU Jin-long,et al.Correlation between Bone Marrow IL-6 Expression and Grade of Bone Marrow Edema in Osteonecrosis of Femoral Head[J].Journal of Medical Information,2019,32(08):65.[doi:10.3969/j.issn.1006-1959.2019.03.021]
[4]刘 锌,杜 斌,孙光权,等.血清岩藻糖苷酶在股骨头坏死保髋患者预后判断中的临床价值[J].医学信息,2018,31(19):64.[doi:10.3969/j.issn.1006-1959.2018.19.021]
　LIU Xin,DU Bin,SUN Guang-quan,et al.Clinical Value of Serum Fucosidase in Predicting the Prognosis of Hip Preservation patients with Osteonecrosis of Femoral Head[J].Journal of Medical Information,2018,31(08):64.[doi:10.3969/j.issn.1006-1959.2018.19.021]
[5]巫 娟,张 峰,郭 莉.VEGF与b-FGF在不同病因缺血性坏死股骨头中的表达及意义[J].医学信息,2018,31(20):78.[doi:10.3969/j.issn.1006-1959.2018.20.022]
　WU Juan,ZHANG Feng,GUO Li.Expression and Significance of VEGF and b-FGF in Avascular Necrosis of Femoral Head with Different Etiology[J].Journal of Medical Information,2018,31(08):78.[doi:10.3969/j.issn.1006-1959.2018.20.022]
[6]仲鹤鹤,杨 晋,刘 毅.关节镜辅助下髓芯减压联合钽棒置入治疗早期股骨头坏死的研究[J].医学信息,2018,31(20):186.[doi:10.3969/j.issn.1006-1959.2018.20.059]
　ZHONG He-he,YANG Jin,LIU Yi.Treatment of Early Femoral Head Necrosis by Arthroscopic Core Decompression Combined with Tantalum Rod Implantation[J].Journal of Medical Information,2018,31(08):186.[doi:10.3969/j.issn.1006-1959.2018.20.059]
[7]韩秀莲.CT与MRI诊断股骨头坏死的价值研究[J].医学信息,2018,31(21):176.[doi:10.3969/j.issn.1006-1959.2018.21.052]
　HAN Xiu-lian.Diagnostic Value of CT and MRI in the Diagnosis of Femoral Head Necrosis[J].Journal of Medical Information,2018,31(08):176.[doi:10.3969/j.issn.1006-1959.2018.21.052]
[8]吴 严,李海波,苟永胜.股骨颈骨折后股骨头坏死的相关因素分析[J].医学信息,2019,32(07):115.[doi:10.3969/j.issn.1006-1959.2019.07.034]
　WU Yan,LI Hai-bo,GOU Yong-sheng.Analysis of Related Factors of Femoral Head Necrosis After Femoral Neck Fracture[J].Journal of Medical Information,2019,32(08):115.[doi:10.3969/j.issn.1006-1959.2019.07.034]
[9]谢卫强,巩 栋,高明暄,等.关节病性银屑病伴髋关节结核1例[J].医学信息,2019,32(07):189.[doi:10.3969/j.issn.1006-1959.2019.07.062]
[10]芶开来,李 明.中医药治疗股骨头坏死的临床研究现况[J].医学信息,2020,33(03):59.[doi:10.3969/j.issn.1006-1959.2020.03.018]
　GOU Kai Lai,LI Ming.Clinical Research on Treatment of Femoral Head Necrosis with Traditional Chinese Medicine[J].Journal of Medical Information,2020,33(08):59.[doi:10.3969/j.issn.1006-1959.2020.03.018]

更新日期/Last Update: 2018-04-15