【摘 要】
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目的:探讨经颈开窗死骨刮除、颗粒骨打压植骨、持续骨牵引治疗股骨头缺血性坏死手术治疗的临床疗效.方法:自2000年8月至2004年10月,收治23例35髋股骨头缺血性坏死患者,男18例
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目的:探讨经颈开窗死骨刮除、颗粒骨打压植骨、持续骨牵引治疗股骨头缺血性坏死手术治疗的临床疗效.方法:自2000年8月至2004年10月,收治23例35髋股骨头缺血性坏死患者,男18例,女5例;年龄19～52岁,平均32岁;Ⅱ期7髋,Ⅲ期28髋.所有病例均有不同程度的髋关节痛,患髋均有不同程度的活动受限.经股骨颈开窗,彻底刮除死骨、肉芽组织、硬化带,将自体颗粒状髂骨分次分层打压植入,术后持续股骨髁上骨牵引.通过术前、术后髋关节疼痛、功能、活动度、X线评价比较治疗效果.结果:出院后定期随访,分别为术后的0.5、1、2、3、4、5年,参照王岩等的百分法进行疗效评价,评分由术前的平均(52.66±12.53)分,提高至术后半年的(88.94±5.84)分,术后1年的(89.78±6.18)分,术后2年的(86.37±7.46)分,术后3年的(84.08±7.57)分,术后4年的(83.76±8.08)分,术后5年的(76.83±8.98)分,术前、术后评分差异有统计学意义.结论:经股骨颈开窗彻底刮除死骨、颗粒状自体髂骨打压植入、术后持续股骨髁上骨牵引治疗股骨头缺血性坏死,可大大提高股骨头缺血治疗满意率或延缓病情发展.
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