范洪伟鹤壁煤业（集团）有限责任公司总医院骨科，河南鹤壁　458000

髓芯减压微创植骨术与全髋关节置换术治疗缺血性股骨头坏死的中期预后比较

范洪伟
鹤壁煤业（集团）有限责任公司总医院骨科，河南鹤壁458000

目的讨论比较髓芯减压微创植骨术与全髋关节置换术治疗缺血性股骨头坏死的中期预后。方法采用随机数字表法将鹤壁煤业（集团）有限责任公司总医院骨科2013年4月—2015年2月128例缺血性股骨头坏死患者进行分组，对照组给予全髋关节置换术，观察组给予髓芯减压微创植骨术，观察两组患者中期的预后情况，比较分析两组术前及术后3个月、6个月、12个月髋关节Harris评分，以及两组术后手术失效率、感染发生率及再次手术率比较。结果 两组Harris评分比较，观察组术后12个月Harris评分（91.25±5.23）分，高于术前（59.57± 4.86）分；对照组术后12个月Harris评分（89.37±5.21）分，高于术前（58.23±4.33）分，差异具有统计学意义（t= 35.4983，P=0.0000＜0.01）。两组间术后3、6、12个月比较，P＜0.05，差异有统计学意义。两组术后手术失效率、感染发生率及再次手术率比较，观察组总发生率3.12%，低于对照组的12.50%，P＜0.05，差异具有统计学意义。结论髓芯减压微创植骨术在治疗缺血性股骨头坏死中，中期预后优于全髋关节置换术，值得临床进一步探讨及推广。

髓芯减压微创植骨术；全髋关节置换术；疗缺血性股骨头坏死；中期预后

［Abstract］Objective To discuss the medium-term prognosis of the treatment of ischemic necrosis of the femoral head by minimally invasive bone grafting and total hip replacement.Methods The random number table method of Hebi Coal Industry（Group）limited liability company general hospital from 2013 April to 2015 February 128 cases of avascular osteonecrosis of the femoral head patients were divided into two groups.Patients in control group were treated by total hip replacement，the observation group given pith decompression of the minimally invasive bone graft and to observe the prognosis of the two groups of patients with middle and comparative analysis of 3 months after operation in the two groups before and after operation and 6 months，the Harris hip score at 12 months，and two groups of postoperative surgical failure rate，infection rate and reoperation rate.Results The Harris scores observation group after 12 months，Harris score（91.25±5.23）points higher than preoperative（59.57±4.86）points；the control group after 12 months，Harris score（89.37±5.21）points，higher than the previous operation（58.23±4.33）points，the difference was statistically significant（t=35.4983，P=0.0000＜0.01）.Between the two groups after 3 months，6 months，12 months comparison，P＜0.05，statistically significant.Postoperative surgical failure rate，infection rate and reoperation rate between the observation group，the total incidence of 3.12%，down from 12.50%in the control group，P＜0.05，the difference was statistically significant.Conclusion Core decompression minimally invasive bone grafting in the treatment of ischemic necrosis of the femoral head，the medium-term prognosis is better than total hip replacement，it is worthy of further study and promotion.

［Key words］Core decompression and minimally invasive bone grafting；Total hip arthroplasty；Ischemic necrosis of the femoral head；Medium-term prognosis

缺血性股骨头坏死是由于多种原因导致的股骨头血运不良，从而引起骨细胞进一步坏死、骨小梁断裂、股骨头塌陷的一种疾病。目前主要分为手术治疗和保守治疗，保守治疗效果局限。……