血管束植入治疗儿童股骨头坏死的远期疗效分析
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王西迅 WANG Xi-xun 台州市博爱医院关节科暨台州市股骨头坏死研究所,浙江台州318050 Bo’ai Hospital of Taizhou City,Institute of Femoral Head Necrosis,Taizhou 318050,Zhejiang,China wangxixun@mai.ltzpt.tz.jcn 
诸葛天瑜 ZHU-GE Tian-yu 台州市博爱医院关节科暨台州市股骨头坏死研究所,浙江台州318050 Bo’ai Hospital of Taizhou City,Institute of Femoral Head Necrosis,Taizhou 318050,Zhejiang,China  
陈旭辉 CHEN Xu-hui 台州市博爱医院关节科暨台州市股骨头坏死研究所,浙江台州318050 Bo’ai Hospital of Taizhou City,Institute of Femoral Head Necrosis,Taizhou 318050,Zhejiang,China  
孙捷 SUN Jie 台州市博爱医院关节科暨台州市股骨头坏死研究所,浙江台州318050 Bo’ai Hospital of Taizhou City,Institute of Femoral Head Necrosis,Taizhou 318050,Zhejiang,China  
袁浩 YUAN Hao 台州市博爱医院关节科暨台州市股骨头坏死研究所,浙江台州318050 Bo’ai Hospital of Taizhou City,Institute of Femoral Head Necrosis,Taizhou 318050,Zhejiang,China  
李恩典 LI En-dian 台州市博爱医院关节科暨台州市股骨头坏死研究所,浙江台州318050 Bo’ai Hospital of Taizhou City,Institute of Femoral Head Necrosis,Taizhou 318050,Zhejiang,China  
郑高伟 ZHENG Gao-wei 台州市博爱医院关节科暨台州市股骨头坏死研究所,浙江台州318050 Bo’ai Hospital of Taizhou City,Institute of Femoral Head Necrosis,Taizhou 318050,Zhejiang,China  
期刊信息:《中国骨伤》2006年,第19卷,第5期,第276-278页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:评价血管束植入治疗儿童股骨头坏死(Legg Calve Perthesdisease,LCPD)的远期疗效。

方法:LCPD患儿27例,男22例,女5例;年龄8~12岁,平均10.5岁。治疗分为两组,Ⅰ组12例,男10例,女2例;年龄8~12岁,平均10.4岁;行多条血管束植入术合改良Chiari骨盆截骨延长术治疗。Ⅱ组15例,男12例,女3例;年龄9~12岁,平均10.6岁;单行改良Chiari骨盆截骨延长术治疗。均于术后3个月后戴外展支架下床承重行走,同时行患髋被动旋转推压疗法治疗。

结果:随访5~8年,平均6年3个月。治疗后两组的髋臼-股骨头指数(AHI)均恢复正常,Ⅰ组出现的并发症较多。疗效评定采用Stulberg标准:Ⅰ组12例中优4例,良2例,中2例,可2例,差2例;Ⅱ组15例中优13例,良1例,中1例。经Fisher检验,有显著性差异(P<0.05),Ⅱ组治疗效果优于Ⅰ组。Ⅰ组的平均恢复时间(25.0±1.6)个月,Ⅱ组(14.0±0.9)个月,经t检验,有显著性差异(P<0.001)。

结论:LCPD是一种自限性疾病,利用血管束植入术不能缩短LCPD的恢复时间,并且并发症多。对于包容不好的患者,手术包容治疗是治疗的关键。
【关键词】Legg-CalvePerthes病  血管移植  Chiari骨盆截骨术
 
Analysis of long-term results of treatment of Legg-Calve-Perthes disease with vascular bundle graft
ABSTRACT  

Objective:To evaluate the long-term results of treatment of Legg-Calve-Perthes disease (LCPD) with vascular bundle graft.

Methods:Twenty-seven patients (22 male male and 5 female) with LCPD were reviewed in the study.The average age of the patients was 10.5 years ranging from 8 to 12 years.The patients were divided randomly into two groups.Twelve patients of group Ⅰ(10 male and 2 female;The average age of 10.4 years ranging from 8 to 12 years) were treated by vascular bundle graft and modified Chiari’s pelvic osteotomy and lengthening.Fifteen patients of group Ⅱ(12 male and 3 female;The average age of 10.6 years ranging from 9 to 12 years) were treated only by modified Chiari’s pelvic osteotomy and lengthening.Three months after operation all the patients were treated with hip ambulatory abudution brace and hip turning motion.

Results:All patients were followed up from 5 to 8 years,with an average of 6 years and 3 months.All the acetabular-head index (AHI) of the patients returned to normal after operation.More complications occurred in the patients of group Ⅰ than that of group Ⅱ.According to the Stulberg criteria,the result of group Ⅰwere excellent in 4 cases,good in 2,midst in 2,fair in 2,poor in 2;The result of group Ⅱ were excellent in 13,good in 1,midst in 1.The rate in group Ⅱ was significantly better than that of group Ⅰ by Fisher test (P<0.05).The treatment time of (14.0+0.9) months in group Ⅱ was less than that of (25.0+1.6)months in group Ⅰ by t test (P<0.001).

Conclusion:LCPD is a kind of natural heal disease.The treatment time of LCPD can’t be shortened by treated with vascular bundle graft,and more complications occurre.It is important to improve the containment by operation for the patiens with poor containment.
KEY WORDS  Legg-Calve-Perthes disease  Vascular graft  Chiari’s pelvic osteotomy
 
引用本文,请按以下格式著录参考文献:
中文格式:王西迅,诸葛天瑜,陈旭辉,孙捷,袁浩,李恩典,郑高伟.血管束植入治疗儿童股骨头坏死的远期疗效分析[J].中国骨伤,2006,19(5):276~278
英文格式:WANG Xi-xun,ZHU-GE Tian-yu,CHEN Xu-hui,SUN Jie,YUAN Hao,LI En-dian,ZHENG Gao-wei.Analysis of long-term results of treatment of Legg-Calve-Perthes disease with vascular bundle graft[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(5):276~278
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