文章摘要
邢更彦,白晓东,杜明奎,李禾,纪惠茹,姜川.体外冲击波治疗成人股骨头缺血性坏死的疗效观察[J].中华物理医学与康复杂志,2003,(8):.-
体外冲击波治疗成人股骨头缺血性坏死的疗效观察
  
DOI:
中文关键词: 股骨头  缺血性坏死  体外冲击波疗法
英文关键词: Femoral head necrosis  ESWT  Avascular necrosis
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作者单位
邢更彦,白晓东,杜明奎,李禾,纪惠茹,姜川 100039北京中国人民武装警察部队总医院骨科 
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中文摘要:
      目的研究体外冲击波疗法治疗69例成人非创伤性股骨头缺血性坏死患者。 方法69例患者均为Ficat分期I~III期,应用高能冲击波治疗机治疗,能量密度0.18~0.25 mJ/mm2,以股骨头坏死区及其相邻骨质为冲击点,每个冲击点每次冲击1 000次,共做8次治疗,患髋3个月内免负重,半年内减少负重。所有病例分别在治疗前、治疗后3,6及12个月行MRI检查(同时测量坏死区域所占股骨头体积的百分比)、髋关节Harris评分(100分)和双侧髋关节X线片检查。 结果69例患者经过1年随访发现,冲击波治疗前及治疗后3,6及12个月,坏死区域所占股骨头体积的百分比,分别为49.9%,19.6%,6.8%及5.6%,髋关节Harris评分分别为47.2,77.9,90.2及92.2分;双侧髋关节X线片示治疗后各组与治疗前相比无股骨头变形及塌陷。各期病例经冲击波治疗后,各时间段坏死区域所占股骨头体积的百分比及髋关节Harris评分与冲击波治疗前比较,差异有显著性意义(P<0.01)。 结论体外冲击波治疗成人非创伤性股骨头缺血性坏死疗效显著,无创伤。我们认为该方法将成为临床治疗该类疾病的主要方法之一。
英文摘要:
      Objective To study the effects of extracorporeal shock wave therapy (ESWT) for the treatment of avascular necrosis of the femoral head in adults. MethodsSixty-nine cases were collected and treated with ESWT. The energy density of ESWT were 0.18~0.25mJ/mm2, the number of shock waves delivered were 4 000~6 000 times in every treatment session. 8 sessions of treatment were performed in one necrosis femoral head. The MRI,X-ray, the Harris hip score were performed, respectively, before ESWT, and at 3, 6 and 12 months after ESWT Results69 cases were followed up through 1 year. The ratio of necrosis of the femoral head as shown by MRI averaged 49.9%(before ESWT), 19.6%(3 months), 6.8%(6 months), 5.6%(12 months), respectively. The Harris hip score averaged 46.2 before ESWT, 78.9 at 3 months after ESWT, 90.2 6 months after ESWT, 92.2 12 months after ESWT.Significant differences were revealed after the ESWT in regard to all the evaluation outcomes as compared to those before the ESWT (P<0.01). No collapse of the femoral head was found on radiograph after using ESWT. ConclusionIt was shown that ESWT could be a very promising intervention for adult femoral head necrosis
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