临床误诊误治2024，Vol.37Issue(6)：36-41,6.DOI:10.3969/j.issn.1002-3429.2024.06.008
经皮扩张式铰刀髓芯减压联合PRO-DENSE可再生骨植骨治疗股骨头坏死的疗效及安全性分析
Efficacy and Safety Analysis of Core Decompression Using Percutaneous Expandable Reamer Combined with PRO-DENSE Renewable Bone Graft-ing for the Treatment of Femoral Head Necrosis
摘要
Abstract
Objective To explore the application value of core decompression using percutaneous expandable reamer combined with PRO-DENSE renewable bone grafting in the treatment of osteonecrosis of the femoral head(ONFH).Methods A total of 100 patients with ONFH treated from January 1,2020 to January 1,2022 were retrospectively selected and divid-ed into two groups with 50 cases in each group according to the surgical method.The control group underwent core decompres-sion and autogenous bone grafting,and the observation group underwent core decompression using percutaneous expandable reamer combined with PRO-DENSE regenerated bone grafting.Surgical observation indexes,surgical efficacy and complica-tions were compared between the two groups.Neurogenic inflammatory markers[nerve growth factor(NGF),prostaglandin E2(PGE2)],serum biochemical markers[hypoxia-inducible factor-1 α(HIF-1α),vascular endothelial growth factor A(VEGF-A),procollagen typeⅠN-propeptide(PⅠNP),osteocalcin(BGP)],visual analogue scale(VAS)score and Har-ris hip function score before and after operation were compared between the two groups.Results The intraoperative blood loss in the observation group[(24.25±4.78)mL]was less than that in the control group[(50.29±8.94)mL],and the length ofhospitalization[(12.50±2.24)d]was shorter than that in the control group[15.12±3.37)d](P＜0.01).Serum NGF and PGE2 in the observation group were lower than those in the control group at 1,3 and 7 d after operation(P＜0.05).Serum HIF-1α,VEGF-A,BGP and Harris hip function scores in observation group were higher than those in control group at 1,3 and 6 months after operation,while serum PⅠNP and VAS scores were lower than those in control group(P＜0.05).There was no significant difference in the excellent and good rate of operation and total incidence of complications between the two groups(P＞0.05).Conclusion Core decompression using percutaneous expandable reamer combined with PRO-DENSE regenerative bone grafting is a safe and reliable treatment for patients with ONFH,which can reduce the level of in-flammatory factors,promote early postoperative recovery,accelerate bone metabolism,promote hip function recovery,and al-leviate patients'pain.关键词
股骨头坏死/髓芯减压/自体骨植骨/扩张式铰刀/PRO-DENSE可再生骨植骨/神经生长因子/疼痛/血管内皮生长因子AKey words
Femoral head necrosis/Core decompression/Autogenous bone grafting/Expandable reamer/PRO-DENSE renewable bone grafting/Nerve growth factor/Pain/Vascular endothelial growth factor A分类
临床医学引用本文复制引用
郝志鹏,吴涛,李晓华,刘永强..经皮扩张式铰刀髓芯减压联合PRO-DENSE可再生骨植骨治疗股骨头坏死的疗效及安全性分析[J].临床误诊误治,2024,37(6):36-41,6.基金项目
河北省医学科学研究重点课题计划项目(20191465) （20191465）
