中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (44): 8327-8330.doi: 10.3969/j.issn.1673-8225.2010.44.039

• 器官移植临床实践 clinical practice of organ transplantation • 上一篇    下一篇

带血管蒂髂骨移植治疗青少年镰状细胞病股骨头缺血性坏死：短中期结果随访

吴  昊1，梁  源2，Hernigou Philippe○3   

  1. 广西壮族自治区人民医院，1骨科，2放射科，广西壮族自治区南宁市   530021；3法国巴黎XII大学亨利蒙多医院矫形和创伤外科，法国克雷岱依  94010
  • 出版日期:2010-10-29 发布日期:2010-10-29
  • 作者简介:吴昊，男，1963年生，广西壮族自治区南宁市人，汉族，1985年广西医科大学医学系毕业，主任医师，主要从事股骨头缺血性坏死的分期治疗的研究 wuhaorthop@yahoo.com.cn

Short and mid-term results of vacularized iliac crest graft for femoral head necrosis with sickle cell disease in juvenile patients

Wu Hao1, Liang Yuan2, Hernigou Philippe3   

  1. 1 Department of Orthopaedics, 2 Department of Radiology, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning  530021, Guangxi Zhuang Autonomous Region, China; 3 Department of Orthopaedic and Traumatic Surgery, Henri Mondor Hospital, University of Paris XII, Créteil  94010, France
  • Online:2010-10-29 Published:2010-10-29
  • About author:Wu Hao, Chief physician, Department of Orthopaedics, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China wuhaorthop@yahoo.com.cn

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摘要：

背景：镰状细胞病是造成非洲青少年股骨头缺血性坏死的主要原因，带血管的髂骨移植用于股骨头缺血性坏死的报告已经很多，它也适用与镰状细胞病股骨头缺血性坏死的患者，可以使坏死区再血管化提高和阻止进行性发展。
目的：探讨带血管蒂髂骨移植治疗青少年镰状细胞性股骨头缺血性坏死的早期和中期疗效。
方法：纳入尼日尔马腊迪省治疗中心的青少年镰状细胞病并股骨头缺血性坏死的患者12例，均采带旋髂深血管髂骨瓣移植治疗，术后随访24~30个月(平均27个月)，观察移植后患者是否髋痛，功能活动和X射线骨盆平片结果。
结果与结论：移植后疼痛消失，无感染等并发症，无重复手术，近中期疗效满意，Harris评分平均从术前75分提高到术后90分，而X射线平片表现并不令人满意。对于Ficat III、IV期的镰状细胞性骨股头缺血性坏死青少年患者，采用带血管蒂髂骨移植治疗，可以解除疼痛，恢复髋关节功能。

关键词: 镰状细胞病, 股骨头缺血性坏死, 自体骨移植, 带血管蒂髂骨

Abstract:

BACKGROUND: Sickle cell disease is the main reason for the ischemic necrosis of the femoral head in African juvenile patients. There are more reports concerning vascularized iliac graft for femoral head necrosis. It is also effective for the treatment of femoral head necrosis with sickle cell disease.
OBJECTIVE: To investigate the short and mid-term results of the vacularized iliac graft for ischemic necrosis of the femoral head in young patients with sickle cell disease.
METHODS: Totally 12 patients suffered from ischemic necrosis of the femoral head with sickle cell disease were treated with vascularized iliac graft in Maradi Province Hospital of Niger. The patients were followed up 24-30 months after operation (mean 27 months). The effects were evaluated on the basis of the Harris hip score and radiological examination.
RESULTS AND CONCLUSION: The clinical results were satisfactory though the radiological was not satisfied. The mean Harris hip score increased from 75 points to 90 points. Pain relief and hip function improvement were achieved in all patients. No patients needed revision during short and mid-term follow up. This method is recommendation for treatment of ischemic necrosis of the femoral head in the Ficat Stages Ⅲ-Ⅳ in juvenile patients with sickle cell disease for pain relief and restoration of hip joint function.

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