摘要
目的探讨中西医结合治疗儿童股骨头软骨缺血性坏死的临床疗效。方法我院自2001年11月至2006年1月收治股骨头缺血性坏死患儿66例,根据外侧柱状分类法：A组42髋,B组11髋,C组4髋,＂B/C＂边界组10髋。A,B组采用股骨颈钻孔减压,C组及＂B/C＂组予股骨粗隆下内翻截骨及内收肌松解,全部病例均行人字管型石膏固定2月,口服骨宝口服液等药物,并评估恢复时间及临床疗效。结果按Stulberg评定标准,67髋中Ⅰ级达65.7%,Ⅱ级19.3%,Ⅲ级6.0%,Ⅳ级7.5%,Ⅴ级1.5%;Mckay髋关节功能评定结果,A组优良率为88.1%,B组为72.7%,C组为50.0%,＂B/C＂边界组为70.0%,总优良率达80.6%。66例患儿随访时间最短2.5年,最长7年,平均5.5年。A组的38髋修复时间为6~9月,A组的剩余4髋和B组的11髋修复时间为1.0~1.5年,＂B/C＂边界组的4髋修复时间为1.5~2.0年,余下10髋修复时间1.8~2.3年。其中5髋出现扁平髋,1髋发生股头畸形愈合,未愈,3髋出现患肢短缩、跛行。结论采用中西医结合分型、分期治疗儿童股骨头软骨缺血性坏死可增强其自愈修复能力,缩短病程,患儿及其家属能否遵从医嘱避免早期过度负重是离院后继续治疗成功的关键。
Objective To investigate the clinical effect of integrated traditional Chinese and western medicine in treating cartilage of femoral head ischemic necrosis. Methods From 2001 November to 2006 January, 66 cases of ischemic necrosis of femoral head in our department, according to the lateral column classification method： 42 hips belonged to group A, 11 hips to group B, 4 hips to group C, 10 hips to boundary group ＂B/C＂. Group A and B were treated with femoral neck drilling decompression. Group C and group ＂B/C＂ were treated with subtrochanteric femoral varus osteotomy and adductor releasing. All the cases were fixed with Gypsum for 2 months and given Gubao Koufuye. Clinical effect and recovery time were compared. Results According to Stulberg evaluation standard, in the 66 cases, 65.7% grade I, 19.3% grade II, 6% grade III, 7.5% grade IV, 1.5% grade V; Mckay hip function assessment results： the excellent rate was 88.1% in group A, 72.7% in group B and 50% in group C, 70% in boundary group ＂B/C＂. The total excellent rate was 80.6%. 66 patients were followed up from 2.5 to 7 years, average 5.5 years. Recovery time of group A was 6 - 9 months for 38 hips, the remaining 4 hips in group A and 11 hips in group B was 1 to 1.5 years, 4 hips inboundary group ＂B/C＂ ranged from 1.5 to 2 years. The remaining 10 hips repaired 1.8 - 2.3 years. 5 hips formed flat hips, 1 hip appeared femoral head deformity healing, 3 hips appeared shortened limb, claudication. Conclusion Integrative traditional Chinese and western medicine can increase self-healing ability in treating ischemic necrosis of femoral head cartilage children, shorten the course of disease. Patients and their families＇ following of the doctor＇ s advice to avoid early excessive weight is the key to successful recovery after leaving the hospital.
出处
《中医儿科杂志》
2015年第1期52-56,共5页
Journal of Pediatrics of Traditional Chinese Medicine
关键词
中西医结合
儿童股骨头缺血性坏死
骨宝口服液
白茅根颗粒
combined of traditional Chinese and western medicine
pediatric ischemic necrosis of femoralhead
Gubao Koufuye
Baimaogen Keli
