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青壮年股骨头缺血坏死的显微手术及康复治疗
Objective To investigate a new method and its clinical results to treatment avascular necrosis of the femoral head in young adults. Methods The necrotic bone of the femoral head was removed and then iliac periosteum and bone with vascular pedicle were transplanted in 25 cases(28 hips),Rehabilitation technique was applied after surgery. Follow up time was 3~ 9.5 years postoperation.Results 16 cases were excellent, 7 cases were good, and 2 cases were fair. The rate of excellent and good was 92% . Conclusions Transplantation of iliac periosteum and bone with vascular pedicle has the effect on revascularization and new bone formation, which following with rehabilitation may promote the reconstruction of the necrotic femoral head and prevent it to collapse. Thus the pathogenesis process had been stopped.
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小儿股骨头无菌性坏死术后康复治疗
Background: Aseptic necrosis of head of femur of children is a kind of ischemic necrosis of the center of epiphysis of femoral head. Currently we treat it with synovectomy, transplantation of vessel tract, intertrochanteric osteotomy and every kinds of pelvic truncation to improve head-mortar relation, but the effect is not satisfying. After head of femur conversion and self-ilium transplantation operation, the follow-up effect is satisfying. Objective: Discussing the treatment effect of operation on children aseptic necrosis of head of femur. Unit:Second People's Hospital of Ningxia Municipality.
关键词: 股骨头无菌性坏死 术后 康复治疗 femoral head -
应用多孔钽金属植入治疗早期股骨头坏死患者的护理
股骨头坏死(osteonecrosis of the femoral head,ONFH)是骨科常见疾病之一,其主要病因包括髋关节创伤、股骨头骨骺特发性无菌性坏死(Legg-Calve-Perthes病)、血红蛋白病、减压病、激素药物应用史、酗酒、放疗及无明确病因的特发性股骨头坏死等[1],其中非创伤性ONFH主要发生于中青年,未经有效治疗的ONFH80%在1~4年会发展到股骨头塌陷而使关节功能损毁[2].
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成人股骨头缺血性坏死的外科治疗进展
成人股骨头缺血性坏死(ANFH)是骨科常见病,其病因及病理变化复杂,常因不能早期获得治疗而致残,严重影响劳动力.本病治疗方法较多,非手术治疗效果不确定,主要用于止痛或辅助治疗,因ANFH患者大多数为青壮年,故应用人工关节置换术远期疗效欠佳,因此主要的治疗方案仍被放眼于保髋的姑息性手术上,其方法很多,疗效相对比较肯定,但没有一种术式是完全满意的.现将近些年来ANFH外科治疗的一些发展归纳如下.
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股骨头缺血性坏死治疗的研究进展
股骨头缺血性坏死(osteonecrosis of femoral head,ONFH)是由于不同的病因,破坏了股骨头的血液循环,终导致股骨头塌陷,髋关节功能障碍的一种疾病.发病年龄多在30~50岁之间.其病因复杂,临床上可将ONFH分为创伤性和非创伤性两大类,后者包括全身性疾病,如红斑狼疮、高雪氏病以及由皮质激素及酒精诱导的股骨头坏死等[1].
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重用木豆叶治疗激素性股骨头坏死60例
股骨头坏死(osteonecrosis of the femoral head,ONFH)是骨科领域难治性疾病之一,占非创伤性ONFH的首位,约为50%[1].主要为肾上腺糖皮质激素服用或注射过量导致股骨头血供障碍,骨质坏死,是临床常见病之一.笔者于2007-02~2011-05采用重用木豆叶中药方治疗激素性股骨头坏死,获得了满意疗效,现报告如下.
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Experimental Study on the Effects of Femoral Head's Osteonetosis on the Biomechanical Properties of the Femoral Head's Cancellous Bone
Do the tension、compress and bend test on the normal and morbid femoral head cancellous bone and do the stress relaxation and creep test on the lognitudinal and the transverse samples. Then compare the mechanical natures of the normal and the morbid femoral head's cancellous bone. The object of this research is to offer the basic theory for the research of artificial joint material、the design of artificial joint、the implantation of artificial femoral head and the bone's creation and rebuilding.
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Experimental Study on the Effects of Femoral Head's Osteonetosis on the Biomechanical Properties of the Femoral Head's Cancellous Bone
Do the tension、compress and bend test on the normal and morbid femoral head cancellous bone and do the stress relaxation and creep test on the lognitudinal and the transverse samples. Then compare the mechanical natures of the normal and the morbid femoral head's cancellous bone. The object of this research is to offer the basic theory for the research of artificial joint material、the design of artificial joint、the implantation of artificial femoral head and the bone's creation and rebuilding.
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高压氧配合动脉灌注治疗股骨头缺血性坏死
介入性治疗股骨头缺血坏死(avascular necrosis of the femoral head,ANFH)是通过导管向股骨头供血血管内直接灌注扩张血管、溶栓、改善微循环类药物来改善股骨头的微循环促使新骨形成和死骨吸收,达到缓解疼痛,改善患侧肢体活动功能的目的,目前单纯的动脉灌注治疗近期疗效较明显,但远期疗效不肯定.随着高压氧(hyperbaric oxygen,HBO)医学的发展,其应用范围日益广泛,对各种缺血、缺氧引起的疾病疗效更为明显.我院自1999年7月至2002年3月应用高压氧配合动脉灌注治疗ANFH52例,取得了较好的临床疗效,现报道如下.
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高压氧治疗股骨头缺血性坏死的心理护理
高压氧(HBO)治疗股骨头缺血性坏死(avascular necrosis of the femoral head , ANFH) 已有多篇报道[1,2],但对于患传染性非典型性肺炎(SARS)后股骨头缺血性坏死的医务人员,在HBO治疗的同时如何做好心理护理工作目前尚未见相关报道.医务人员从SARS病房出院回家后不久,先后出现股骨头缺血性坏死影响到他们的生活和工作,出现了很大的心理障碍,因此,在HBO治疗期间,护士对他们进行心理护理十分重要.我们在HBO治疗期间坚持对患者进行心理护理,取得一定效果,报告如下.
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高压氧治疗SARS后股骨头坏死六例
近期在部分传染性非典型性肺炎(SARS)康复者中相继发现缺血性股骨头坏死(avascular necrosis of the femoral head,ANFH)的病例,目前我科已收治50余例患者,现将早进行高压氧(hyperbaric oxygenation,HBO)治疗的6例患者的临床治疗情况和X线、MRI复查结果报告如下.
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激素性股骨头缺血性坏死及其高压氧治疗的研究进展
股骨头缺血性坏死(avascular necrosis of the femoral head,ANFH)是指由于不同原因使股骨头发生部分或完全性缺血,导致骨细胞、骨髓造血细胞及脂肪细胞坏死的病理过程.
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Total hip arthroplasty(THA)for the treatment of end-stage osteochondritis dissecans(OD)of the femoral head
Osteochondritis dissecans(OD)is an idiopathic,localized disorder where articular cartilage and subchondral bone become separated and fragmentized from the articular surface[1-2]This unusual disease usually affects the distal part of the femur,humerus and ankle[3].However,OD of the femoral head is rarely seen which was generally and typically reported as a complication of Perthes' disease or congenital dislocation of the hip[4-5].
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股骨头坏死候选基因相关研究进展
股骨头坏死(osteonecrosis of femoral head,ONFH)是由于不同病因破坏股骨头的血液供应所造成的终结果,但股骨头坏死的发病机制目前尚不清楚,其可能的病因为髋关节创伤、激素、酒精、凝血系统紊乱、镰状细胞贫血、结缔组织疾病和特发性缺血性坏死等.由股骨头塌陷造成的髋关节病残程度较重,治疗较困难.孪生子患病的特发性股骨头坏死和家族性股骨头坏死病例的集群现象首先提示,遗传因素在ONFH的发病机制中起作用[1-2].Liu等[3]研究了3例家族性股骨头坏死患者,发现该病可呈常染色体显性遗传,致病基因定位于12q13.
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股骨头缺血性坏死的介入治疗及临床护理
股骨头缺血性坏死(avascular necrosis of the femoral head,简称AFNH)是成年人常见的髋关节疾患.早期诊断和治疗是保留股骨头和恢复髋关节正常功能的关键.导管介入疗法是一种微创治疗手段,具有损伤小、疗效佳、费用低廉等优点.本院自1991年开始应用此方法治疗股骨头缺血性坏死,在临床上取得了较为满意的结果.笔者在对该组患者的护理过程中积累了一定的经验,报告如下.
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成人股骨头缺血性坏死非手术治疗的研究进展
股骨头缺血性坏死(avascular necrosis of the femoral head,ANFH)是骨科常见疾病,其病理机制复杂,通常认为可能是各种原因导致股骨头内血供受损并引起骨细胞和骨髓细胞死亡的病理过程.ANFH仍是骨科领域迄今尚未解决的疾病之一.
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DHS与人工股骨头置换治疗高龄股骨颈基底部骨折
股骨颈骨折是老年人常见的损伤,约占全身骨折的3.58%.因为高龄患者全身情况的差异,在治疗上应该因人而异,才能减少并发症的发生.本院自1993年6月至2005年7月,共收治70岁以上股骨颈基底部骨折66例.其中57例分别采用DHS内固定术及双极人工股骨头置换术进行治疗,51例得到临床随访.
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股骨头缺血坏死的诊断和介入治疗现状
股骨头缺血坏死(avascular necrosis of the femoral head,ANFH),是一种骨科常见的慢性进行性致残性疾病,其发病率近年来呈逐年上升趋势,有资料表明,股骨头缺血坏死已取代了髋关节结核的位置,位居髋关节疾病的首位.ANFH晚期股骨头塌陷,致残率极高,故早期诊断和治疗对预后至关重要.目前国内外学者对股骨头缺血坏死的治疗进行了大量研究,但至今尚无突破性进展,药物或其他非手术治疗已被证明效果不尽人意,而人工关节置换术不适合于年轻患者,且因股骨头坏死行人工关节置换后其效果比因其他病因行此术的效果要差.
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股骨头血供及股骨颈骨折血管破坏研究进展
股骨颈骨折致股骨头缺血性坏死(avascular necrosis of the femoral head,ANFH)的基本病理是股骨颈骨折后血管破坏导致股骨头血供丧失.因此股骨头血供及股骨颈骨折血管破坏研究是ANFH治疗的重要理论基础.一直以来,有很多学者对股骨头血供及股骨颈骨折后血管破坏进行研究,现就这方面的研究进展综述如下.
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29例股骨头缺血性坏死术后护理体会
股骨头缺血性坏死(avascular necrosis of the femoral head,ANFH)是以股骨头血液供应障碍为其病理特点的骨科疾病,目前其发病原因和机理尚不清楚.如果得不到及时正规的治疗,将会错过佳治疗时机,再加上负重(如走路、爬楼、抬重物等)引起股骨头塌陷,形成骨性关节炎,将严重影响生活质量.本次研究对29例31头股骨头缺血性坏死进行了手术治疗,经随访证实效果满意,其护理重点是进行术前、术后评估,指导病人早期正确进行功能锻炼,现就护理体会报道如下.