陈宁;韦标方;

• 1:广州中医药大学
• 2:山东省临沂市人民医院

摘要(Abstract)：

[目的]探讨高位股骨头颈开窗植骨支撑术治疗中青年ARCOIII期股骨头坏死患者的临床疗效。[方法]回顾分析2012年1月～2017年6月采用高位股骨头颈开窗植骨支撑术治疗中青年股骨头坏死ARCOIII期患者58例(69髋)。随访评价保髋是否成功,比较成功与失败组术前资料,采用COX风险模型及Kaplan-Meier生存曲线分析影响术后失败的因素。[结果] 58例(69髋)均顺利完成手术且随访12～48个月,平均随访(39.17±1.72)个月。末次随访Harris评分为(81.72±8.12)分,与术前(73.47±11.91)分比较差异有统计学意义(P<0.05)。术后评定19髋临床失败,股骨头生存率为72.50%。成功组术前Harris评分显著高于失败组(P<0.05),成功组术前ARCO分期和术前CJFH分型显著优于失败组(P<0.05)。Cox风险模型分析显示,术前Harris评分为手术成功的保护因素,Harris评分每增加1分,手术失败的发生风险降低4.18%(HR=0.958,95%CI:0.919-0.999,P=0.046)。术前CJFH分型及术前ARCO分期的HR值均>1,为危险因素,但尚未达到统计学显著性。Kaplan-Meier生存曲线分析示,ARCO IIIB期患者临床失败率高于ARCO IIIA期患者。[结论]采用高位股骨头颈开窗植骨支撑术治疗中青年ARCO IIIA期患者可获得良好的临床效果,尤其对于术前Harris评分较高的C+L1型患者效果最佳。

关键词(KeyWords)： 股骨头坏死;股骨头颈开窗;植骨支撑术;生存曲线

Abstract:

Keywords:

基金项目(Foundation): 山东省科技攻关计划项目（编号：2014GSF119022）;; 临沂市人民医院博士研究生培养基金项目（编号：YJS2019008）

作者(Author): 陈宁;韦标方;

Email:

DOI:

参考文献(References)：

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