2025 年第 9 期 第 20 卷

改良多孔髓芯减压术联合负压吸引术治疗成人早期股骨头缺血性坏死的临床效果

Clinical effect of modified porous core decompression combined with vacuum sealing drainage in the treatment of early avascular necrosis of the femoral head in adults

作者：谢志涛1陈欣志2张永涛2田再杰2马智林2王珅2刘博宇2何全杰2褚兆珍2 乔国勇2

英文作者：Xie Zhitao1 Chen Xinzhi2 Zhang Yongtao2 Tian Zaijie2 Ma Zhilin2 Wang Shen2 Liu Boyu2 He Quanjie2 Chu Zhaozhen2 Qiao Guoyong2

单位：1河北工程大学附属医院关节外科，邯郸056004；2河北工程大学附属医院骨科，邯郸056004

英文单位：1Department of Joint Surgery Affiliated Hospital of Hebei University of Engineering Handan 056004 China; 2Department of Orthopedics Affiliated Hospital of Hebei University of Engineering Handan 056004 China

关键词：早期股骨头缺血性坏死；改良多孔髓芯减压术；负压吸引术；髋关节功能；疼痛

英文关键词：Earlyavascularnecrosisofthefemoralhead;Modifiedporouscoredecompression;Vacuumsealingdrainage;Hipjointfunction;Pain

• 摘要：

• 目的 探讨改良多孔髓芯减压术（CD）联合负压吸引术（VSD）治疗成人早期股骨头缺血性坏死（AVN）的临床效果。方法 回顾性选取2022年5月至2024年1月河北工程大学附属医院收治的80例成人早期AVN患者，依照手术方式的不同分为CD组（37例，采用改良多孔CD术）和联合组（43例，采用改良多孔CD联合VSD）。比较2组治疗效果、髋关节功能、疼痛情况、髋关节活动度、术后并发症。结果 联合组总有效率高于CD组［95.3%（41/43）比81.1%（30/37）］（χ2=4.055，P=0.004）。术后3、6、12个月联合组Harris髋关节评分均高于CD组，疼痛视觉模拟量表评分均低于CD组（均P<0.05）；术后6个月联合组髋关节活动度大于CD组（均P<0.05）。术后远期并发症总发生率联合组低于CD组［7.0%（3/43）比24.3%（9/37）］，差异有统计学意义（χ2=4.694，P=0.030）。结论 改良多孔CD联合VSD治疗成人早期AVN患者，具有较好的效果，可改善髋关节功能，控制疾病进展，减轻疼痛程度，增加髋关节活动度，安全性较高。

• Objective To investigate the clinical effect of modified porous core decompression (CD) combined with vacuum sealing drainage (VSD) in the treatment of early avascular necrosis (AVN) of the femoral head in adults. Methods A total of 80 adult patients with early AVN admitted to the Affiliated Hospital of Hebei University of Engineering from May 2022 to January 2024 were retrospectively selected. According to the different surgical methods , they were divided into CD group (37 cases, treated with modified porous CD) and combined group (43 cases, treated with modified porous CD combined with VSD). The treatment effect, hip joint function, pain, hip joint activity and postoperative complications were compared between the two groups. Results The total effective rate of the combined group was higher than that of the CD group ［95.3%(41/43) vs 81.1%(30/37)］(χ2=4.055, P=0.004). At 3, 6, and 12 months after operation, the Harris hip scores of the combined group were higher than those of the CD group, and the visual analogue scale scores of pain were lower than those of the CD group (all P<0.05). The range of motion of hip joint in the combined group was greater than that in the CD group at 6 months after operation (P<0.05). The total incidence of long-term postoperative complications in the combined group was lower than that in the CD group ［7.0%(3/43) vs 24.3%(9/37)］(χ2=4.694, P=0.030). Conclusion Modified porous CD combined with VSD has a good effect in the treatment of adult patients with early AVN, which can improve hip joint function, control disease progression, reduce pain, increase hip joint activity, and has high safety.