体外冲击波联合钻孔减压术对早期股骨头坏死患者关节功能、肌力及生活质量的影响

目的:探讨体外冲击波(ESWT)联合钻孔减压术对早期股骨头坏死患者关节功能、肌力及生活质量的影响。方法:回顾性分析2017年9月~2018年12月期间收治的80例早期股骨头坏死患者的临床资料,依据治疗方式将其分为A组(n=37,钻孔减压治疗)和B组(n=43,钻孔减压联合ESWT治疗),对比两组患者关节功能、肌力、生活质量及并发症情况。结果:两组治疗后3、6、9个月的视觉模拟评分(VAS)评分较治疗前降低(P<0.05),髋关节Harris评分较治疗前升高(P<0.05);B组治疗后3、6、9个月VAS评分低于A组,髋关节Harris评分则高于A组(P<0.05)。两组患者治疗后9个月生理功能、情感职能、躯体疼痛、生理职能、活力、社会功能、总体健康、精神健康这8个维度评分均较治疗前升高,且B组高于A组(P<0.05)。B组患者治疗后9个月肌力3级者少于治疗前及A组同时间点,肌力4级者多于治疗前及A组同时间点(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论:相比于单独采用钻孔减压术,ESWT联合钻孔减压术治疗早期股骨头坏死,可有效减轻患者疼痛症状,改善患者关节功能、肌力及生活质量,且不增加并发症发生率。

Effect of Extracorporeal Shock Wave Combined with Drilling Decompression on Joint Function, Muscle Strength and Quality of Life of Patients with Early Femoral Head Necrosis

ABSTRACT Objective: To investigate the effect of extracorporeal shock wave(ESWT) combined with drilling decompression on joint function, muscle strength and quality of life in patients with early femoral head necrosis. Methods: The clinical data of 80 patients with early necrosis of the femoral head from September 2017 to December 2018 were analyzed retrospectively, the patients were divided into group A (n=37, drilling decompression treatment) and group B (n=43, drilling decompression combined with ESWT treatment) according to the different operation methods. The joint function, muscle strength, quality of life and complications of the two groups were compared. Results: 3, 6 and 9 months after treatment, the visual analogue pain score (VAS) of the two groups were lower than that before treatment (P<0.05), and the Harris score of hip joint were higher than that before treatment (P<0.05). The VAS score of group B at 3, 6 and 9 months after treatment were lower than those of group A, and the Harris score of hip joint were higher than that of group A (P<0.05). The scores of physiological function, physical pain, emotional function, physiological function, vitality, overall health, social function and mental health of the two groups were higher than those before treatment, and those of group B were higher than those of group A (P<0.05). 9 months after treatment, the level 3 muscle strength of group B were lower than that before treatment and at the same time point in group A, and the level 4 muscle strength of were higher than that before treatment and at the same time point in group A (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: Compared with using borehole decompression alone, ESWT combined with drilling decompression in the treatment of early femoral head necrosis can reduce pain symptoms effectively, which can improve joint function, muscle strength and quality of life of patients without increasing the incidence of complications.