早期诊断和治疗

А. В. Антонов, В. Е. Воловик
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引用次数: 1

摘要

股骨头无菌性坏死——严重的慢性骨科病理(1.2- 12%),诊断相当困难。诊断快的问题,临床症状千篇一律,疾病发展快导致残疾。高危人群包括中青年男性。本病的病因不明,保守治疗的可能性仅适用于早期,疗效可疑,在手术中没有一个是最好的。这项研究是在哈巴罗夫斯克创伤学中心进行的,该中心是公共卫生工作者研究生院的临床基地。2014-2019年,对97例诊断为股骨头无菌性坏死患者的医学图进行统计资料,对治疗结果进行回顾性分析,对49例股骨头制剂进行病理形态学研究;对手术组患者细胞免疫、甲状腺激素等免疫学指标进行实验室分析。检测到的免疫变化表明疾病的全身性。提出了一种微创两阶段股骨颈减压术。与以前的手术治疗方法相比,开发的最小损伤治疗方法具有不可否认的优势。该技术已应用于17例,中期临床效果良好。股骨头无菌性坏死是一种具有形态学特征的病理,其诊断相当困难,与年轻时的高风险相关,是当前的一个问题,需要进一步研究,以实现永久的长期缓解,甚至可能是患者的绝对康复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early Diagnosis and Treatment
Aseptic necrosis of a femoral head - severe chronic orthopedic pathology (1.2-12 %), diagnostics of which presents considerable difficulties. Problems of fast diagnostics, identical clinical symptoms, rapid development of the disease leads to disability. Risk group includes young and middle-aged men. The cause of the disease is unknown, the possibilities of conservative treatment are applied only in the early stages with doubtful efficiency, and among surgical none is the best. The research is performed in the traumatology center of Khabarovsk - clinical base of a Postgraduate Institute for Public Health Workers. During 2014-2019, retrospective analysis of treatment results was carried out on the basis of statistical data of 97 medical maps of patients diagnosed with aseptic necrosis of a femoral head, pathomorphological study of 49 preparations of the femoral head; laboratory analysis of immunological indicators of cellular immunity and thyroid hormones in the operated group of patients was carried out. Detected immunological changes indicate the systemic nature of the disease. Method of minimally invasive two-stage decompression of femoral neck is developed. Minimum injury of the developed method of treatment provides undeniable advantages in contrast to previous methods of surgical treatment. The technique has been applied in 17 cases, with positive medium-term clinical results. Aseptic necrosis of a femoral head is a pathology with a polymorphologicpicture, diagnosis of which presents considerable difficulties, associated with high risk of development atyoung age, is a current problem and demands further studying for the purpose of achievement of permanent long remission, and, perhaps, and an absolute recovery of the patient.
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