| 常永霞,曲淑婕,王晓娜,郎晓燕,王殷,孟海超,戈蕾,张春玲,王正田,田龙.聚焦式冲击波对股骨头坏死早期和中期疗效的比较[J].中国康复,2026,41(1):31-37 |
| 聚焦式冲击波对股骨头坏死早期和中期疗效的比较 |
| Comparative study on the clinical efficacy of focused shock wave on patients with early and intermediate stages of femoral head necrosis |
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| DOI：10.3870/zgkf.2026.01.006 |
| 中文关键词: 股骨头坏死 聚焦式冲击波 早期 中期 疗效 |
| 英文关键词: osteonecrosis of the femoral head focused shockwave therapy early and intermediate stages efficacy comparison |
| 基金项目:河北省重点研发计划项目（22377778D） |
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| 中文摘要: |
| 目的：观察聚焦式体外冲击波（fESWT）治疗股骨头坏死（ONFH）早期和中期患者的临床效果。方法：选取在我院康复科接受fESWT治疗的ONFH患者60例。依据国际骨微循环研究协会（ARCO）分期分为早期组（n=30）和中期组（n=30），比较2组治疗前后疼痛视觉模拟评分（VAS）、Harris髋关节评分（HHS）、骨髓水肿（BME）和坏死面积。结果：重复测量方差分析结果显示VAS、HHS的时间×组别交互效应显著（均P＜0.01）,坏死面积的时间×组别交互效应不显著。进一步简单分析显示，治疗前，早期组VAS评分低于中期组（P＜0.01）；治疗后，早期组VAS评分降低（P＜0.01），中期组VAS评分亦降低（P＜0.01），且早期组VAS评分低于中期组（P＜0.01）。治疗前，早期组HHS评分高于中期组（P＜0.01）；治疗后，早期组HHS评分增加（P＜0.01），中期组HHS评分亦增加（P＜0.01），且早期组HHS评分高于中期组（P＜0.01）。治疗前，早期组BME评级低于中期组（P＜0.01）；治疗后，早期组BME评级降低（P＜0.01），中期组BME评级亦降低（P＜0.01），且早期组BME评级低于中期组（P＜0.01）。结论：fESWT可以改善股骨头坏死早、中期的临床症状，恢复髋关节功能，促进骨髓水肿吸收，对早期患者的效果优于中期患者。 |
| 英文摘要: |
| Objective: To compare the clinical efficacy of focused extracorporeal shock wave therapy (fESWT) in the treatment of patients with early and intermediate stages of osteonecrosis of the femoral head (ONFH). Methods: A total of 60 ONFH patients who underwent fESWT treatment in Rehabilitation Department of The First Affiliated Hospital of Hebei Northern University were screened. According to the Association Research Circulation Osseous (ARCO) staging system, the patients were divided into an early-stage group (n=30) and an intermediate-stage group (n=30). The visual analog scale (VAS) for pain, Harris Hip Score (HHS), bone marrow edema (BME), and necrotic area were compared between the two groups. Results：Before treatment, the VAS scores and BME scores in the early-stage group were significantly lower than those in the intermediate-stage group (P<0.01), and the HHS score was significantly higher than that in the intermediate-stage group (P<0.01). After treatment, the VAS and BME scores in both the early-stage and intermediate-stage groups were significantly lower than those before treatment (P<0.01), and the HHS score was significantly higher than before treatment (P<0.01). The differences in VAS, HHS, and BME scores before and after treatment in the early-stage group were significantly greater than those in the intermediate-stage group (P<0.01). Conclusion: Focused shockwave therapy can improve clinical symptoms, restore hip joint function, and promote the absorption of bone marrow edema in the early and in-termediate stages of femoral head necrosis, with better efficacy in the early stage than in the intermediate stage. |
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