1.Linyi People'2.'3.s Hospital
[目的] 探讨冲击波对非创伤性股骨头坏死患者不同坏死面积的临床疗效。[方法] 回顾性收集2017年1月至2018年9月经冲击波治疗的69例（101髋）ARCO II期非创伤性股骨头坏死患者的临床资料，对比分析坏死面积≤ 30%（A组）与坏死面积> 30%（B组）患者的VAS评分、Harris评分和影像学进展情况。[结果]两组患者冲击波治疗后VAS评分较治疗前显著降低（P<0.05），Harris评分均比治疗前显著提高（P<0.05）。治疗后12个月、24个月，A组患者VAS评分、Harris评分均优于B组（P<0.001）。对比两组影像学资料结果显示，A组2髋从ARCO II期改善为ARCO I期；3髋从坏死面积≤ 30%进展到坏死面积>30%。B组1髋从ARCO II期坏死面积>30%改善为ARCO II期从死面积≤ 30%；6髋从ARCO II期进展为ARCO III期，差异无统计学意义（P>0.05）。治疗过程中，两组患者未出现严重不良反应。[结论] 冲击波治疗ARCO II期非创伤性股骨头坏死患者可明显缓解疼痛，改善功能。冲击波治疗ARCO II期坏死面积≤ 30%的患者6个月后的疗效优于ARCO II期坏死面积> 30%的患者。
[Objective] To investigate the clinical effect of shock wave on different necrotic area in patients with non-traumatic necrosis of femoral head. [Methods] The clinical information of 69 patients (101 hips) with ARCO II non-traumatic femoral head necrosis who received shock wave treatment from January 2017 to September 2018 were retrospectively collected. VAS score, Harris score and imaging were compared between the necrotic area ≤ 30% (group A) and > 30% (group B). [Results] After shock wave treatment, VAS score was significantly lower than that before treatment (P<0.05), and Harris score was significantly higher than that before treatment (P<0.05). At 12 and 24 months after treatment, VAS score and Harris score in group A were better than those in group B (P<0.001). The imaging data showed that the two hips in group A improved from ARCO II stage to ARCO I stage, and 3 hips progressed from necrotic area ≤ 30% to >30%. One hip in group B was improved from necrotic area >30% to ≤ 30% in ARCO II stage, and six hips progressed to ARCO III. No statistical significance was obsserved (P>0.05). No serious adverse reactions occurred in all patients during the treatment. [Conclusion] Shockwave therapy can significantly relieve pain and improve function in ARCO II patients with non-traumatic necrosis of femoral head. Shockwave therapy favors patients with ARCO II necrotic area ≤ 30% over ARCO II necrotic area > 30% after 6 months.