成人非创伤性股骨头缺血性坏死DSA影像表现及介入治疗的临床效果分析
DSA Findings of Adult Non-Traumatic Necrosis of Femoral Head and Clinical Effect of Interventional Therapy

目的：探讨分析DSA影像在治疗成人非创伤性股骨头缺血性坏死的表现以及介入治疗的临床效果。方法：选取2019年4月至2020年6月期间本院收治的成人非创伤性股骨头缺血性坏死50例患者作为研究资料。在血管灌注介入治疗之前，所有患者均需进行数字减影血管造影术以描述供血动脉血管的改变，便于医生观察患者症状的改善情况。结果：治疗前患者闭孔、旋股外侧与旋股内侧的动脉血管管径分别为0.4 ± 0.2、0.6 ± 0.2、0.8 ± 0.1，1线、2线、3线的血管计数分别为2.4 ± 0.1、2.3 ± 0.3、2.1 ± 0.4；治疗后患者闭孔、旋股外侧与旋股内侧的动脉血管管径分别为0.8 ± 0.1、1.3 ± 0.2、1.9 ± 0.2，1线、2线、3线的血管计数分别为3.4 ± 0.5、3.3 ± 0.3、3.2 ± 0.3，差异显著(P < 0.05)；治疗前，患者觉得髋关节功能改善为优的情况有1例，良的情况有6例，可的情况有21例，差的情况有22例；治疗后，患者觉得髋关节功能改善为优的情况有4例，良的情况有15例，可的情况有26例，差的情况有5例，说明患者髋关节功能改善明显。结论：在成人非创伤性股骨头缺血性坏死的治疗中，DSA影像表现可以提示引起股骨头坏死发生与发展的影响因素是股骨头供血动脉血管的改变。数字减影血管造影介入治疗既可以促进血液循环又可以促进新骨形成，疗效较好，值得进行推广。
Objective: To investigate and analyze the manifestations of DSA in the treatment of adult non-traumatic necrosis of the femoral head and the clinical effect of interventional therapy. Meth-ods: 50 adult patients with non traumatic necrosis of the femoral head treated in our hospital from April 2019 to June 2020 were selected. Before vascular perfusion interventional therapy, all patients need digital subtraction angiography to describe the changes of blood supply arteries. Results: Before treatment, the diameters of obturator, lateral femoral circumflex and medial femoral circumflex were 0.4 ± 0.2, 0.6 ± 0.2 and 0.8 ± 0.1 respectively, and the vascular counts of line 1, line 2 and line 3 were 2.4 ± 0.1, 2.3 ± 0.3 and 2.1 ± 0.4 respectively; after treatment, the diameters of obturator, lateral femoral circumflex and medial femoral circumflex were 0.8 ± 0.1, 1.3 ± 0.2 and 1.9 ± 0.2 respectively, and the vascular counts of line 1, line 2 and line 3 were 3.4 ± 0.5, 3.3 ± 0.3 and 3.2 ± 0.3 respectively (P < 0.05); before treatment, the patients felt that the improvement of hip function was excellent in 1 case, good in 6 cases, fair in 21 cases and poor in 22 cases; after treatment, the patients felt that the improvement of hip function was excellent in 4 cases, good in 15 cases, medium in 26 cases and poor in 5 cases, indicating that the patient’s hip function improved significantly. Conclusion: In the treatment of adult non-traumatic necrosis of the femoral head, DSA findings suggest that the influencing factor causing the occurrence and development of necrosis of the femoral head is the change of blood supply artery of the femoral head. Digital subtraction angiography interventional therapy can promote blood circulation, and promote new bone formation. It has good curative effect and is worthy of application.