Clinical Study Of Shock Wave Combined With Hyperbaric Oxygen And Drugs For Promoting Blood Circulation And Removing Blood Stasis In The Treatment Of Adult Femoral Head Necrosis In Early And Middle Stage

Objective:to study the treatment of adult femoral head necrosis in early and middle stage by extracorporeal shock wave(ESWT),hyperbaric oxygen and drugs for promoting blood circulation and removing blood stasis,and to explore a more valuable way for the treatment of adult femoral head necrosis.Therefore,it provides more theoretical basis for slowing down the progress of(ONFH)of avascular necrosis of femoral head and the treatment of preserving hip joint.Methods:from October 2017 to October 2018,40 patients(40 hips)with adult femoral head necrosis in Binzhou Medical College affiliated Hospital were treated with shock wave combined with hyperbaric oxygen and drugs for promoting blood circulation and removing blood stasis.Load-bearing was strictly prohibited on the necrotic hip during the study period.All patients were examined by double hip X-ray and double hip MR before treatment.blood samples were taken to detect vascular endothelial growth factor(vascular endothelial growth factor,VEGF)and osteocalcin(osteocalcin,OC)in the blood of the patients.VAS score and Harris score of hip joint were performed.After three courses of systematic treatment,VAS score and Harris score were performed respectively,and the values of VEGF and OC in the patient's blood were measured.The changes of VAS score,Harris score,serum VEGF and OC in patients with stage I,II and III femoral head necrosis before and after triple therapy were compared.At the end of the third course of treatment,double hip orthotopic position and double hip MRI,were performed again to compare the imaging results of(ONFH)patients with avascular necrosis of femoral head before and after treatment,and the changes of necrosis area were observed.All the above data were collected and analyzed by statistical methods.Results:after 3 months follow-up,it was found that shock wave combined with hyperbaric oxygen and drugs for promoting blood circulation and removing blood stasis were effective in the treatment of 40 cases(40 hips)of adult avascular necrosis of femoral head in the early and middle stages.By comparing the patients before and after treatment,it was not difficult to find that the VAS score of the patients after treatment was lower than that before treatment,and the difference was statistically significant(P<0.05),and the Harris score after treatment was higher than that before treatment(P<0.05),the difference was statistically significant.After treatment,VEGF was higher than that before treatment(P<0.05),the difference was statistically significant,OC after treatment was higher than that before treatment(P<0.05),the difference was statistically significant.In imaging findings,the area of avascular necrosis of femoral head before and after treatment was smaller than that before treatment.Therefore,(ONFH)patients with avascular necrosis of femoral head in stage ?,? and ? of ARCO stage were treated with extracorporeal shock wave(ESWT)combined with hyperbaric oxygen(HBO)and drug system of promoting blood circulation and removing blood stasis.The VAS score and Harris score of hip joint were significantly improved compared with those before treatment,VEGF and OC were significantly higher than those before treatment(P<0.05),and the difference was statistically significant.Compared with the curative effect after treatment,the effect of stage ? was better than that of ?,and the effect of stage ? was better than that of ?.To sum up,extracorporeal shock wave(ESWT)combined with hyperbaric oxygen(HBO)and Huoxue Huayu drug triple therapy is effective in the treatment of early and middle stage adult avascular necrosis of femoral head(ONFH).Conclusion:extracorporeal shock wave(ESWT)combined with hyperbaric oxygen(HBO)and drugs for promoting blood circulation and removing blood stasis are effective in the treatment of(ONFH)in early and middle stages of adult avascular necrosis of femoral head,and the therapeutic effect of stage ? is better than that of ? and ?.