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关节腔内及膝周痛点注射富血小板血浆治疗膝关节骨性关节炎
Hits: 4026   Download times: 1100   Received:April 09, 2019    
作者Author单位UnitE-Mail
杜薇 DU Wei 中国人民解放军总医院第六医学中心康复医学科, 北京 100048 Department of Rehabilitation, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China  
崔洪鹏 CUI Hong-peng 中国人民解放军总医院第六医学中心康复医学科, 北京 100048 Department of Rehabilitation, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China cuihong-peng@163.com 
付本升 FU Ben-sheng 中国人民解放军总医院第六医学中心康复医学科, 北京 100048 Department of Rehabilitation, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China  
李雯 LI Wen 中国人民解放军总医院第六医学中心康复医学科, 北京 100048 Department of Rehabilitation, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China  
刘倩 LIU Qian 中国人民解放军总医院第六医学中心康复医学科, 北京 100048 Department of Rehabilitation, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China  
钟毓贤 ZHONG Yu-xian 中国人民解放军总医院第六医学中心康复医学科, 北京 100048 Department of Rehabilitation, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China  
董妍含 DONG Yan-han 中国人民解放军总医院第六医学中心康复医学科, 北京 100048 Department of Rehabilitation, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China  
期刊信息:《中国骨伤》2020年33卷,第3期,第209-213页
DOI:10.12200/j.issn.1003-0034.2020.03.004


目的:观察关节腔内及膝周痛点注射富血小板血浆治疗膝关节骨性关节炎的临床疗效,并分析其安全性和可行性。

方法:将2017年1月至12月收治的膝关节骨性关节炎患者48例分为观察组和对照组,每组24例。观察组男8例,女16例;年龄43~68(58.04±7.87)岁,病程1~8(4.69±1.96)年;身体质量指数(24.53±5.26)kg/m2;给予关节腔内注射富血小板血浆2 ml,膝周痛点注射富血小板血浆共2 ml,1次/周,共治疗3次;对照组男7例,女17例;年龄47~72(60.54±8.93)岁;病程1.5~9(5.27±1.68)年;身体质量指数(23.47±4.62)kg/m2;给予关节腔内注射透明质酸钠20 mg,膝周痛点封闭治疗,每点2 ml药液,1次/周,共治疗3次。记录并比较两组患者治疗前、治疗后1个月及6个月VAS评分和Lysholm评分以进行疗效评估。

结果:48例患者均获6个月随访,未发生严重不良反应或并发症。观察组与对照组治疗前、治疗后1和6个月VAS评分分别为7.35±1.47,4.15±1.52,2.26±1.02和7.51±1.39,3.84±1.76,3.66±1.18;治疗后6个月,观察组VAS评分低于对照组(P<0.05)。观察组与对照组治疗前、治疗后1和6个月Lysholm评分分别为55.21±5.78,79.16±7.25,85.45±6.87和54.65±6.40,77.58±6.94,82.34±7.12;两组治疗后总分均较治疗前明显改善(P<0.05);治疗后1个月,两组总分比较差异无统计学意义(P>0.05);治疗后6个月,观察组总分优于对照组(P<0.05)。

结论:关节腔内及膝周痛点注射富血小板血浆疗法可有效缓解膝关节疼痛,改善膝关节功能,同时安全性较高,虽短期疗效与传统治疗方法无明显差别,但中远期疗效稳定,是一种安全有效治疗膝关节骨性关节炎的方法。
[关键词]:骨关节炎,膝  富血小板血浆  注射,关节内
 
Platelet-rich plasma intra-articular and extra-articular injection for the treatment of knee osteoarthritis
Abstract:

Objective: To observe clinical effects of platelet-rich plasma (PRP) intra-articular and extra-articular injection for patients with knee osteoarthritis(KOA),and analyze its safety and clinical efficacy.

Methods: From January to December 2017,48 patients with KOA were randomly divided into observation group and control group,24 cases in each group. The observation group was treated with intra-articular injection of PRP(2 ml) and extra-articular injection of PRP(2 ml),once a week,for three times,including 8 males and 16 females with an average of(58.04±7.87) years old ranging from 43 to 68 years old,the courses of disease ranged from 1 to 8 years with an average of(4.69±1.96) years,the body mass index(BMI) was (24.53±5.26) kg/m2. The control group was treated with intra-articular injection of sodium hyaluronate (20 mg),extra-articular injection of analgesic drug(2 ml for one point),once a week,for three times,including 7 males and 17 females with an average of (60.54±8.93) years old ranging from 47 to 72 years old,the courses of disease ranged from 1.5 to 9 years with an average of (5.27±1.68) years,BMI was(23.47±4.62) kg/m2. VAS score and Lysholm score before operation and the 1st,6th month after treatment were compared between two groups.

Results: All patients were followed up at least 6 months without occurrence serious adverse reactions or complications. VAS score in observation group and control group before treatment and 1st,6th month after treatment were 7.35±1.47,4.15±1.52,2.26±1.02 and 7.51±1.39,3.84±1.76,3.66±1.18,respectively;VAS score in obsevation group was lower than that of control group at 6 months after treatment. Lysholm score in observation group and control group before treatment and 1st,6th month after treatment were 55.21±5.78,79.16±7.25,85.45±6.87 and 54.65±6.40,77.58±6.94,82.34±7.12. There were significant differences in Lysholm score before and after injection between two groups(P<0.05). There was no significant difference in Lysholm score between two groups at 1 month after treatment(P>0.05),while Lysholm score in observation group was better than that of control group at 6 months after treatment(P<0.05).

Conclusion: Intra-articular and extra-articular injection of PRP could relieve pain symptoms and improve function of knee joint with higher safety,although the short-term effect is not significantly different from traditional treatment,its medium-long-term effect is stable. It is a safe and effective method for the treatment of knee osteoarthritis.
KEYWORDS:Osteoarthritis,knee  Platelet-rich plasma  Injections,intra-articular
 
引用本文,请按以下格式著录参考文献:
中文格式:杜薇,崔洪鹏,付本升,李雯,刘倩,钟毓贤,董妍含.关节腔内及膝周痛点注射富血小板血浆治疗膝关节骨性关节炎[J].中国骨伤,2020,33(3):209~213
英文格式:DU Wei,CUI Hong-peng,FU Ben-sheng,LI Wen,LIU Qian,ZHONG Yu-xian,DONG Yan-han.Platelet-rich plasma intra-articular and extra-articular injection for the treatment of knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(3):209~213
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