摘要
目的比较超声引导下关节腔注射自体富白细胞血小板血浆(PRP)与透明质酸钠(HA)治疗膝骨关节炎(KOA)临床疗效。方法收集2020年2月1日至2022年2月1日在福建医科大学附属第一医院疼痛科门诊收治的56例K-L分级Ⅰ~Ⅲ级KOA患者。其中, PRP组30例, 采用超声引导关节腔内注射PRP治疗;HA组26例, 采用超声引导关节腔内注射HA治疗。两组患者每次注射3.5 ml PRP或HA, 间隔2周, 一共注射3次, 于治疗后1、3、6个月采用疼痛视觉模拟评分(VAS)及Lysholm膝关节评分量表对患者的临床疗效进行评价。结果两组患者在治疗过程中均未见严重并发症, 治疗后1、3、6个月时, VAS评分均较治疗前改善, 差异有统计学意义(P均<0.05), 治疗后1、3个月时, 两组间VAS评分差异无统计学意义(P均>0.05)。治疗后6个月时, PRP组的VAS评分及Lysholm膝关节评分量表总分均优于HA组[(2.3±1.2)比(3.2±1.4), (75.8±9.8)比(59.0±7.6), P均<0.05]。治疗后6个月时, PRP组优效率、总有效率均较HA组高[33.3%(10/30例)比7.7%(2/26例), χ^(2)=5.44, P=0.020;90.0%(27/30例)比38.5%(10/26例), χ^(2)=16.50, P<0.001]。结论超声引导PRP注射治疗KOA患者具有确切的临床疗效, 持久性方面优于HA注射。
Objective To compare the clinical efficacy of ultrasound-guided intra-articular injection of autologous leukocyte and platelet-rich plasma(PRP)or sodium hyaluronate(HA)in the treatment of knee osteoarthritis(KOA).Methods From February 1,2020 to February 1,2022,56 patients with Keligren Lawrence gradeⅠ-ⅢKOA were collected in the Department of Painology of the First Affiliated Hospital of Fujian Medical University.With ultrasound-guided,30 patients received 3.5 ml PRP intra-articular injection in PRP group,and 26 patients received 3.5 ml HA intra-articular injection in HA group,every 2 weeks for a total of 3 times.Visual analogue score(VAS)and Lysholm knee joint score were evaluated at 1 month,3 months and 6 months after the treatment.Results No serious complications were found in the two groups during the treatment.At 1 month,3 months and 6 months after the treatment,VAS was improved(all P<0.05).VAS had no significant difference in the two groups at 1 month and 3 months after the treatment.But at 6 months after the treatment,VAS and the total score of Lysholm knee joint in the PRP group were significantly better than those in the HA group[(2.3±1.2)vs.(3.2±1.4),(75.8±9.8)vs.(59.0±7.6),all P<0.05].At 6 months after treatment,the efficiency rate and total effective rate in PRP group were higher than those in HA group[33.3%(10/30 cases)vs.7.7%(2/26 cases),χ^(2)=5.44,P=0.020;90.0%(27/30 cases)vs.38.5%(10/26 cases),χ^(2)=16.50,P<0.001].Conclusion Ultrasound-guided PRP injection has a positive clinical effect in the treatment of KOA,and is better than HA injection in the long term effects.
作者
何龙
江昊
林鹏
陈嘉芳
林章雅
He Long;Jiang Hao;Lin Peng;Chen Jiafang;Lin Zhangya(Department of Painology,The First Affiliated Hospital of Fujian Medical University,National Regional Medical Center,Binhai Campus of the First Affiliated Hospital,Fujian Medical University,Fuzhou City,Fujian Province 350000,China)
出处
《中华疼痛学杂志》
2023年第5期752-757,共6页
Chinese Journal Of Painology
