文章摘要
袁俊虎,陈扬,魏鲁青,陈显辉,蓝涛,苏萌,吴君豪.富含血小板血浆与常规药物关节腔注射治疗早期膝骨关节炎的临床疗效比较.骨科,2019,10(1):25-30
富含血小板血浆与常规药物关节腔注射治疗早期膝骨关节炎的临床疗效比较
Clinical efficacy comparison of platelet-rich plasma vs. traditional medicine intra-articular injection in treatment of early osteoarthritis of knee joint
投稿时间:2018-06-19  
DOI:10.3969/j.issn.1674-8573.2019.01.005
中文关键词: 膝骨关节炎  富含血小板血浆  透明质酸
英文关键词: Knee osteoarthritis  Platelet-rich plasma  Sodium hyaluronate
基金项目:
作者单位E-mail
袁俊虎 安徽医科大学深圳市第二人民医院临床学院骨科广东深圳 518000  
陈扬 佛山市第一人民医院(中山大学附属佛山医院)骨科广东佛山 528000 drchenyang@163.com 
魏鲁青 佛山市第一人民医院(中山大学附属佛山医院)骨科广东佛山 528000  
陈显辉 佛山市第一人民医院(中山大学附属佛山医院)骨科广东佛山 528000  
蓝涛 深圳市第二人民医院骨科广东深圳 518000  
苏萌 深圳市第二人民医院骨科广东深圳 518000  
吴君豪 安徽医科大学深圳市第二人民医院临床学院骨科广东深圳 518000  
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中文摘要:
      目的 比较富含血小板血浆(platelet-rich plasma, PRP)与常规药物关节腔注射治疗早期膝骨关节炎的临床疗效。方法 选择2016年1月至2017年6月深圳市第二人民医院收治的120例早期膝骨关节炎病人,采用随机数字表法分组,PRP组60例采用PRP关节腔注射治疗,常规药物组60例采用透明质酸钠为主的常规药物注射治疗。收集并比较两组病人治疗前及完成全部药物注射治疗后第1、3、6、12个月的西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities, WOMAC)骨关节炎指数及疼痛视觉模拟量表(visual analogue scale, VAS)评分。结果 PRP组58例、常规药物组56例病人完成注射治疗及完整随访。两组病人治疗后各观察时间点的WOMAC评分和VAS评分均较治疗前明显降低,其中PRP组的得分呈持续下降趋势,常规药物组治疗后1个月时的分值最低,而后有所回升。两组治疗后6、12个月时的WOMAC评分、VAS评分比较,差异均有统计学意义(P均<0.05)。PRP组、常规药物组治疗的总有效率分别为96.55%(56/58)、78.57%(44/56),差异有统计学意义(χ2=15.467,P=0.001)。在完成治疗12个月后至今的远期随访中,常规药物组共有10例病人行膝关节手术,PRP组仅1例病人行膝关节手术治疗。结论 关节腔注射PRP或透明质酸钠治疗早期膝骨关节炎,短期(治疗后第1、3个月)效果无明显差异;但采用PRP治疗的远期效果更优,更能延缓膝骨关节炎的进展。
英文摘要:
      Objective To compare the clinical efficacy of platelet-rich plasma (PRP) vs. traditional drugs (sodium hyaluronate) in the treatment of early knee osteoarthritis by intra-articular injection. Methods A total of 120 qualified patients with early knee osteoarthritis of Shenzhen Second People's Hospital from January 2016 to June 2017 were included in this study, and randomly divided into PRP group and sodium hyaluronate group by random number table. The PRP group was given PRP intra-articular injection, and sodium hyaluronate group received sodium hyaluronate intra-articular injection. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) and visual analogue scale (VAS) scores were collected and compared between the two groups before and 1, 3, 6 and 12 months after drug injections. Results Fifty-eight patients in PRP group and 56 patients in sodium hyaluronate group completed the injection treatment and the follow-up. The WOMAC and VAS scores in the two groups at each observation time point after treatment were significantly lower than those before treatment. The scores in PRP group showed a continuous downward trend, while those in sodium hyaluronate group were lowest one month after treatment, and then increased. The WOMAC and VAS scores between the two groups showed significant difference at 6th and 12th month after treatment (P<0.05). The total effective rates in PRP group and sodium hyaluronate group were 96.55% (56/58) and 78.57% (44/56) respectively, with the difference being statistically significant (χ2=15.467, P=0.001). During the long-term follow-up, at 12th month after the treatment up to now, 10 patients in sodium hyaluronate group underwent knee surgery, while only 1 patient in the PRP group underwent knee surgery. Conclusion There was no significant difference in the short-term effect (1 and 3 months after treatment) of PRP vs. sodium hyaluronate injection in the treatment of early knee osteoarthritis, but the long-term effect of PRP treatment was better than that of sodium hyaluronate, and PRP could delay the progress of knee osteoarthritis.
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