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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 预览

Clinical efficacy comparison of platelet-rich plasma vs. traditional medicine intra-articular injection in treatment of early osteoarthritis of knee joint
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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。 Objective To compare the clinical efficacy of platelet-rich plasma(PRP) vs. traditionaldrugs(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 fromJanuary 2016 to June 2017 were included in this study, and randomly divided into PRP group and sodiumhyaluronate group by random number table. The PRP group was given PRP intra-articular injection, and sodiumhyaluronate group received sodium hyaluronate intra-articular injection. The Western Ontario and McMasterUniversities Arthritis Index(WOMAC) and visual analogue scale(VAS) scores were collected and comparedbetween the two groups before and 1, 3, 6 and 12 months after drug injections. Results Fifty-eight patients inPRP 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 significantlylower than those before treatment. The scores in PRP group showed a continuous downward trend, while those insodium hyaluronate group were lowest one month after treatment, and then increased. The WOMAC and VASscores between the two groups showed significant difference at 6th and 12 th 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(χ~2=15.467, P=0.001). During the long-term follow-up, at 12 th month after the treatment up to now, 10 patients in sodium hyaluronate group underwent kneesurgery, while only 1 patient in the PRP group underwent knee surgery. Conclusion There was no significantdifference in the short-term effect(1 and 3 months after treatment) of PRP vs. sodium hyaluronate injection inthe treatment of early knee osteoarthritis, but the long-term effect of PRP treatment was better than that ofsodium hyaluronate, and PRP could delay
作者 袁俊虎 陈扬 魏鲁青 陈显辉 蓝涛 苏萌 吴君豪 YUAN Jun-hu;CHEN Yang;WEI Lu-qing;CHEN Xian-hui;LAN Tao;SU Meng;WU Jun-hao(Shenzhen Second People's Hospital, Clinical Medicine College of Anhui Medical University, Shenzhen 518000, China;Department of Orthopaedics, Foshan First People 's Hospital, Foshan 528000, China;Shenzhen Second People's Hospital, Shenzhen 518000, China)
出处 《骨科》 CAS 2019年第1期25-30,共6页 Central China Medical Journal
关键词 膝骨关节炎 富含血小板血浆 透明质酸 Knee osteoarthritis Platelet-rich plasma Sodium hyaluronate
作者简介 通信作者:陈扬,E-mail:drchenyang@163.com
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