本文選題：富血小板血漿 + 前交叉韌帶重建��； 參考：《中國修復重建外科雜志》2017年04期

【摘要】：目的探討自體富血小板血漿(platelet rich plasma,PRP)輔助前交叉韌帶(anterior cruciate ligament,ACL)重建治療的臨床療效。方法 2014年8月—2016年8月選擇符合標準的ACL斷裂需行韌帶重建手術患者42例,隨機分為PRP治療組(試驗組)及非PRP治療組(對照組),每組21例;因隨訪過程中6例失訪,故最終試驗組和對照組納入研究例數(shù)分別為17例和19例。兩組患者性別、年齡、體質量指數(shù)、側別、損傷原因、病程、Kellgren-Lawrence分級及術前疼痛視覺模擬評分(VAS)、Lysholm評分、國際膝關節(jié)文獻委員會(IKDC)評分等一般資料比較差異均無統(tǒng)計學意義(P0.05),具有可比性。試驗組采用自體PRP輔助ACL重建治療,對照組單純行常規(guī)ACL重建治療。術后采用VAS評分、Lysholm評分及IKDC評分評估膝關節(jié)疼痛及功能狀態(tài),并于術后12個月進行MRI及關節(jié)鏡二次探查。結果兩組患者均獲隨訪,隨訪時間3~12個月,平均9.83個月。術后3、12個月兩組VAS評分、Lysholm評分及IKDC評分均較術前顯著改善(P0.05),術后3個月試驗組各評分均優(yōu)于對照組(P0.05),術后12個月兩組比較差異均無統(tǒng)計學意義(P0.05)。隨訪期間兩組患者膝關節(jié)均未見顯著滲液、感染或過敏反應等并發(fā)癥。膝關節(jié)MRI復查示所有患者ACL移植物走行良好,位置佳;少數(shù)患者(試驗組3例、對照組4例)可見重建移植物呈混雜信號或腱-骨界面存在積液,提示移植物愈合程度欠佳。試驗組和對照組MRI評分分別為(3.53±1.13)分和(3.21±0.92)分,差異無統(tǒng)計學意義(t=0.936,P=0.356)。9例患者行關節(jié)鏡二次探查顯示,試驗組韌帶重塑評分優(yōu)于對照組(t=3.248,P=0.014),而兩組滑膜覆蓋評分及軟骨修復發(fā)生率比較差異無統(tǒng)計學意義(t=2.190,P=0.064;χ~2=0.090,P=0.764)。結論 PRP輔助膝關節(jié)ACL重建治療能夠緩解早期術后關節(jié)疼痛、改善關節(jié)功能,并能有效促進移植物韌帶重塑。
[Abstract]:Objective to investigate the clinical effect of autologous platelet rich plasma-assisted anterior cruciate ligamentum reconstruction (ACLR).Methods from August 2014 to August 2016, 42 patients with ACL rupture needed ligamentous reconstruction were randomly divided into PRP treatment group (experimental group) and non- treatment group (control group, 21 cases, each group, 21 cases).So the final trial group and control group included 17 cases and 19 cases respectively.Sex, age, body mass index, side type, cause of injury, course of disease and preoperative visual analogue score of pain and visual analogue score (VASA) and Lysholm score were analyzed in both groups.There was no significant difference in general data such as IKDC score between the International knee Joint Literature Committee and so on, which was comparable.The experimental group was treated with autologous PRP plus ACL reconstruction, while the control group was treated with conventional ACL reconstruction alone.The pain and function of knee joint were evaluated by VAS score, Lysholm score and IKDC score. MRI and arthroscopy were performed 12 months after operation.Results the two groups were followed up for 3 ~ 12 months with an average of 9.83 months.At 3 and 12 months after operation, the VAS scores and IKDC scores in the two groups were significantly improved compared with those before operation (P 0.05). At 3 months after operation, the scores in the trial group were better than those in the control group (P 0.05). There was no significant difference between the two groups at 12 months after operation (P 0.05).During the follow-up period, no significant effusion, infection or allergic reaction were found in the knee joint of the two groups.MRI examination of knee joint showed that the ACL graft was in good position in all patients and a few patients (3 in the experimental group and 4 in the control group) showed mixed signals or accumulated fluid in the tendin-bone interface, suggesting that the graft healing degree was not good.The MRI scores of the test group and the control group were 3.53 鹵1.13 and 3.21 鹵0.92, respectively. There was no significant difference between the two groups.The score of ligamentum remodeling in the experimental group was better than that in the control group. However, there was no significant difference in the score of synovial covering and the incidence of cartilage repair between the two groups, and there was no significant difference between the two groups in the score of synovial covering and the incidence of cartilage repair.Conclusion PRP combined with ACL reconstruction of knee joint can relieve early postoperative joint pain, improve joint function and promote remodeling of graft ligament.
【作者單位】： 吉林大學中日聯(lián)誼醫(yī)院骨科;
【基金】：吉林大學研究生創(chuàng)新基金資助項目(2016219)~~
【分類號】：R687.4

【相似文獻】

相關期刊論文 前10條

1 袁霆;張長青;李四波;郭尚春;曾炳芳;;富血小板血漿促進骨修復的理論研究與臨床實踐(英文)[J];中國臨床康復;2006年05期

2 陳健民;陳立安;黃炳生;黃炯鋒;楊遠良;黎應森;;自體富血小板血漿促進慢性難愈合傷口修復的研究進展[J];醫(yī)學理論與實踐;2010年08期

3 趙強;譚顯春;陳興愛;林達強;;自制富血小板血漿治療難治性創(chuàng)口的臨床觀察[J];華西醫(yī)學;2010年08期

4 倪明;王巖;肖逸鵬;于德剛;宋迪煜;石斌;;富血小板血漿促進牽拉成骨礦化過程的放射學評估[J];解放軍醫(yī)學雜志;2008年06期

5 于紹斌;王亞斌;董啟榕;;富血小板血漿及其在骨科領域的應用進展[J];中國修復重建外科雜志;2008年07期

6 余情;陳統(tǒng)一;;創(chuàng)傷后富血小板血漿治療研究進展[J];國際骨科學雜志;2008年04期

7 唐明杰;袁霆;歐陽躍平;張長青;;富血小板血漿促進慢性難愈合傷口修復的研究進展[J];臨床骨科雜志;2009年02期

8 馬金勇;蔡志軍;劉潤華;陰炳俠;;富血小板血漿關節(jié)腔內注射治療膝關節(jié)骨性關節(jié)炎57例療效觀察[J];河北中醫(yī);2014年08期

9 黃山東;費志軍;趙曉亮;謝寧靈;何s，

本文編號：1758958