自体富血小板血浆局部注射治疗肱骨外上髁炎  

Local injection of autologous platelet-rich plasma for the treatment of lateral epicondylitis

作　　者：虞陆超 商培洋 程晏[1] 庄伟康 周军杰[1] 纪斌[1] 仇建军 YU Luchao;SHANG Peiyang;CHEN Yan;ZUANG Weikang;ZHOU Junjie;JI Bin;QIU Jianjun(Department of Orthopaedics,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200333,China)

机构地区：[1]上海中医药大学附属普陀医院骨科,200062

出　　处：《国际骨科学杂志》2018年第5期321-325,共5页International Journal of Orthopaedics

摘　　要：目的探究自体富血小板血浆(PRP)局部注射治疗肱骨外上髁炎的临床疗效。方法选取2015年1月至2016年6月上海中医药大学附属普陀医院骨科就诊的肱骨外上髁炎患者120例纳入研究。研究对象分为3组:PRP组、自体全血(AWB)组和激素组,分别予局部注射自体PRP、AWB和甲基强的松龙。于治疗前,治疗后1、3、6和12个月分别对研究对象以视觉模拟评分(VAS)和Mayo肘关节功能评分(MEPS)评估其疼痛和肘关节功能。结果 3组患者治疗后12个月与治疗前比较,PRP组和AWB组VAS均降低(P<0.05),而激素组无差异(P>0.05);3组患者治疗前VAS无差异(P>0.05),治疗后VAS存在差异(P<0.05);治疗后12个月时,PRP组和AWB组间VAS存在差异(P<0.05)。3组患者治疗后12个月时与治疗前比较,MEPS均升高(P<0.05);3组患者治疗前MEPS无差异(P>0.05),治疗后1、6、12个月时MEPS存在差异(P<0.05);治疗后6、12个月时,PRP组和AWB组间MEPS均存在差异(P<0.05)。与治疗前相比,治疗后12个月时PRP组和AWB组在MEPS 4项指标——疼痛、活动度、稳定性和日常能力方面均改善(P<0.05);PRP组与AWB组在治疗后6个月时MEPS的疼痛评分有差异(P<0.05)。结论自体PRP局部注射治疗肱骨外上髁炎能较好地缓解疼痛症状,改善肘关节功能。Objective To investigate the efficacy of local injection of autologous platelet-rich plasma （PRP） for treatment of lateral epicondylitis.Methods From January 2015 to June 2016, 120 patients with lateral epicondylitis were divided into three groups. Patients in the PRP group were treated with local injection of autologous PRP; patients in the autologous whole blood （AWB） group were treated with local injection of AWB; patients in the glucocorticoid group were treated with local injection of methylprednisolone. Visual analogue scale （VAS） and Mayo elbow performance（MEP） scores were used to evaluate clinical status for each patient before treatment, and at 1, 3, 6 and 12 months after treatment.Results VAS scores were decreased in both the PRP group and AWB group at 12 months after treatment （ P 〈 0.05） , but no difference was found in glucocorticoid group, compared with the pre-treatment level （ P 〉 0.05）. There was no difference in terms of VAS scores among the 3 groups before treatment （ P 〉 0.05）, but significant difference was observed after treatment （ P 〈 0.05）. At 12 months after treatment, VAS scores were significantly different between the PRP group and AWB group （ P 〈 0.05）. In all the 3 groups, the MEP scores increased at 12 month after treatment （ P 〈 0.05）. Despite with no difference among the 3 groups before treatment （ P 〉 0.05）, significant difference in the MEP scores were noted among the 3 groups at 1, 6 and 12 month after treatment （ P 〈 0.05）. At 6 and 12 month after treatment, MEP scores were significantly different between the PRP group and AWB group （ P 〈 0.05）. Pain, activity, stability and ability were all improved in the PRP group and AWB group at 1 year after treatment （all P 〈 0.05）. Pain scores were significantly different between the PRP group and the AWB group at 6 month after treatment （ P 〈 0.05）.Conclusion Local injection of PRP treatment for lateral epicondylitis is beneficial in pain relief and elbow

关 键 词：肱骨外上髁炎 网球肘 富血小板血浆 

分 类 号：R686[医药卫生—骨科学]