微创手术联合关节腔内注射富血小板血浆治疗膝关节骨性关节炎疗效观察  

Effect of minimally invasive surgery combined with intra-articular injection of platelet rich plasma on knee osteoarthritis

作　　者：刘义[1] 徐丽丽[2] 党红胜[1] 吴五洲[1] 程建明[3] LIU Yi;XU Lili;DANG Hongsheng;WU Wuzhou;CHENG Jianming(Department of Orthopedics,Taihe Hospital of Shiyan,Shiyan 442000,China)

机构地区：[1]十堰市太和医院骨科,湖北十堰442000 [2]十堰市太和医院神经内科,湖北十堰442000 [3]十堰市太和医院针灸科,湖北十堰442000

出　　处：《中华实用诊断与治疗杂志》2018年第9期890-892,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：湖北省教育厅科研项目(B20122406)

摘　　要：目的探讨膝关节骨性关节炎患者应用关节镜微创手术联合关节腔内注射富血小板血浆治疗的效果及安全性。方法膝关节骨性关节炎患者169例,随机分为微创组86例和联合组83例;微创组全身麻醉下行微创手术治疗,联合组微创手术后于关节腔内注射富血小板血浆。治疗后12个月评定2组疗效;分别于治疗前、治疗后1周及3、6、12个月应用视觉模拟评分(visual analogue scales,VAS)评估膝关节疼痛程度,应用Lysholm膝关节评分评估膝关节功能;记录2组并发症发生情况。结果联合组治疗有效率(94.0%)高于微创组(73.3%)(P<0.05);微创组治疗后1周及3、6、12个月VAS评分[(4.32±0.63)、(4.11±1.21)、(3.54±1.14)、(2.92±1.12)分]均低于治疗前[(4.81±0.44)分],膝关节Lysholm评分[(61.12±5.63)、(64.39±4.57)、(77.16±6.39)、(84.12±7.14)分]高于治疗前[(57.14±4.36)分](P<0.05);联合组治疗后1周及3、6、12个月VAS评分[(4.31±0.69)、(3.01±1.21)、(2.56±0.91)、(1.96±0.45)分]均低于治疗前[(4.75±0.51)分],膝关节Lysholm评分[(62.32±3.69)、(78.32±3.28)、(85.69±4.32)、(93.62±5.55)分]高于治疗前[(58.13±3.91)分](P<0.05);联合组治疗后3、6、12个月VAS评分低于微创组,膝关节Lysholm评分高于微创组(P<0.05);联合组并发症发生率(7.2%)与微创组(11.6%)比较差异无统计学意义(P>0.05)。结论膝关节骨性关节炎患者行微创手术联合关节腔内注射富血小板血浆治疗可明显减轻疼痛,改善膝关节功能,且安全性高。Objective To investigate the effect and safety of minimally invasive arthroscopic surgery combined with intra articular injection of platelet rich plasma on knee osteoarthritis （OA）. Methods Totally 169 patients with knee OA were divided into minimally invasive group （n = 86） receiving minimally invasive surgery under general anesthesia and combination group （n=83） receiving intra-articular injection of platelet rich plasma after minimally invasive surgery. The therapeutic effect was evaluated in both two groups in 12 months after treatment. The visual analogue scale （VAS） score and Lysholm score were analyzed to assess the degree of knee joint pain and knee joint function before treatment, in 1 week, in 3 months, 6 months and 12 months after treatment. The complications were recorded in two groups. Results The effective rate was significantly higher in combination group （94.0%） than that in minimally invasive group （73.3%） （P〈0.05）. The VAS scores （4. 32 ±0. 63, 4. 11± 1. 21, 3. 54 ± 1. 14, 2. 92 ±1. 12） were significantly lower and Lyshoimscores （61. 12±5.63, 64. 39±4. 57, 77. 16±6. 39, 84. 12±7. 14） were significantly higher in 1 week, 3 months, 6 months and 12 months after treatment than those before treatment （4.81±0.44, 57.14±4.36） in minimally invasivegroup （P〈0.05）. The VASscores （4. 31±0. 69, 3.01±1.21, 2.56±0.91, 1.96±0.45） were significantly lower and Lysholm scores （62.32±3. 69, 78. 32±3. 28, 85. 69±4. 32）, 93. 62±5. 55） were significantly higher in 1 week, 3 months, 6 months and 12 months after treatment than those before treatment （4.75±0.51, 58. 13±3.91） in combination group （P〈0.05）. The VAS scores were significantly lower and Lysholm scores were significantly higher in combination group than those in minimally invasive group in 3, 6 and 12 months after treatment （P〈0.05）. There was no significant difference in the incidence of complications between combination group （7. 2%） and minimally invasive gro

关 键 词：膝关节骨性关节炎 富血小板血浆 关节腔内注射 微创手术 

分 类 号：R687.4[医药卫生—骨科学]