超声引导腰椎小关节腔内注射自体富血小板血浆用于腰椎小关节综合征治疗临床研究  

Clinical study of ultrasound-guided intra-articular injection of autologous platelet rich plasma for the treatment of lumbar facet joint syndrome

作　　者：文传兵 林涛 刘柳 代月娥 杜宇 吴莹 江平 李祥奎 Wen Chuanbing;Lin Tao;Liu Liu;Dai Yuee;Du Yu;Wu Ying;Jiang Ping;Li Xiangkui(Department of Pain Medicine,Sichuan Academy of Medical Sciences,Sichuan Province People's Hospital,Chengdu 610072,China)

机构地区：[1]四川省医学科学院,四川省人民医院疼痛科,成都610072

出　　处：《国际麻醉学与复苏杂志》2019年第9期824-828,共5页International Journal of Anesthesiology and Resuscitation

基　　金：四川省卫生健康委员会课题基金(140090)。

摘　　要：目的观察超声引导腰椎小关节腔内注射自体富血小板血浆(platelet rich plasma,PRP)的临床疗效.方法选择符合纳入标准的腰椎小关节综合征所致腰痛患者40例,按随机数字表法分为腰椎小关节腔内注射自体PRP组(P组)和注射糖皮质激素与局部麻醉药组(S组),每组20例.观察患者治疗前及治疗后即刻、1周、1个月、3个月、6个月时的VAS评分、疼痛缓解率[(治疗前VAS评分-治疗后VAS评分)/治疗前VAS评分]、疼痛缓解率≥50%的患者例数,观察治疗后即刻到1周患者不良反应情况(如疼痛加重、局部或全身感染症状、神经损伤相关症状、出血情况、发热等).结果治疗后即刻、1周、1个月的VAS评分、疼痛缓解率、疼痛缓解率≥50%的患者例数比较,S组优于P组,差异有统计学意义(P<0.05).治疗后3个月及6个月的VAS评分、疼痛缓解率、疼痛缓解率≥50%的患者例数比较,P组优于S组,差异有统计学意义(P<0.05).两组患者治疗后即刻到1周均未出现疼痛加重、局部或全身感染症状、神经损伤相关症状、出血、发热等不良反应.结论超声引导腰椎小关节腔内注射自体PRP在治疗后即刻、1周和1个月的临床疗效没有注射糖皮质激素和局部麻醉药好,但注射后3个月及6个月的临床疗效优于注射糖皮质激素和局部麻醉药.Objective To investigate the clinical efficacy of ultrasound-guided intra-articular injection of autologous platelet rich plasma(PRP)for lumbar facet joint.Methods A total of 40 patients with back pain caused by lumbar facet joint syndrome were enrolled in this study according to the inclusion criteria.They were assigned into two groups(n=20)using the method of random number table to receive the treatment of intra-articular injection of autologous PRP(P group)and glucocorticoid combined with local anesthetic treatment(S group).The therapeutic effects at postoperative(immediately,1 week,1 month,3 months,6 months)were evaluated by using the Visual Analogue Scale(VAS)score,remission rate of pain[(VAS score before operation-VAS score after operation)/VAS score before operation]and the number of patients with pain relief rate(≥50%).In addition,the adverse reactions,such as aggravation of pain,symptoms of local or systemic infection,symptoms related to nerve injury,hemorrhage and fever from the immediately end after injection to one week after treatment of the two groups were also compared.Results The S group has lower VAS score,higher pain relief rate and more numbers of patients with pain relief rate≥50% than that of P group at postoperative(immediately,1 week,1 month)(P<0.05).However,the P group has lower VAS score,higher pain relief rate and more numbers of patients with pain relief rate≥50% than that of S group at 3 months and 6 months after operation(P<0.05).Both groups didn't show the adverse reactions immediately and 1 week after operation.Conclusions The clinical efficacy of ultrasound-guided intra-articular injection of autologous PRP for lumbar facet joint is not better than glucocorticoid combined with local anesthetic injection at the time of end of operation,1 week and 1 month after the treatment,but is better than the effect at the time points of 3 months and 6 months after the treatment.

关 键 词：腰椎小关节综合征 富血小板血浆 糖皮质激素 

分 类 号：R68[医药卫生—骨科学]