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作 者:许育兵 刘广亚 陈旭琼 朱展鸿 周谋 张卫 单桂秋 XU Yubing;LIU Guangya;CHEN Xuqiong;ZHU Zhanhong;ZHOU Mou;ZHANG Wei;SHAN Guiqiu(Department of Blood Transfusion,General Hospital of Southern Theater Command,Guangzhou 510010,China.;Orthopedics Department,General Hospital of Southern Theater Command,Guangzhou 510010,China.)
机构地区:[1]南部战区总医院输血科,广东广州510010 [2]南部战区总医院骨科,广东广州510010
出 处:《中国输血杂志》2022年第3期254-257,共4页Chinese Journal of Blood Transfusion
基 金:广东省医学科学技术研究基金(A2020217);广州市科技计划项目(202102080531);全军后勤科研面上项目(CLB18J038)。
摘 要:目的观察长骨干骨折患者术中及术后使用自体富血小板血浆(PRP)治疗骨不连的临床疗效。方法选取2019年1月-2020年6月本院创伤骨科收治的长骨干骨折后骨不连患者34名,随机均分为实验组:在自体髂骨移植联合术中及术后使用自体PRP治疗[在术中将激活的自体PRP与患者自体髂骨充分融合后一道移植给患者,术后借助超声引导,精准定位,每隔7 d继续注射自体PRP 5 mL/(人)次(共4次)];对照组:单以自体髂骨移植联合术治疗。随访观察并比较2组患者骨折临床愈合时间,不同时间点骨痂形成评分及患侧肢体功能恢复等级。结果2组患者全部完成随访;实验组与对照组比较,临床骨折愈合时间(个月)为5.03±1.24vs6.91±1.41(P<0.05);6及9个月的骨折愈合率为94%(16/17)vs59%(10/17)、82%(14/17)(P<0.05);3、6及9个月的骨痂评分2.11±0.69vs1.53±0.80,3.06±0.90vs2.59±0.87,3.82±0.73vs3.35±0.86(均为P<0.05);患侧肢体功能恢复评级“优”“良”比例为82.35(14/17)%vs76.47%(13/17)(P<0.05)。结论术中及术后使用自体PRP治疗长骨干骨折后骨不连具有较好的疗效.Objective To explore the clinical effects of autologous platelet-rich plasma(PRP)in the treatment of postoperative bone nonunion for long bone shaft fractures during operation and after operation.Methods A total of 34 patients with postoperative bone nonunion for long bone shaft fracture,who were admitted and cured in the Orthopedics Department of our hospital from January 2019 to June 2020,were selected.They were randomly divided into the experimental group(n=17)and control group(n=17).Individuals in the control were treated with autologous iliac bone alone.,while the experimental group were treated with autologous iliac bone graft plus autologous PRP during and after operation.After surgery,the autogenous PRP was accurately injected with ultrasound guidance every 7 days(5 mL/person,4 occasions in total).The clinical healing time of the fracture,the grading of callus formation and the functional rehabilitation level of limbs on the affected side at different time were observed in both groups.Results All 34 patients were followed up.In the experimental group and the control group,the clinical healing time(month)of the fracture was(5.03±1.24)vs(6.91±1.41),P<0.05.The healing rate of the fracture for 6 months and 9 months was 94%(16/17)vs59%(10/17)and 94%(16/17)vs82%(14/17),respectively(P<0.05).The grading of callus formation within 3,6 and 9 months was(2.11±0.69)vs(1.53±0.80),(3.06±0.90)vs(2.59±0.87)and(3.82±0.73)vs(3.35±0.86),respectively(P<0.05).The acceptance rate of functional rehabilitation of limbs on the affected side was 82.35%(14/17)vs76.47%(13/17),P<0.05.Conclusion The application of autologous PRP in the treatment of postoperative bone nonunion for long bone shaft fractures during operation and after operation can achieve good clinical treatment.
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