富血小板血浆联合Kessler缝合法在跟腱断裂患者中的应用  

Application of platelet-rich plasma combined with Kessler suture in patients with achilles tendon rupture

作　　者：屈增辉 喻元 郑坤 石磊 QU Zeng-hui;YU Yuan;ZHENG Kun;SHI Lei(The Third Department of Orthopedics,Ankang Central Hospital,Ankang 725000,Shaanxi,CHINA)

机构地区：[1]安康市中心医院骨三科,陕西安康725000

出　　处：《海南医学》2022年第24期3203-3206,共4页Hainan Medical Journal

摘　　要：目的 观察富血小板血浆(PRP)联合Kessler缝合法对跟腱断裂患者的修复效果,并探讨其对患者血管内皮生长因子(VEGF)、转化生长因子β_(1)(TGF-β_(1))的影响。方法 选取2018年5月至2021年4月安康市中心医院骨三科诊治的82例跟腱断裂患者为研究对象,依据随机数表法分为对照组和研究组,每组41例。对照组患者接受微创Kessler缝合法治疗,研究组患者在对照组治疗的基础上接受PRP治疗。随访1年后,比较两组患者的美国足踝骨科协会(AOFAS)踝-后足评分、临床疗效、跟腱愈合评级、并发症发生率及术前与术后3个月回院复查时的VEGF、TGF-β_(1)水平。结果 随访1年后,研究组患者的AOFAS疼痛、功能及总评分分别为(37.71±2.53)分、(46.16±3.40)分、(93.52±2.17)分,明显高于对照组的(31.96±2.76)分、(42.09±3.33)分、(84.02±2.51)分,差异均有统计学意义(P<0.05);研究组患者的治疗总有效率为94.74%,明显高于对照组的72.97%,差异有统计学意义(P<0.05);研究组患者的跟腱愈合优良率为100.00%,明显高于对照组的83.78%,差异有统计学意义(P<0.05);研究组患者的并发症发生率为7.89%,略低于对照组的18.92%,但差异无统计学意义(P>0.05);术前,两组患者的VEGF、TGF-β_(1)水平比较差异均无统计学意义(P>0.05);术后3个月,两组患者的VEGF、TGF-β_(1)水平均明显高于术前,且研究组患者的VEGF、TGF-β_(1)水平分别为(20.11±2.17) ng/L、(437.83±36.29)μg/L,明显高于对照组的(16.25±1.79) ng/L、(389.15±37.40)μg/L,差异均有统计学意义(P<0.05)。结论 PRP联合Kessler缝合法应用于跟腱断裂患者可显著改善临床疗效,提升VEGF、TGF-β_(1)水平,具有临床应用价值。Objective To observe the repair effect of platelet-rich plasma(PRP) combined with Kessler suture in patients with Achilles tendon rupture, and to explore its effect on vascular endothelial growth factor(VEGF) and transforming growth factor β_(1)(TGF-β_(1)). Methods A total of 82 patients with Achilles tendon rupture diagnosed and treated in the Third Department of Orthopedics, Ankang Central Hospital from May 2018 to April 2021 were selected as the research objects. According to the random number table method, they were divided into a control group and a study group, with 41 patients in each group. The patients in the control group received minimally invasive Kessler suture, and the patients in the study group received PRP treatment on the basis of the control group. After 1-year follow-up, the American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score, clinical efficacy, achilles tendon healing rating, complication rate, VEGF, and TGF-β_(1) levels before and 3 months after surgery were compared between the two groups. Results After 1 year of follow-up, the AOFAS pain, function, and total score in the study group were(37.71±2.53) points,(46.16±3.40) points, and(93.52±2.17) points, which were significantly higher than(31.96±2.76) points,(42.09±3.33) points,(84.02±2.51) points in the control group(P<0.05). The total effective rate in the study group was 94.74%, which was significantly higher than 72.97% in the control group(P<0.05). The excellent and good rate of Achilles tendon healing in the study group was 100.00%, which was significantly higher than 83.78% in the control group(P<0.05). The incidence of complications in the study group was 7.89%, slightly lower than 18.92% in the control group(P>0.05). Before surgery, the levels of VEGF and TGF-β_(1) showed no statistically significant difference between the two groups(P>0.05). At 3 months after operation, VEGF, TGF-β_(1) levels were significantly higher than those before operation, and the levels in the study group were(20.11±2.17) ng/L

关 键 词：KESSLER缝合法 富血小板血浆 跟腱断裂 修复效果 血管内皮生长因子 转化生长因子Β1 

分 类 号：R622.2[医药卫生—整形外科]