关节腔内注射富血小板血浆或玻璃酸钠联合体外冲击波治疗膝骨关节炎的疗效  

Efficacy of intra-articular injection of platelet-rich plasma or sodium hyaluronate combined with extracorporeal shock wave therapy in patients with knee osteoarthritis

作　　者：王继兵[1] 尹正录[1] 林舜艳[2] 孟兆祥[1] 黄吉军[3] WANG Jibing;YIN Zhenglu;LIN Shunyon(Department of Rebabiltation,Northern Jiangsu People's Hospial,Yangzhou 225002,CHINA)

机构地区：[1]江苏省苏北人民医院康复医学科,江苏扬州225002 [2]江苏省苏北人民医院麻醉科,江苏扬州225002 [3]江苏省苏北人民医院骨科,江苏扬州225002

出　　处：《江苏医药》2023年第2期134-137,共4页Jiangsu Medical Journal

基　　金：江苏省青年医学重点人才项目(QNRC2016320)。

摘　　要：目的比较关节腔内注射自体富血小板血浆(PRP)或玻璃酸钠联合体外冲击波(ESWT)治疗膝骨关节炎(KOA)的临床疗效。方法37例KOA患者随机分为玻璃酸钠组(19例)和PRP组(18例)。两组患者均给予常规康复训练、行为干预和ESWT治疗。玻璃酸钠组予膝关节腔内注射玻璃酸钠20 mg,每周1次,连续4周;PRP组予膝关节腔内注射自体PRP 5 mL,每2周1次,连续4周。治疗前(T1)、治疗结束时(T2)、治疗后3个月(T3)和6个月(T4)时分别采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评估两组膝关节功能,并记录不良事件发生情况。结果两组患者均顺利完成治疗,无明显不良事件发生。两组T1时WOMAC各评分比较均无统计学差异(P>0.05)。与T1时比较,两组T2~T4时WOMAC各评分均下降(P<0.01)。与玻璃酸钠组比较,PRP组T3、T4时WOMAC关节疼痛评分和T4时关节功能评分均下降(P<0.05)。结论关节腔内注射自体PRP或玻璃酸钠联合ESWT均能有效缓解KOA患者膝关节疼痛,改善膝关节功能,自体PRP的疗效更好。Objective To compare the efficacy of intra-articular injection of autologous platelet-rich plasma(PRP)or sodium hyaluronate combined with extracorporeal shock wave therapy(ESWT)in the patients with knee osteoarthritis(KOA).Methods Thirty-seven patients with KOA were randomly divided into two groups.On the basis of routine rehabilitation training,behavioral intervention and ESWT treatment,group SH(19 cases)was given intra-articular injection of sodium hyaluronate 20 mg into the knee joint,once a week for 4 weeks,and group PRP(18 cases)was given intra-articular injection of autologous PRP 5 mL into the knee joint,once every two weeks for 4 weeks.Western Ontario and McMaster Universities osteoarthritis index(WOMAC)was used to assess knee joint function before treatment(T1),at the end of treatment(T2),in 3 months(T3)and 6 months(T4)after treatment in two groups.Adverse events were recorded as well.Results The patients of both groups were successfully completed the treatment without obvious adverse events.There was no significant difference in WOMAC scores between the two groups at T1(P>0.05).Compared with T1,WOMAC scores were decreased at T2-T4 in the two groups(P<0.01).Compared with group SH,WOMAC joint pain score at T3 and T4,and joint function score at T4 were decreased in group PRP(P<0.05).Conclusion Both intra-articular injection of autologous PRP or sodium hyaluronate combined with ESWT can effectively alleviate knee pain and improve knee function in the patients with KOA,and the efficacy of PRP is better.

关 键 词：膝关节 骨性关节炎 富血小板血浆 玻璃酸钠 体外冲击波 

分 类 号：R684[医药卫生—骨科学]