超声引导下注射富血小板血浆治疗中度膝骨关节炎的临床疗效观察  

Clinical efficacy of ultrasound-guided platelet-rich plasma injection for moderate knee osteoarthritis

作　　者：柳曦[1] 钱林学[1] 胡向东[1] 孙鹏飞 李小飞 LIU Xi;QIAN Lin-xue;HU Xiang-dong(Department of Ultrasound,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院超声科,北京100050 [2]首都医科大学附属北京友谊医院输血科,北京100050

出　　处：《临床和实验医学杂志》2023年第5期539-543,共5页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金资助项目(编号:7222035)。

摘　　要：目的探讨超声引导下膝关节腔内注射富血小板血浆(PRP)治疗中度膝骨关节炎的临床疗效。方法采用前瞻性研究方法,选取2021年1至10月在首都医科大学附属北京友谊医院收治的单侧中度膝骨关节炎患者70例,按照随机数字表法将患者分为治疗组和对照组,每组35例。治疗组在超声引导下每周向膝关节腔内注射PRP 1 mL,一共注射4次;对照组患者在超声引导下每周向膝关节腔内注射透明质酸钠2 mL,一共注射4次。所有患者均门诊随访24周,记录治疗前、治疗后4周和末次随访时患者的视觉模拟疼痛评分(VAS)、西安大略麦克马斯特大学骨关节炎指数(WOMAC)和6 min步行距离,并比较两种治疗方法的临床疗效。结果治疗组32例患者得到完整随访,而对照组33例患者得到完整随访。治疗后4周和末次随访,两组患者VAS评分较治疗前降低,且治疗组VAS评分为(4.5±0.6)、(3.3±0.5)分,均低于对照组[(6.2±0.5)、(6.0±0.5)分],差异均有统计学意义(P<0.05)。治疗后4周和末次随访,两组患者WOMAC低于治疗前,6 min行走距离高于治疗前,且治疗组WOMAC为(31.8±5.4)、(26.8±4.1)分,明显低于对照组[(40.5±7.2)、(26.8±4.1)分],6 min行走距离为(492.7±21.9)、(501.8±23.1)m,高于对照组[(375.3±20.6)、(501.8±23.1)m],差异均有统计学意义(P<0.05)。治疗组的治疗总有效率为93.8%,明显高于对照组(63.6%),差异有统计学意义(P<0.05)。结论超声引导下膝关节腔注射PRP能够减轻膝关节疼痛,并且提高膝关节功能,是中度膝骨关节炎有效的非手术治疗方法。Objective To investigate the efficacy of ultrasound-guided platelet-rich plasmainjectionin(PRP)knee articular cavity for treating moderate knee osteoarthritis.Methods A prospective study was performed from January 2021to October 2021.In Beijing Friendship Hospital,Capital Medical University,seventy patients who suffered moderate knee osteoarthritis were enrolled and divided into two groups equally according to the method of random number table:treatment group and control group,35 cases in each group.The patients in treatment group were treated by 1 mL PRP injection in knee articular cavityevery week,a total of four times.While the patients in control group were treated by 2 mL sodium hyaluronate injection in knee articular cavity every week,a total of four times.All the patients were outpatient followed for 24 weeks.Visual analogue scale(VAS),The Western Ontario and McMaster UniversitiesOsteoarthritis Index(WOMAC)and 6-minute walk distance before treatment,at 4 weeks after treatment and final followed-up of all patients were recorded and compared.Results At the fourth week and the last follow-up after treatment,the VAS scores of the two groups were lower than those before treatment,and the VAS scores of the treatment group were(4.5±0.6)and(3.3±0.5)points,which were lower than those of the control group[(6.2±0.5)and(6.0±0.5)points],the differences were statistically significant(P<0.05).Four weeks after treatment and the last follow-up,the WOMAC of patients in the two groups were lower than those before treatment,and the 6-minute walking distance were higher than those before treatment,and the WOMAC in the treatment group were(31.8±5.4),(26.8±4.1)points,which were lsignificantly lower than those in the control group[(40.5±7.2),(26.8±4.1)points],and the 6-minute walking distance were(492.7±21.9),(501.8±23.1)m,which were lhigher than those in the control group[(375.3±20.6),(501.8±23.1)m],the differences were statistically significant(P<0.05).The total effective rate of treatment in ultrasound-guided plate

关 键 词：膝骨关节炎 超声引导 膝关节腔内注射 富血小板血浆 疼痛 膝关节功能 

分 类 号：R684.3[医药卫生—骨科学]