骨髓干细胞富血小板血浆增强镜下肩袖修复  

Arthroscopic rotator cuff repair augmented with bone marrow stem cell and platelet-rich plasma

作　　者：刘景云 石辉[1] 刘涛[1] 蔺超[1] 任强[1] LIU Jing-yun;SHI Hui;LIU Tao;LIN Chao;REN Qiang(Department of Orthopedic Surgery,Affiliated Hospital,Binzhou Medical University,Binzhou 256600,China)

机构地区：[1]滨州医学院附属医院骨关节外科,山东滨州256600

出　　处：《中国矫形外科杂志》2023年第10期881-886,共6页Orthopedic Journal of China

基　　金：山东省医药卫生科技发展计划项目(编号:2017WS040);滨州医学院徐荣祥再生医学发展计划项目(编号:BY2019XRX04);2020年产学合作协同育人项目(编号:202002204024)。

摘　　要：[目的]评估骨髓间质细胞(bone marrow mesenchymal stem cells,BMSCs)联合富血小板血浆(platelet-rich plasma,PRP)治疗肩袖损伤的临床疗效。[方法]回顾性分析2019年7月—2021年10月行关节镜下肩袖修复术160例患者的临床资料。其中,缝合组80例仅给予镜下肩袖修复术,联合组80例予以镜下肩袖修复联合局部BMSCs与PRP注射。比较两组围手术期、随访和影像资料。[结果]两组患者均顺利完成手术,围手术期无并发症。两组手术时间、切口总长度、术中失血量、主动活动时间、切口愈合等级和住院时间的差异均无统计学意义(P>0.05)。随时间推移两组早期VAS评分均显著降低(P<0.05)。随访时间平均(13.6±0.8)个月。与术前相比,术后3个月两组前屈上举、外展上举与体侧外旋ROM均显著减少(P<0.05),而UCLA评分显著增加(P<0.05),末次随访时,上述指标较术前均显著增加(P<0.05)。相应时间点,两组间上述指标的差异均无统计学意义(P>0.05)。影像方面,随时间推移,两组AHI和MRI评级较术前均显著改善(P<0.05)。术前和术后3个月两组AHI和MRI评级的差异均无统计学意义(P>0.05)。末次随访时,联合组AHI和MRI评级均显著优于缝合组(P<0.05)。末次随访时,缝合组再撕裂率32.5%(26/80),联合组再撕裂率15.0%(12/80)。[结论]BMSCs与PRP显著改善了肩袖损伤修复术后愈合,降低了再撕裂率。[Objective]To evaluate the clinical efficacy of bone marrow mesenchymal stem cells(BMSCs)combined with platelet-rich plasma(PRP)augmented arthroscopic rotator cuff repair.[Methods]A retrospective study was conducted on 160 patients who underwent arthroscopic rotator cuff repair for rotator cuff tear in our department from July 2019 to October 2021.Among them,80 patients in the suture group received arthroscopic rotator cuff repair only,while the remaining 80 patients in the combined group received arthroscopic rota-tor cuff repair combined with local injection of BMSCs and PRP.The perioperative period,follow-up and imaging data were compared between the two groups.[Results]All patients in both groups had operation done successfully without serious complications.There were no significant differences in operation time,total incision length,intraoperative blood loss,postoperative active motion time,incision healing and hospital stay between the two groups(P>0.05),whereas the VAS scores in both groups were significantly decreased over time in the early stage after operation(P<0.05).All of them were followed up for(13.6±0.8)months on an average.Compared with those preoperatively,the forward flexion,abduction and internal-external rotation range of motions(ROMs)significantly reduced in both groups 3 months after operation(P<0.05),while the UCLA score was significantly increased(P<0.05),whereas which all significantly increased at the last followup(P<0.05).However,there was no significant difference in the above items between the two groups at any corresponding time points(P>0.05).Radiographically,the acromiohumeral interval(AHI)and Sugaya MRI classification significantly improved postoperatively compared with those before surgery(P<0.05).Although there were no significant differences between the two groups before and 3 months after surgery(P>0.05),the combined group proved significantly superior to the suture group in AHI and MRI classification at the latest follow-up(P<0.05).At the last interview,the rate of rotator

关 键 词：肩袖损伤 关节镜肩袖修复术 骨髓干细胞 富血小板血浆 

分 类 号：R318[医药卫生—生物医学工程]