富血小板血浆裂解液联合接骨丸治疗胫腓不连接  

Platelet rich plasma lysate and Jiegu pill for tibiofibular fracture nonunion

作　　者：张中禹 于丽 林治建 姜泽威 周纪平 姜红江 ZHANG Zhong-yu;YU Li;LIN Zhi-jian;JIANG Ze-wei;ZHOU Ji-ping;JIANG Hong-jiang(Wendeng Orthopedic Hospital of Shandong Province,Weihai 264400,China)

机构地区：[1]山东省文登整骨医院,山东威海264400

出　　处：《中国矫形外科杂志》2023年第17期1625-1629,共5页Orthopedic Journal of China

基　　金：第三批威海市重点专科项目(创伤科)。

摘　　要：[目的]评价富血小板血浆裂解液联合接骨丸治疗胫腓不连接的临床疗效。[方法]2019年1月—2022年1月,对46例胫腓骨不连接患者局部注射治疗。依据医患沟通结果,23例采用富血小板血浆裂解液联合接骨药丸治疗(联合组),另外23例采用富血小板血浆裂解液治疗(单一组)。比较两组临床与影像资料。[结果]两组所有患者均顺利接受治疗,无严重不良反应。两组治疗顺应性VAS评分的差异无统计学意义(P>0.05)。至治疗后6个月,联合组23例(100%),单一组21例(91.3%)达到临床愈合,联合组临床愈合时间显著早于单一组[(3.2±0.5)个月vs(4.1±0.7)个月,P<0.001]。随时间推移,两组患者局部压痛VAS评分均显著下降(P<0.05);治疗后2个月,联合组局部压痛VAS评分显著低于单一组[(4.1±0.2)vs(5.1±0.2),P<0.001]。影像方面,随时间推移,两组影像评分均显著增加(P<0.05),治疗前两组间影像评分的差异无统计学意义(P>0.05),治疗后2个月,联合组影像学评分显著高于单一组[(2.5±0.4)vs(1.9±0.4),P<0.001]。[结论]富血小板血浆裂解液联合接骨丸治疗胫腓不连接,创伤小,疗效确切。[Objective]To evaluate the clinical outcomes of local injection of platelet rich plasma lysate combined oral Jiegu pill for tibiofibular fracture nonunion.[Methods]From January 2019 to January 2022,a total of 46 patients received local injection for tibiofibular fracture nonunion.According to doctor-patient communication,23 patients were treated with local injection of platelet-rich plasma lysate combined with oral Jiegu pills(the combined group),while other 23 patients underwent local injection of platelet-rich plasma lysate only(the mere group).The clinical and imaging data were compared between the two groups.[Results]All patients in both groups received treatment successfully without serious adverse reactions.There was no significant difference in VAS score for therapy compliance between the two groups(P>0.05).By 6 months after treatment,23 cases(100%)in the combined group,while 21 cases(91.3%)in the mere group achieved clinical healing,and the clinical healing time in the combined group was significantly earlier than that in the mere group[(3.2±0.5)months vs(4.1±0.7)months,P<0.001].The VAS scores of local tenderness in both groups decreased significantly over time(P<0.05),and the combined group had significantly lower local tenderness VAS score than the mere group 2 month after treatment[(4.1±0.2)vs(5.1±0.2),P<0.001].Radiographically,the image scores increased significantly over time in both groups(P<0.05).Although there was no significant difference in image scores between the two groups before treatment(P>0.05),the combined group proved significantly superior to the mere group 2 months after treatment[(2.5±0.4)vs(1.9±0.4),P<0.001].[Conclusion]The local injection and platelet-rich plasma lysate combined with oral Jiegu pill is a less traumatic and effective therapy for tibiofibular fracture nonunion.

关 键 词：胫腓骨折 骨不连接 富血小板血浆裂解液 局部注射 接骨药丸 

分 类 号：R681.57[医药卫生—骨科学]