富血小板血浆治疗急性跟腱损伤有效性与安全性的Meta分析  

Efficacy and safety of platelet-rich plasma for acute achilles tendon injury:a meta-analysis

作　　者：杜亚丽 付凯飞 王燕菊 张蓉 崔成文 蒋学兵 DU Yali;FU Kaifei;WANG Yanju;ZHANG Rong;CUI Chengwen;JIANG Xuebing(Department of Transfusion Medicine,The Sixth Medical Center of PLA General Hospital,Beijing 100048,China;Department of Rehabilitation,Senior Department of Orthopedics,The Fourth Medical Center of PLA General Hospital)

机构地区：[1]中国人民解放军总医院第六医学中心输血医学科,北京100048 [2]中国人民解放军总医院第四医学中心骨科医学部康复医学科

出　　处：《中国输血杂志》2024年第4期471-476,共6页Chinese Journal of Blood Transfusion

基　　金：军队卫勤科研项目(22QNFC126)。

摘　　要：目的 通过Meta分析评价富血小板血浆治疗急性跟腱损伤的临床疗效与安全性。方法 计算机检索万方数据库、中国知网、维普数据库、中国生物文献数据库、中国临床试验注册中心、PubMed、Embase、Cochrane、美国临床试验注册中心建库截止至2023年8月发表的有关富血小板血浆治疗急性跟腱损伤的临床随机对照试验的文献。富血小板血浆治疗组在常规急性跟腱损伤治疗基础上加用富血小板血浆;对照组采用急性跟腱损伤常规治疗。Meta分析主要评价指标为疼痛视觉模拟评分;次要结局指标为患者跟腱断裂评分、脚跟最大上升高度、小腿围、踝关节活动范围。使用Cochrane手册评估文献的质量;使用RevMan 5.3软件对符合质量标准的文献进行Meta分析。结果 最终纳入7篇文献,共包括421例急性跟腱损伤患者,其中,富血小板血浆治疗组212例,对照组209例。Meta分析结果显示:富血小板血浆组较对照组疼痛视觉模拟评分(SMD=-0.44,95%CI:-0.94~0.06,P>0.05),小腿围(MD=1.14,95%CI:-1.56~3.84,P>0.05),踝关节趾屈活动范围(SMD=1.85,95%CI:-1.38~5.09,P>0.05),踝关节背屈活动范围(SMD=2.61,95%CI:-0.95~6.17,P>0.05),跟腱断裂评分(MD=-5.60,95%CI:-15.36~4.16,P>0.05)与脚跟最大上升高度(MD=-2.48,95%CI:-5.30~0.33,P>0.05)2组间所有评分系统结局无差异,且2组间不良反应发生无差异(χ^(2)=2.455,P>0.05)。结论 PRP注射治疗急性跟腱断裂并不能改善患者的生物力学和临床结局,使用富血小板血浆治疗没有增加不良反应发生。Objective To evaluate the clinical efficacy and safety of platelet-rich plasma(PRP)in acute achilles tendon injury by meta-analysis.Methods Literature on clinical randomized controlled trial of PRP in the treatment of acute achilles tendon injury from Wanfang database,CNKI,VIP database,The Chinese Biological Literature Database,The Chinese Clinical Trials Registry,PubMed,Embase,Cochrane and The US Clinical Trials Registry as of August 2023 were retrieved.The control group received conventional treatment for acute achilles tendon injury,while PRP treatment group received additional PRP treatment.The primary outcome measure was visual analogue pain scale,and the secondary outcome measures were the achilles tendon fracture score,maximum heel rise height,calf circumference and ankle range of motion.The quality of the literature was assessed using the Cochrane manual,and a meta-analysis of qualified literature was performed using RevMan 5.3 software.Results Seven articles were finally included,involving 421 patients with acute achilles tendon injury,including 212 patients in the PRP treatment group,and 209 patients in the conventional treatment group.The results of meta-analysis showed that there was no difference between the conventional treatment group and the PRP treatment group in terms of the visual analogue pain scale(SMD=-0.44,95%CI:-0.94~0.06,P>0.05),calf circumference(MD=1.14,95%CI:-1.56-3.84,P>0.05),ankle joint toe flexion range of motion(SMD=1.85,95%CI:-1.38-5.09,P>0.05),ankle dorsiflexion range of motion(SMD=2.61,95%CI:-0.95-6.17,P>0.05),achilles tendon fracture score(MD=-5.60,95%CI:-15.36-4.16,P>0.05)and the maximum heel rise height(MD=-2.48,95%CI:-5.30-0.33,P>0.05).And there was no difference in the incidence of adverse reactions between the two groups(X 2=2.455,P>0.05).Conclusion PRP injection for acute achilles tendon injury does not improve the biomechanical and clinical outcomes of patients,and the use of PRP does not increase the occurrence of adverse reactions.

关 键 词：急性跟腱损伤 富血小板血浆 META分析 

分 类 号：R457.1[医药卫生—治疗学] R331.143[医药卫生—临床医学]