辅助钢板联合自体单采富血小板血浆治疗长骨骨折髓内固定后骨不连的临床效果  

Clinical observation of auxiliary steel plate combined with autologous platelet rich plasma for the treatment of bone nonunion after intramedullary fixation of long bone fractures

作　　者：周振宇 张贵春 武文 黄象艳 ZHOU Zhenyu;ZHANG Guichun;WU Wen;HUANG Xiangyan(Department of Orthopedics,The 960th Hospital of the PLA Jonit Logistics Support Force,Jinan 250031,China;Department of Blood Transfusion,The 960th Hospital of the PLA Jonit Logistics Support Force,Jinan 250031,China)

机构地区：[1]中国人民解放军联勤保障部队第九六〇医院骨科,山东济南250031 [2]中国人民解放军联勤保障部队第九六〇医院输血医学科,山东济南250031

出　　处：《中国输血杂志》2024年第5期556-560,共5页Chinese Journal of Blood Transfusion

基　　金：济南市临床医学科技创新计划(202225066)。

摘　　要：目的分析辅助钢板联合自体单采富血小板血浆(platelet-rich plasma,PRP)移植治疗四肢长骨骨折髓内固定后骨不连的临床疗效。方法选取2020年1月—2022年9月本院骨科创伤病区收治的四肢长骨干骨折髓内固定后骨不连患者33名,其中男28名,女5名;年龄22~55岁,平均为(37.2±6.7)岁。按入院顺序分为试验组(n=15)与对照组(n=18)。所有患者均保留髓内固定,骨折端加用重建钢板固定。试验组15例自体髂骨移植联合术中及术后使用自体单采PRP治疗。具体方法为术中将激活的自体PRP与患者自体髂骨充分融合后移植于骨缺损部位,术后借助超声引导,精准定位,术后14、28 d分别注射自体PRP 10 mL/(人)次;对照组18例仅以自体髂骨移植于骨缺损部位。随访观察并比较2组患者骨折临床愈合情况。结果33名患者均获得完整随访,随访时间9~30个月,平均(11.8±2.7)月;试验组与对照组比较,临床骨折愈合时间(月)为(5.25±1.18)vs(7.27±1.38)(P<0.05);术后6个月愈合率为93.3%(14/15)vs 61.1%(11/18)(P<0.05)。结论辅助钢板联合术中及术后使用自体单采PRP可促进四肢长骨干骨折髓内固定后骨不连愈合,利于患者早期功能锻炼。Objective To evaluate the clinical efficacy of utilizing auxiliary steel plates in conjunction with autologous platelet-rich plasma(PRP)therapy for the treatment of bone non-union following intramedullary fixation of long shaft fractures in the limbs.Methods From January 2020 to September 2022,33 patients with non union after intramedullary fixation of long shaft fractures of the limbs admitted to the orthopedic trauma ward of the 960 th Hospital of the PLA Jonit Logistics Support Force were selected as the research subjects,including 28 males and 5 females.The age range was 22 to 55 years,with an average of(37.2±6.7)years.The patients were divided into the experimental group(n=15)and the control group(n=18)in order of admission.All patients retained intramedullary fixation,and the fracture end was fixed with reconstruction steel plates.According to the random number table method,15 cases in the experimental group were treated with autologous iliac bone transplantation combined with intraoperative and postoperative autologous PRP.The activated autologous PRP was fully fused with the patient′s autologous iliac bone during surgery and transplanted to the bone defect site.Ultrasound guidance was used to accurately locate the location.Autologous PRP was injected 10 mL/(person)occasion on the 14 th and 28 th day after surgery respectively.Eighteen cases in the control group received the treatment of autologous iliac bone transplantation at the bone defect site only.The clinical healing status of fractures between the two groups of patients were observed and compared.Results All 33 patients were followed up for a complete period of 9 to 30 months,with an average of(11.8±2.7)months.Compared with the control group,the clinical fracture healing time(months)was 5.25±1.18 vs 7.27±1.38(P<0.05);The healing rate was 93.3%(14/15)vs 61.1%(11/18)(P<0.05).Conclusion The combination of intraoperative and postoperative use of autologous PRP and auxiliary steel plates could promote the healing of bone non union after intramedul

关 键 词：富血小板血浆 长骨干骨折 骨不连 

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