冲击波联合自体血活性浓集物治疗骨折不愈合的临床疗效  

Clinical efficacy of combined shock wave therapy and autologous blood-derived bioactive concentrate for fracture nonunion treatment

作　　者：唐洪涛 孙瑞波 田涛涛 仝昭方 倘艳锋 樊丽霞 林继红 程真真 TANG Hongtao;SUN Ruibo;TIAN Taotao;TONG Zhaofang;TANG Yanfeng;FAN Lixia;LIN Jihong;CHENG Zhenzhen(The 3 rd Department of Hip Joint Surgery,Luoyang Orthopedic-Traumatological Hospital of Henan Province&Henan Provincial Orthopedic Hospital,Luoyang 471002,Henan,China)

机构地区：[1]河南省洛阳正骨医院&河南省骨科医院髋关节外三科,河南洛阳471002

出　　处：《贵州医科大学学报》2024年第7期1082-1087,共6页Journal of Guizhou Medical University

基　　金：2019河南省中医科学研究专项课题(2019ZY1026)。

摘　　要：目的探讨冲击波联合自体血活性浓集物治疗下肢骨折不愈合的临床疗效。方法54例下肢骨折不愈合患者随机分为研究组和对照组,研究组给予冲击波联合自体血生物活性浓集物治疗,对照组给予体外冲击波治疗;于治疗后2个月、3个月、6个月时采用骨痂X线评分评估两组骨折端愈合情况,同时负重状态下采用视觉模拟评分(VAS)评估患肢疼痛反应;于治疗结束时比较两组患者的愈合率、负重时间及不良反应,评估两组患者的临床疗效。结果研究组治疗后2个月时骨痂X线评分与对照组比较,差异无统计学意义(P>0.05);治疗后3个月及6个月时,研究组骨痂X线评分高于对照组(P<0.05);治疗后2个月时,研究组VAS评分与对照组比较,差异无统计学意义(P>0.05);治疗后3个月及6个月时,研究组VAS评分低于对照组(P<0.05);研究组治愈率高于对照组(P<0.05),研究组开始负重时间早于对照组(P<0.05);两组不良反应比较,差异无统计学意义(P>0.05)。结论冲击波联合自体血活性浓集物骨折端注入对骨折不愈合患者具有较好的疗效可促进骨折端愈合能力。Objective To evaluate the clinical efficacy of combined shock wave therapy and autologous blood-derived bioactive concentrate in treating lower extremity fracture nonunion.Method Fifty-four patients with lower extremity fracture nonunion were randomly assigned to either the study group or the control group.The study group received a combination of shock wave therapy and autologous blood-derived bioactive concentrate treatment,while the control group received extracorporeal shock wave therapy alone.Callus formation was assessed using X-ray scores at 2,3,and 6 months post-treatment.Pain was evaluated using the visual analog scale(VAS)under weight-bearing conditions.Healing rates,time to weight-bearing,and adverse reactions were compared between groups at the end of treatment to assess clinical efficacy.Result No significant difference in callus X-ray scores was observed between groups at 2 months post-treatment(P>0.05).However,the study group showed significantly higher callus X-ray scores at 3 and 6 months post-treatment(P<0.05).VAS scores were comparable between groups at 2 months(P>0.05)but were significantly lower in the study group at 3 and 6 months post-treatment(P<0.05).The study group demonstrated a higher cure rate(P<0.05)and earlier weight-bearing time(P<0.05)compared to the control group.No significant difference in adverse reactions was noted between groups(P>0.05).Conclusion The combination of shock wave therapy and autologous blood-derived bioactive concentrate injection at the fracture site demonstrates superior efficacy in treating fracture nonunion,enhancing the fracture healing process.

关 键 词：体外冲击波 自体血活性浓集物 微创治疗 骨折不愈合 

分 类 号：R683.4[医药卫生—骨科学]