可视化富血小板血浆注射联合阶梯式康复治疗军事训练三角纤维软骨复合体损伤的效果  

Application of visualized platelet-rich plasma injection combined with stepped rehabilitation in the treatment of triangular fibrocartilage complex injuries from military training

作　　者：阮剑辉 陈燕 何阳 魏世隽 徐丹 刘万兵 余挺 甘国胜 宋晓阳 RUAN Jian-hui;CHEN Yan;HE Yang;WEI Shi-jun;XU Dan;LIU Wan-bing;YU Ting;GAN Guo-sheng;SONG Xiao-yang(Department of Anesthesiology,General Hospital of Central Theater Command,Wuhan 430070,Hubei,China;不详)

机构地区：[1]中国人民解放军中部战区总医院麻醉科,湖北武汉430070 [2]湖北医药学院,湖北十堰442000 [3]中国人民解放军中部战区总医院骨科,湖北武汉430070 [4]中国人民解放军中部战区总医院康复科,湖北武汉430070 [5]中国人民解放军中部战区总医院输血科,湖北武汉430070

出　　处：《广东医学》2024年第9期1131-1136,共6页Guangdong Medical Journal

基　　金：湖北省卫生计生委联合基金项目(WJ2018H0082)。

摘　　要：目的探讨超声引导富血小板血浆(PRP)注射联合阶梯式康复训练在军事训练三角纤维软骨复合体(TFCC)损伤治疗中的临床观察。方法回顾性分析2019年1月至2023年1月接受经超声引导PRP注射治疗军事训练创伤型TFCC损伤患者44例。22例采用超声引导PRP注射治疗联合阶梯式康复功能训练(观察组),另外22例在超声引导下注射地塞米松棕榈酸酯联合训练(对照组),随访6~12个月,比较两组术后第8、16周腕关节背伸、掌屈、旋转、DASH评分、握力(对比正常一侧)、视觉模拟评分(VAS)。结果所有患者均顺利完成治疗并获得完整随访,腕关节疼痛及功能较治疗前均有明显改善,差异有统计学意义(P<0.05)。治疗后第8周观察组背伸、掌屈、旋转、评分较对照组要低,而静息/动态VAS及DASH评分要高,差异有统计学意义(P<0.05)。治疗后16周观察组背伸、掌屈、旋转评分及握力较对照组要高,而静息/动态VAS及DASH评分要低,差异有统计学意义(P<0.05)。结论超声引导PRP和地塞米松棕榈酸酯注射联合康复训练治疗可缓解患者疼痛,改善患者腕关节功能;PRP远期疗效可能更佳。Objective To evaluate the clinical outcomes of ultrasound-guided platelet-rich plasma(PRP)injection combined with stepped rehabilitation training in the treatment of traumatic triangular fibrocartilage complex(TFCC)injuries resulting from military training.Methods A retrospective analysis was conducted on 44 patients with TFCC injuries due to military training,who received ultrasound-guided PRP injections between January 2019 and January 2023.Among these,22 patients underwent PRP injection combined with stepped rehabilitation training(Observation Group),while the remaining 22 patients received ultrasound-guided dexamethasone palmitate injections combined with training(Control Group).The follow-up period was 6 to 12 months,during which wrist extension,flexion,rotation,Disabilities of the Arm,Shoulder,and Hand(DASH)scores,grip strength(compared to the normal side),and visual analog scale(VAS)scores were compared at 8 and 16 weeks post-treatment.Results All patients successfully completed the treatment and follow-up.Both groups showed significant improvement in wrist pain and function compared to pre-treatment levels.The differences between the two groups were statistically significant(P<0.05).At 8 weeks post-treatment,the Observation Group had lower wrist extension,flexion,and rotation scores but higher resting/dynamic VAS and DASH scores compared to the Control Group,with statistically significant differences(P<0.05).At 16 weeks post-treatment,the Observation Group had higher scores in wrist extension,flexion,rotation,and grip strength,and lower resting/dynamic VAS and DASH scores than the Control Group,with statistically significant differences(P<0.05).Conclusion Ultrasound-guided PRP and dexamethasone palmitate injections combined with rehabilitation training can alleviate pain and improve wrist function in patients with TFCC injuries.PRP may provide better long-term outcomes.

关 键 词：富血小板血浆治疗 阶梯式康复 三角纤维软骨复合体损伤 腕关节功能恢复 

分 类 号：R493[医药卫生—康复医学] E251[医药卫生—临床医学]