关节镜下桡侧腕短伸肌腱松解联合富血小板血浆治疗慢性肱骨外上髁炎的临床疗效  

Clinical effect of arthroscopic extensor carpi radialis brevis release combined with platelet-rich plasma in treatment of Lateral epicondylitis of the humerus

作　　者：黄子帅 张树昂 王建旭 杨光 王健 丰浩田 HUANG Zishuai;ZHANG Shuang;WANG Jianxu;YANG Guang;WANG Jian;FENG Haotian(Shandong First Medical University,Jinan 250117,Shandong,China;Department of Orthopaedics,Shandong Provincial Hospital affiliated to Shandong First Medical University,Jinan 250021,Shandong,China)

机构地区：[1]山东第一医科大学,山东济南250117 [2]山东第一医科大学附属省立医院骨关节科,山东济南250021

出　　处：《山东大学学报(医学版)》2025年第3期8-13,共6页Journal of Shandong University:Health Sciences

摘　　要：目的探讨关节镜下桡侧腕短伸肌腱(extensor carpi radialis brevis,ECRB)松解联合富血小板血浆(platelet-rich plasma,PRP)注射治疗慢性肱骨外上髁炎的临床疗效及安全性。方法回顾性分析2023年9月至2024年3月山东第一医科大学附属省立医院骨关节科收治的慢性肱骨外上髁炎患者20例。根据患者意愿,10例采用关节镜下ECRB松解联合PRP注射治疗(PRP组),10例采用单纯关节镜下ECRB松解(松解组)。比较两组患者术前及术后6个月视觉模拟评分(visual analogue scale,VAS)、MAYO肘关节功能评分(MAYO elbow-performance score,MEPS)、美国肩肘外科医师评分(American shoulder and elbow surgeons score,ASES-S),以及术后重返工作的时间和并发症。结果两组患者术后6个月的静息VAS评分、活动VAS评分、MEPS评分、ASES-S评分均较术前显著改善(P<0.01)。术后6个月两组患者静态VAS评分[(0.40±0.70)vs.(0.60±0.52)]和动态VAS评分[(0.40±0.52)vs.(0.80±0.63)],差异无统计学意义(P>0.05),术后6个月PRP组的MEPS评分[(94.40±0.52)vs.(92.90±0.88)]和ASES-S评分[(90.60±0.70)vs.(89.60±0.84)]均显著优于松解组,差异有统计学意义(P<0.05)。所有患者末次随访均未出现感染、血管神经损伤等并发症。PRP组术后重返工作时间显著早于松解组[(2.52±0.23)周vs.(3.08±0.40)周,P<0.05]。结论关节镜下ECRB松解联合PRP注射治疗慢性肱骨外上髁炎可获得满意疗效,有效改善肘关节疼痛症状及功能,同时提前复工时间。Objective To investigate the clinical efficacy and safety of combining arthroscopic extensor carpi radialis brevis(ECRB)tendon release with platelet-rich plasma(PRP)injection for the treatment of chronic lateral epicondylitis.Methods This study retrospectively analysed the clinical data of 20 patients diagnosed with chronic humeral epicondylitis,who were admitted to the Department of Orthopaedics,Provincial Hospital Affiliated to Shandong First Medical University between September 2023 and March 2024.Based on the results of doctor-patient communication,10 cases were treated with arthroscopic ECRB release combined with PRP injection,while the other 10 cases received arthroscopic ECRB release alone.The study compared the visual analogue scale(VAS)scores,MAYO elbow-performance score(MEPS),and american shoulder and elbow surgeons score(ASES-S)both preoperatively and six months postoperatively between the two groups.In addition,the time to return to work and any complications were evaluated.Results The resting VAS score,active VAS score MEPS and ASES-S scores of both groups were significantly improved six months postoperatively(P<0.01).Six months postoperatively,there was no significant difference in static VAS score[(0.40±0.70)vs.(0.60±0.52),P>0.05]and dynamic VAS score[(0.40±0.52)vs.(0.80±0.63),P>0.05],but MEPS score[(94.40±0.52)vs.(92.90±0.88),P<0.05]and ASES-S score[(90.60±0.70)vs.(89.60±0.84),P<0.05]in the PRP group were significantly better than those in the release group.No complications,such as infection or vascular and nerve injury,occurred in any patient at the last follow-up.The time to return to work in PRP group was significantly earlier than that in the release group[(2.52±0.23)weeks vs.(3.08±0.40)weeks,P<0.05].Conclusion Arthroscopic release of the extensor carpi radialis brevis(ECRB),when combined with platelet-rich plasma(PRP)injection,has been shown to provide satisfactory results in the treatment of chronic lateral epicondylitis.This approach facilitates effective patient recovery,alleviat

关 键 词：肱骨外上髁炎 桡侧腕短伸肌腱 关节镜 富血小板血浆 松解术 

分 类 号：R681.7[医药卫生—骨科学]