富血小板血浆辅助治疗前十字韧带重建的临床疗效分析

发布时间：2018-04-17 09:18

本文选题：富血小板血浆 + 前十字韧带重建　；参考：《吉林大学》2017年硕士论文

【摘要】：目的探讨自体富血小板血浆辅助治疗前十字韧带重建的临床疗效。方法自2014年8月至2016年8月,将本院骨科收治的42例拟接受初次膝关节前十字韧带重建患者随机均等分为富血小板血浆治疗组(试验组)及非富血小板血浆治疗组(对照组),每组21例,但随访期6例患者失联,最终试验组及对照组分别为17例和19例。富血小板血浆组采用自体富血小板血浆辅助治疗前十字韧带重建,男性8例,女性9例;年龄17~44岁,平均31.59岁。体质指数18.84~31.39 kg/m2,平均24.94 kg/m2。左侧膝10例,右侧膝7例。病程2~28天,平均11.82天。对照组单纯进行常规前十字韧带重建,男性7例,女性12例;年龄18~44岁,平均33.68岁。体质指数18.31~35.38 kg/m2,平均27.21 kg/m2。左侧膝7例,右侧膝12例。病程3~34天,平均10.21天。手术均由同一组医师完成。采用VAS、Lysholm、IKDC评分分别评估ACL重建术前及术后3、12个月膝关节疼痛及功能状态,并于术后12个月行MRI复查及关节镜二次探查。采用SPSS21.0统计学软件分别对试验组,对照组数据进行分析。结果两组患者随访12个月,期间两组患者无术后不良反应及前十字韧带重建并发症发生。富血小板血浆组及对照组术后3、12个月的膝关节疼痛及功能评分较术前均得到显著改善,差异具有统计学意义。富血小板血浆组,较对照组在术后3个月疼痛及功能评分差异具有统计学意义,而术后12个月评分差异无统计学意义。术后12个月,膝关节MRI复查显示所有病例ACL移植物均具有良好走行,位置佳;少数患者(试验组3例,对照组4例)可见重建移植物呈混杂信号或腱-骨界面存在积液,提示移植物愈合程度欠佳。两组MRI评分比较差异无统计学意义;关节镜二次探查显示,富血小板血浆组移植物韧带重塑比例和滑膜覆盖比例较高。结论富血小板血浆辅助治疗膝关节前十字韧带重建,能够在早期缓解术后关节疼痛、改善关节功能,并且能够有效促进移植物韧带重塑。
[Abstract]:Objective to investigate the clinical efficacy of autologous platelet rich plasma assisted treatment of anterior cruciate ligament reconstruction. Methods from August 2014 to August 2016, the hospital department of orthopedics treated 42 cases underwent primary anterior cruciate ligament reconstruction were randomly divided into platelet rich plasma treatment group (test group) and platelet rich plasma treatment group (control group), 21 cases in each group, but 6 patients were lost to follow-up, the final test group and control group were 17 cases and 19 cases. The platelet rich plasma group with autologous platelet rich plasma assisted treatment of anterior cruciate ligament reconstruction, 8 cases of male, 9 female; age 17~44 years old, average 31.59 years old. The body mass index 18.84~31.39 kg/m2, an average of 24.94 kg/m2. on the left knee in 10 cases, right knee in 7 cases. The course of 2~28 days, average 11.82 days. The control group only routine anterior cruciate ligament reconstruction, 7 cases were male, 12 female; age 18~44 years old, average 33.68 years old. The body mass index 18.31~35.38 kg/m2, an average of 27.21 kg/m2. on the left knee in 7 cases, 12 cases of right knee. The course of 3~34 days, average 10.21 days. The operations were performed by the same group of surgeons. By VAS, Lysholm, IKDC scores were assessed with knee pain and functional status of 3,12 months ACL reconstruction before and after operation, and after operation in 12 a month for MRI review and arthroscopic exploration. Two times respectively in the experimental group using SPSS21.0 statistical software, the control group data were analyzed. Results two patients were followed up for 12 months, two groups of patients during operation after the occurrence of adverse reactions and complications of anterior cruciate ligament reconstruction. Platelet rich plasma group and control group after operation of knee joint 3,12 months of pain and function score were significantly improved, the difference was statistically significant. The platelet rich plasma group than the control group in 3 months after surgery, pain and function scores have statistical significance, and 12 months after the operation scores No statistical significance. 12 months after surgery, the knee joint MRI examination showed that all cases of ACL grafts have good running, good location; a small number of patients (3 cases of test group and control group 4 cases) showed a mixed signal reconstruction graft or tendon bone interface effusion, prompt graft healing is poor. The MRI scores of the two groups had no significant difference; two showed arthroscopic exploration, platelet rich plasma graft ligament remodeling ratio and synovial coverage ratio is higher. Conclusion the platelet rich plasma assisted treatment of anterior cruciate ligament reconstruction, can alleviate postoperative pain in the early stage, improve joint function, and can effectively promote the graft ligament remodeling.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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