全膝关节置换联合自体富血小板血浆凝胶治疗膝骨关节炎患者疗效分析

发布时间：2018-06-21 01:31

本文选题：富血小板血浆 + 膝　；参考：《中华骨与关节外科杂志》2016年06期

【摘要】：背景:全膝关节置换术(TKA)是目前膝骨关节炎的常用治疗方式,但术中及术后失血仍为影响术后恢复的重要因素。目的目的:探究TKA联合富血小板血浆(PRP)治疗膝骨关节炎的临床效果。方法:收集2009年3月至2014年8月在我院行TKA治疗并自愿参与本试验的80例单膝骨关节炎患者的临床资料。分为PRP组和对照组,每组40例。两组患者的一般资料具有可比性。PRP组在TKA术中向膝关节周围喷涂PRP和凝血酶,对照组在安装完假体后喷涂等量的生理盐水与凝血酶。两组患者术后给予相同的抗凝、抗感染及功能锻炼。记录手术时间、引流量、总失血量、切口炎症反应率及甲级愈合率、美国特种外科医院(HSS)术前膝关节评分、膝关节疼痛视觉模拟评分法(VAS)评分及膝关节活动度(ROM)。结果结果:PRP组术后引流量及总失血量低于对照组(P0.05)。两组患者手术时间、切口炎症反应率及甲级愈合率差异无统计学意义(P0.05)。末次随访两组患者HSS评分、疼痛VAS评分、膝ROM均优于术前(P0.05)。术后3个月PRP组HSS评分、疼痛VAS评分、膝ROM优于对照组,差异有统计学意义(P0.05),而末次随访时两组HSS评分、疼痛VAS评分、膝ROM无统计学差异(P0.05)。结论结论:TKA联合PRP凝胶能有效降低失血,加快创面修复及膝关节功能恢复,同时安全性较高,并未增加不良反应的风险,值得临床推广。
[Abstract]:Background: total knee arthroplasty (TKA) is a common treatment for knee osteoarthritis, but blood loss during and after operation is still an important factor affecting postoperative recovery. Objective: to investigate the clinical effect of TKA combined with platelet rich plasma propofol (PRP) in the treatment of knee osteoarthritis. Methods: the clinical data of 80 patients with knee osteoarthritis who were treated with TKA in our hospital from March 2009 to August 2014 were collected. They were divided into PRP group and control group with 40 cases in each group. The general data of the two groups were comparable. The PRP group sprayed PRP and thrombin around the knee joint during TKA, while the control group sprayed the same amount of normal saline and thrombin after the prosthesis was installed. Patients in both groups were given the same anticoagulant, anti-infection and functional exercises after operation. The operation time, drainage volume, total blood loss, incision inflammatory response rate and grade A healing rate, knee joint score before HSS, visual analogue score of knee joint pain (VAS-VAS-VAS-VAS-VAS-VAS-VAS-VAS-VAS) and knee motion were recorded. Results the postoperative drainage volume and total blood loss in the group of% PRP were lower than those in the control group (P 0.05). There was no significant difference in operation time, incision inflammatory response rate and grade A healing rate between the two groups (P 0.05). The scores of HSS, pain VAS and knee ROM in the last follow-up group were better than those before operation (P 0.05). Three months after operation, the scores of HSS, VAS and knee ROM in PRP group were significantly higher than those in control group (P 0.05). However, there was no significant difference in HSS score, pain VAS score and knee ROM score between the two groups at the last follow-up. ConclusionTwo TKA combined with PRP gel can effectively reduce blood loss, accelerate wound repair and function recovery of knee joint, at the same time, it is safe and does not increase the risk of adverse reactions, which is worthy of clinical promotion.
【作者单位】：孝感市第一人民医院骨科;孝感市中心医院骨科;
【分类号】：R687.4

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