实用老年医学

实用老年医学 ›› 2023, Vol. 37 ›› Issue (7): 690-694.doi: 10.3969/j.issn.1003-9198.2023.07.011

• 临床研究 • 上一篇    下一篇

超声引导下自体富血小板血浆注射联合体外冲击波治疗肩袖损伤的临床研究

王继兵, 尹正录, 孟兆祥, 王战业, 黄吉军, 陈波   

  1. 225002 江苏省扬州市, 扬州大学临床医学院苏北人民医院康复医学科(王继兵,尹正录,孟兆祥,陈波);超声医学科(王战业);骨科(黄吉军)
  • 收稿日期:2022-08-08 出版日期:2023-07-20 发布日期:2023-07-25
  • 通讯作者: 尹正录,Email:yinzhenglu@126.com.
  • 基金资助:
    江苏省级学科带头人B类项目(DTRB201805)

Injection of platelet-rich plasma under the guidance of ultrasound combined with extracorporeal shock wave treatment for rotator cuff injury

WANG Ji-bing, YIN Zheng-lu, MENG Zhao-xiang, WANG Zhan-ye, HUANG Ji-jun, CHEN Bo   

  1. Department of Rehabilitation(WANG Ji-bing, YIN Zheng-lu, MENG Zhao-xiang, CHEN Bo); Department of Ultrasound(WANG Zhan-ye); Department of Orthopedics(HUANG Ji-jun), Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou 225002, China
  • Received:2022-08-08 Online:2023-07-20 Published:2023-07-25
  • Contact: YIN Zheng-lu, Email:yinzhenglu@126.com

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摘要： 目的 观察超声引导下自体富血小板血浆(PRP)注射联合体外冲击波(ESW)治疗部分及全层小撕裂型肩袖损伤的疗效。 方法 选取肩袖损伤病人75例,按随机数法分为PRP组、ESW组和联合组3组,每组25例。PRP组在超声引导下进行2次自体PRP治疗;ESW组进行4次ESW治疗;联合组进行2次自体PRP注射和4次ESW治疗。治疗前、治疗结束时及治疗结束后4、12和24周分别采用VAS评估肩关节疼痛,采用Constant-Murley肩关节功能评分(CMS)评估肩关节功能。 结果 与治疗前比较,3组治疗后不同时间点VAS评分均降低,差异有统计学意义(P＜0.05);与PRP组比较,ESW组治疗结束时、治疗结束后4周VAS评分较低,治疗后12、24周评分较高,差异均有统计学意义(P＜0.05);与PRP组和ESW组比较,联合组治疗结束时、治疗结束后4、12、24周VAS评分均显著降低,差异有统计学意义(P＜0.05)。与治疗前比较,3组治疗后不同时间点CMS评分均增高,差异均有统计学意义(P＜0.05);与PRP组比较,ESW组治疗结束时、治疗结束后4周CMS评分较高,治疗结束后12、24周评分较低,差异均有统计学意义(P＜0.05);与PRP组和ESW组比较,联合组治疗结束时、治疗结束后4、12、24周CMS评分均显著增高,差异有统计学意义(P＜0.05)。 结论 超声引导下自体PRP注射联合ESW能够有效缓解部分及全层小撕裂型肩袖损伤病人肩部疼痛,改善肩关节功能。

关键词: 肩袖损伤, 富血小板血浆, 体外冲击波, 肌骨超声

Abstract: Objective To observe the efficacy of ultrasound-guided autologous platelet-rich plasma(PRP) injection combined with extracorporeal shock wave(ESW) in the treatment of partial and full-thickness small tear rotator cuff injury. Methods Seventy-five patients with rotator cuff injury were randomly divided into PRP group, ESW group and combined group(PRP+ESW), with 25 patients in each group. In PRP group, autologous PRP treatment was performed under ultrasound guidance for two times; ESW group received ESW treatment for 4 times; Combined group received injection of autologous PRP for 2 times and ESW treatment for 4 times. Before the treatment, at the end of treatment,as well as 4,12 and 24 weeks after treatment, the patients of the three groups were evaluated using Visual Analog Scale(VAS) and Constant-Murley Shoulder Function Score(CMS). Results Compared with that before treatment, the VAS score was decreased at a time-dependent manner after treatment in the three groups(P<0.05); Compared with PRP group, the VAS score in ESW group was lower at the end of treatment and 4 weeks after treatment, and was higher 12 and 24 weeks after treatment(P<0.05). Compared with PRP group and ESW group, the VAS score of the combined group was significantly lower at the end of treatment and 4, 12 and 24 weeks after treatment(P<0.05). Compared with that before treatment, the CMS scores after treatment were significantly higher in the three groups(P<0.05). Compared with PRP group, the CMS score of ESW group was higher at the end of treatment and 4 weeks after treatment, and was lower 12 and 24 weeks after treatment(P<0.05). Compared with PRP group and ESW group, the CMS score of the combined group at the end of treatment and 4, 12 and 24 weeks after treatment were significantly higher than those of the other two groups(P<0.05). Conclusions Injection of PRP under the guidance of ultrasound combined with ESW treatment can significantly relieve the shoulder pain and improve the function of the shoulder joint in the patients with rotator cuff injury.

Key words: rotator cuff injury, platelet-rich plasma, extracorporeal shock wave, musculoskeletal ultrasound

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