摘要
背景:近年来,越来越多的学者聚焦关节镜下肩袖修补联合富血小板血浆治疗肩袖撕裂,以期降低再撕裂率,改善患者预后。但由于富血小板血浆的剂型、激活状态、使用次数、使用时机及浓度等差异,各临床研究结果不一。目的:评估不同浓度贫白细胞富血小板血浆对接受关节镜下肩袖修补患者术后疼痛、肩关节功能和结构完整性的影响。方法:纳入2020年1-9月华北理工大学附属医院及唐山市第二医院收治的肩袖全层撕裂患者80例,采用随机数字表法分2组,对照组40例接受关节镜下肩袖修补手术;试验组40例接受关节镜下肩袖修补手术的同时,于肌腱下注入自体贫白细胞富血小板血浆约3 mL,其中低浓度组(n=20)注入贫白细胞富血小板血浆中的血小板浓度为(330.20±172.65)×109 L-1,高浓度组(n=20)注入贫白细胞富血小板血浆中的血小板浓度为(807.76±218.98)×109 L-1。比较各组目测类比评分、肩关节前屈上举及外展上举的活动度、肩关节功能评分及再撕裂率。结果与结论:①试验组术后12个月的目测类比评分低于对照组(P<0.05),高浓度组术后14 d及1,3,6,12个月的目测类比评分低于低浓度组(P<0.05),但是未达到最小临床意义变化值;②各组术后12个月的肩关节前屈上举及外展上举活动度比较差异均无显著性意义(P>0.05);③高浓度组术后12个月的美国肩肘外科评分高于低浓度组(P<0.05),但是未达到最小临床意义变化值,其余组间肩关节功能美国肩肘外科评分、Constant-Murley评分、美国洛杉矶评分比较差异均无显著性意义(P>0.05);④术后12个月,各组间肩袖再撕裂率比较差异无显著性意义(P>0.05);⑤低浓度和高浓度贫白细胞富血小板血浆均无法改善肩袖全层撕裂患者术后的关节活动度、疼痛、功能和再撕裂率,因此,不推荐关节镜下肩袖修补术联合贫白细胞富血小板血浆治疗肩袖损伤,但是需要�
BACKGROUND:In recent years,more and more scholars have focused on arthroscopic rotator cuff repair combined with platelet-rich plasma for the treatment of rotator cuff tears,in order to reduce the re-tear rate and improve the prognosis of patients.However,due to differences in the dosage form,activation state,frequency of use,timing of use,and concentration of platelet-rich plasma,the results of various clinical studies vary.OBJECTIVE:To evaluate the effects of different concentrations of leucocyte platelet-rich plasma on postoperative pain,functional and structural integrity outcomes in patients accepted arthroscopic rotator cuff repair.METHODS:A total of 80 patients with full-thickness tear of the rotator cuff admitted to the Affiliated Hospital of North China University of Science and Technology and The Second Hospital of Tangshan from January to September 2020 were included.The patients were randomly divided into two groups.In the control group(n=40),cases underwent arthroscopic rotator cuff repair.In the trial group(n=40),about 3 mL of autologous leukocyte-poor platelet-rich plasma was injected under the tendon in patients undergoing arthroscopic rotator cuff repair.Among them,the platelet concentration in the low-concentration group(n=20)injected into the leukocyte-poor platelet-rich plasma was(330.20±172.65)×109 L-1,and the platelet concentration in the high-concentration group(n=20)injected into the leukocyte-poor platelet-rich plasma was(807.76±218.98)×109 L-1.Visual analog scale scores,range of motion,shoulder function score,and retear rate of shoulder flexion lift and abduction lift of each group were were compared.RESULTS AND CONCLUSION:(1)Visual analog scale scores of the trial group at 12 months after surgery was lower than that of the control group(P<0.05).The visual analog score of the high-concentration group at 14 days and 1,3,6,and 12 months after surgery was lower than that of the low-concentration group(P<0.05),but it did not reach the minimum clinical significance change value.(2)There w
作者
白晓松
高丽颖
张顶顶
刘文龙
张涛
申晓阳
梁春雨
孙晓新
Bai Xiaosong;Gao Liying;Zhang Dingding;Liu Wenlong;Zhang Tao;Shen Xiaoyang;Liang Chunyu;Sun Xiaoxin(North China University of Science and Technology,Tangshan 063000,Hebei Province,China;Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,Hebei Province,China;Affiliated Orthopedic Hospital of Shenzhen University,Shenzhen 518000,Guangdong Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2023年第16期2467-2472,共6页
Chinese Journal of Tissue Engineering Research
基金
河北省优秀人才培养项目,项目负责人:梁春雨
河北省适用技术跟踪项目(G2018064),项目负责人:梁春雨
河北省适用技术跟踪项目(GZ2021074),项目负责人:孙晓新。
关键词
肩袖撕裂
肩袖全层撕裂
富血小板血浆浓度
富血小板血浆
肩袖
关节镜
rotator cuff tears
full-thickness rotator cuff tears
platelet-rich plasma concentration
platelet-rich plasma
rotator cuff
arthroscopy
