| 自体单采富血小板血浆结合可调节钛板固定治疗RockwoodⅢ型肩锁关节脱位的临床疗效观察 |
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Received:November 04, 2024
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| 作者 | Author | 单位 | Unit | E-Mail |
| 蔡巍 |
CAI Wei |
中国人民解放军联勤保障部队第 921 医院暨湖南师范大学第二附属医院, 湖南 长沙 410003 |
The 921 Hospital of PLA, the Second Affiliated Hospital of Hunan Normal University, Changsha 410003, Hunan, China |
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| 吴安平 |
WU An-ping |
中国人民解放军联勤保障部队第 921 医院暨湖南师范大学第二附属医院, 湖南 长沙 410003 |
The 921 Hospital of PLA, the Second Affiliated Hospital of Hunan Normal University, Changsha 410003, Hunan, China |
hnyywap302@qq.com |
| 谭海涛 |
TAN Hai-tao |
中国人民解放军联勤保障部队第 921 医院暨湖南师范大学第二附属医院, 湖南 长沙 410003 |
The 921 Hospital of PLA, the Second Affiliated Hospital of Hunan Normal University, Changsha 410003, Hunan, China |
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| 徐高兵 |
XU Gao-bing |
中国人民解放军联勤保障部队第 921 医院暨湖南师范大学第二附属医院, 湖南 长沙 410003 |
The 921 Hospital of PLA, the Second Affiliated Hospital of Hunan Normal University, Changsha 410003, Hunan, China |
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| 符卓毅 |
FU Zhuo-yi |
中国人民解放军联勤保障部队第 921 医院暨湖南师范大学第二附属医院, 湖南 长沙 410003 |
The 921 Hospital of PLA, the Second Affiliated Hospital of Hunan Normal University, Changsha 410003, Hunan, China |
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| 彭勇 |
PENG Yong |
中国人民解放军联勤保障部队第 921 医院暨湖南师范大学第二附属医院, 湖南 长沙 410003 |
The 921 Hospital of PLA, the Second Affiliated Hospital of Hunan Normal University, Changsha 410003, Hunan, China |
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| 桂迪世 |
GUI Di-shi |
中国人民解放军联勤保障部队第 921 医院暨湖南师范大学第二附属医院, 湖南 长沙 410003 |
The 921 Hospital of PLA, the Second Affiliated Hospital of Hunan Normal University, Changsha 410003, Hunan, China |
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| 卜俏梅 |
PU Qiao-mei |
中国人民解放军联勤保障部队第 921 医院暨湖南师范大学第二附属医院, 湖南 长沙 410003 |
The 921 Hospital of PLA, the Second Affiliated Hospital of Hunan Normal University, Changsha 410003, Hunan, China |
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| 期刊信息：《中国骨伤》2025年38卷，第6期，第587-593页 |
| DOI：10.12200/j.issn.1003-0034.20230763 |
| 基金项目:湖南省教育厅科学研究项目(编号:21B0080;20C1147) |
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目的：探讨自体单采富血小板血浆(platelet-rich plasma,PRP)治疗RockwoodⅢ型肩锁关节脱位的临床疗效。
方法：自2019年1月至2021年7月,采用微创可调节钛板内固定术治疗32例RockwoodⅢ型肩锁关节脱位患者,根据是否行PRP治疗分为PRP和对照组,每组16例。PRP组男10例,女6例;年龄28~47(36.75±7.14)岁;受伤至手术时间19~31(26.13±3.98) h;左侧5例,右侧11例;分别于术中及术后第4、8周各注射1次PRP。对照组男8例,女8例;年龄30~52(38.50±5.48)岁;受伤至手术时间18~29(25.48±3.11) h;左侧7例,右侧9例;行微创手术治疗。分别于术前,术后1、3、6、12个月采用疼痛视觉模拟评分(visual analogue scale,VAS)评价患者疼痛缓解情况,并采用肩关节功能Constant-Murley评分评估肩关节活动功能恢复情况。
结果：所有患者获得随访,时间12~28(18.3±5.2)个月。所有患者切口愈合可,无感染等不良事件。PRP组术后1、3、6个月VAS分别为(5.5±1.2)、(3.7±1.6)、(2.4±1.2)分,对照组分别为(6.6±1.4)、(4.9±1.1)、(3.7±1.3)分;PRP组术后1、3、6个月VAS较对照组明显降低,差异有统计学意义(P<0.05)。两组术前、术后12个月VAS比较,差异无统计学意义(P>0.05)。PRP组术后1、3、6个月Constant-Murley评分分别为(64.09±11.61)、(73.19±12.89)、(82.61±14.81)分,对照组分别为(52.32±17.42)、(61.65±14.43)、(72.52±11.04)分;PRP组术后1、3、6个月肩关节Constant-Murley评分优于对照组,差异有统计学意义(P<0.05);术后12个月两组比较,差异无统计学意义(P>0.05)。PRP组术后6个月与12个月比较,差异无统计学意义(P>0.05),其余时间点(术后1个月与术前、术后3个月与术后6个月、术后3个月与术后1个月)比较,差异均有统计学意义(P<0.05)。对照组术后1个月与3个月比较,差异无统计学意义(P>0.05),其余时间点(术后1个月与术前、术后3个月与术后6个月、术后6个月与术后12个月)比较,差异均有统计学意义(P<0.05)。
结论：可调节钛板固定结合术后注射PRP治疗Rockwood Ⅲ型肩锁关节脱位具有促进肩关节功能恢复、减少疼痛的作用。 |
| [关键词]:富血小板血浆 肩锁关节脱位 临床疗效 病例对照研究 |
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| Clinical efficacy of autologous apheresis platelet-rich plasma combined with adjustable titanium plate fixation in the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation |
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Abstract:
Objective To explore clinical efficacy of autologous platelet rich plasma (PRP) in treating Rockwood type Ⅲ acromioclavicular dislocation.
Methods From January 2019 to July 2021,32 patients with Rockwood type Ⅲ acromioclavicular dislocation were treated with minimally invasive adjustable titanium plate internal fixation,and were divided into PRP group and control group according to whether PRP treatment was performed,with 16 patients in each group. In PRP group,there were 10 males and 6 females,aged from 28 to 47 years old with an average of (36.75±7.14) years old;the time from injury to surgery ranged from 1 to 31 h with an average of (26.13±3.98) h;5 patients on the left side and 11 patients on the right side;PRP was injected once during operation and the 4th and 8th weeks after operation respectively. In control group,there were 8 males and 8 females,aged from 30 to 52 years old with an average of (38.50±5.48) years old; the time from injury to surgery ranged from 1 to 29 h with an average of (25.48±3.11) h;7 patients on the left side and 9 patients on the right side; minimally invasive surgical treatment was performed. Visual analogue scale (VAS) was used to evaluate pain and Constant -Murley score for shoulder joint function was used to evaluate the recovery of shoulder joint movement function before operation and 1,3,6,and 12 months after operation respectively.
Results All patients were followed up for 12 to 28 months with an average of (18.3±5.2) months. All incisions patients healed well without adverse events such as infection. Postoperative VAS of PRP group at 1,3, and 6 months were (5.5±1.2),(3.7±1.6),and (2.4±1.2),respectively,while were lower than those of control group (6.6±1.4), (4.9±1.1),and (3.7±1.3),respectively;and had statistical differences between two groups (P<0.05). There was no statistically significant difference in VAS between two groups before operation and 12 months after operation (P>0.05). Postoperative Constant-Murley scores of PRP group at 1,3,and 6 months were (64.09±11.61),(73.19±12.89),and (82.61±14.81) points,respectively,which were higher than those of control group were (52.32±17.42),(61.65±14.43),and (72.52±11.04) respectively;and the differences were statistically significant (P<0.05). There was no statistically significant difference in ConstantMurley scores at 12 months after operation between two groups (P>0.05). In PRP group,there was no statistically significant difference at 6 months and 12 months after operation (P>0.05),while there were statistically significant differences at the other time points (1 month after operation compared with before operation,3 months after operation compared with 6 months after operation,and 3 months after operation compared with 1 month after operation) (P<0.05). In control group,there was no statistically significant difference when comparing 1 month and 3 months after operation (P>0.05),while at the other time points (1 month after operation with before operation,3 months after operation with 6 months after operation,and 6 months after operation with 12 months after operation),the differences were all statistically significant (P<0.05).
Conclusion Adjustable titanium plate fixation combined with postoperative injection of PRP for the treatment of Rockwood type III acromioclavicular joint dislocation has effect of promoting the recovery of shoulder joint function and reducing pain. |
| KEYWORDS:Platelet-rich plasma Acromioclavicular dislocation Clincal effect Case-control study |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 蔡巍,吴安平,谭海涛,徐高兵,符卓毅,彭勇,桂迪世,卜俏梅.自体单采富血小板血浆结合可调节钛板固定治疗RockwoodⅢ型肩锁关节脱位的临床疗效观察[J].中国骨伤,2025,38(6):587~593 |
| 英文格式: | CAI Wei,WU An-ping,TAN Hai-tao,XU Gao-bing,FU Zhuo-yi,PENG Yong,GUI Di-shi,PU Qiao-mei.Clinical efficacy of autologous apheresis platelet-rich plasma combined with adjustable titanium plate fixation in the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(6):587~593 |
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