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富血小板血浆凝胶在全膝关节置换术中的临床研究

[Clinical study of platelet-rich plasma gel in total knee arthroplasty].

作者信息

Dong Peilong, Tang Xiaobo, Wang Jian, Zhu Zhenan

机构信息

Department of Orthopedics,Jianhu Hospital Affiliated to Nantong University,Yancheng 224700, China.

Department of Orthopedics,Jianhu Hospital Affiliated to Nantong University,Yancheng 224700, China. Email:

出版信息

Zhonghua Wai Ke Za Zhi. 2014 Nov;52(11):851-5.

Abstract

OBJECTIVE

To investigate the effect of platelet-rich plasma (PRP) gel in total knee arthroplasty.

METHODS

From January 2011 to January 2013, 30 patients of total knee arthroplasty were received PRP (PRP group) and 30 patients won't received PRP(normal saline group).Routine drainage and functional exercise were applied to the two groups after operation. Postoperative drainage volume, inflammatory reaction, grade of wound healed, Hospital for Special Surgery (HSS) Score for knee, the Feller Score for patella and range of motion (ROM) for knee were evaluated.Independent samples t-test, grade data used rank sum test were used to compared two groups.

RESULTS

Postoperative drainage volume was (152 ± 22) ml in PRP group and (432 ± 35) ml in normal saline group. Postoperative drainage volume were statistically significant difference between two groups (t = 37.098, P < 0.05). At 4 days after operation, no inflammatory reaction was observed in 27 cases of PRP group and in 24 cases of normal saline group, mid inflammatory reaction in 2 cases of PRP group and in 4 cases of normal saline group, moderate inflammatory reaction in 1 cases of PRP group and in 2 cases of normal saline group.Wound healed by first intention in 30 patients of PRP group and in 29 patients of normal saline group (29/30), by second intention after 3 days of dressing change in 1 patient of normal saline group using 75% alcohol wet compressed. The adverse reaction rate was 3.3%. The average follow-up period was 16 months, ranging from 10 to 24 months. Three months postoperative HSS score for knee, scores of patellar, scores of anterior knee pain and ROM for knee were statistically significant difference in PRP group and normal saline group (t = 2.288, 2.097, 2.630, 2.104; all P < 0.05). Inflammatory reaction, grade of wound healed, final follow-up HSS score for knee, scores of patellar, scores of anterior knee pain and ROM for knee had no statistically significant difference between PRP group and normal saline group (P > 0.05).

CONCLUSIONS

Using PRP gel in total knee arthroplasty can reduce postoperative drainage volume, accelerate the healing of operation incision with no extra complications.It has good short-term clinical effect.

摘要

目的

探讨富血小板血浆(PRP)凝胶在全膝关节置换术中的作用。

方法

2011年1月至2013年1月,30例行全膝关节置换术的患者接受PRP治疗(PRP组),30例未接受PRP治疗(生理盐水组)。两组术后均采用常规引流及功能锻炼。评估术后引流量、炎症反应、伤口愈合等级、膝关节特殊外科医院(HSS)评分、髌骨Feller评分及膝关节活动范围(ROM)。采用独立样本t检验,等级资料采用秩和检验比较两组。

结果

PRP组术后引流量为(152±22)ml,生理盐水组为(432±35)ml。两组术后引流量差异有统计学意义(t=37.098,P<0.05)。术后4天,PRP组27例无炎症反应,生理盐水组24例无炎症反应;PRP组2例有轻度炎症反应,生理盐水组4例有轻度炎症反应;PRP组1例有中度炎症反应,生理盐水组2例有中度炎症反应。PRP组30例患者伤口一期愈合,生理盐水组29例患者伤口一期愈合(29/30),生理盐水组1例患者术后3天换药后采用75%酒精湿敷,伤口二期愈合。不良反应发生率为3.3%。平均随访16个月,范围为10至24个月。术后3个月,PRP组与生理盐水组膝关节HSS评分、髌骨评分、膝关节前方疼痛评分及ROM差异有统计学意义(t=2.288、2.097、2.630、2.104;均P<0.05)。炎症反应、伤口愈合等级、末次随访膝关节HSS评分、髌骨评分、膝关节前方疼痛评分及ROM在PRP组与生理盐水组之间差异无统计学意义(P>0.05)。

结论

全膝关节置换术中使用PRP凝胶可减少术后引流量,加速手术切口愈合,且无额外并发症。具有良好的短期临床效果。

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