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前瞻性队列研究：富血小板血浆联合腕管松解术治疗腕管综合征。

A prospective cohort study: platelet-rich plasma combined with carpal tunnel release treating carpal tunnel syndrome.

机构信息

Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, 200233, China.

Shanghai Institute of Technology, Shanghai, 201418, China.

出版信息

BMC Musculoskelet Disord. 2022 Aug 17;23(1):787. doi: 10.1186/s12891-022-05733-8.

DOI:10.1186/s12891-022-05733-8
PMID:35978299
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9382812/
Abstract

BACKGROUND

PRP injection was proved to promote the health condition of individuals with mild to moderate Carpal Tunnel Syndrome (CTS). However, carpal tunnel release (CTR) was still a necessary treatment for individuals with moderate and severe CTS.

METHODS

To explore whether adjuvant PRP treatment would improve the prognosis while using CTR, we included 82 patients in this study. Preoperative and postoperative visual analog scale (VAS), Boston carpal tunnel syndrome questionnaire-symptom severity scale (BCTQ-SSS), Boston carpal tunnel syndrome questionnaire-functional status scale (BCTQ-FSS), and grip strength were used to examine the patient's symptoms and function.

RESULTS

CTR combined with PRP treatment improved the VAS (1.9 ± 0.5 versus 1.4 ± 0.4, P < .05), BCTQ-SSS (1.8 ± 0.4versus 1.5 ± 0.3, P < .05) and BCTQ-FSS (1.8 ± 0.5 versus 1.4 ± 0.6, P < .05) in patients with moderate symptoms within one month after surgery. At the same time, it does not show any advantages in treating individuals with severe carpal tunnel syndrome.

CONCLUSIONS

PRP does not affect long-term prognosis while increasing the surgery cost. To conclude, PRP as an adjuvant treatment of CTR has limited effect. Considering the additional financial burden on patients, CTR combined with PRP should be cautious in CTS treatment.

摘要

背景

富血小板血浆 (PRP) 注射已被证明可促进轻度至中度腕管综合征 (CTS) 患者的健康状况。然而，对于中度和重度 CTS 患者，仍需要进行腕管松解术 (CTR)。

方法

为了探讨在使用 CTR 时辅助 PRP 治疗是否会改善预后，我们纳入了 82 例患者。使用视觉模拟量表 (VAS)、波士顿腕管综合征问卷症状严重程度量表 (BCTQ-SSS)、波士顿腕管综合征问卷功能状态量表 (BCTQ-FSS) 和握力来评估患者的症状和功能。

结果

在术后一个月内，与单独接受 CTR 的患者相比，联合 PRP 治疗可显著改善中度 CTS 患者的 VAS（1.9±0.5 比 1.4±0.4，P<.05）、BCTQ-SSS（1.8±0.4 比 1.5±0.3，P<.05）和 BCTQ-FSS（1.8±0.5 比 1.4±0.6，P<.05）。但对于重度 CTS 患者，联合 PRP 治疗并没有显示出优势。

结论

PRP 增加了手术成本，但对长期预后没有影响。总之，PRP 作为 CTR 的辅助治疗效果有限。考虑到对患者的额外经济负担，在 CTS 治疗中应慎重考虑 CTR 联合 PRP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4721/9382812/a1ded7285c17/12891_2022_5733_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4721/9382812/0ff1e733f91c/12891_2022_5733_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4721/9382812/a1ded7285c17/12891_2022_5733_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4721/9382812/0ff1e733f91c/12891_2022_5733_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4721/9382812/a1ded7285c17/12891_2022_5733_Fig2_HTML.jpg

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The Efficacy of Hyaluronic Acid for Carpal Tunnel Syndrome: A Randomized Double-Blind Clinical Trial.透明质酸治疗腕管综合征的疗效：一项随机、双盲临床试验。
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Extracorporeal shock wave therapy versus local corticosteroid injection for the treatment of carpal tunnel syndrome: a meta-analysis.
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