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超声引导下富血小板血浆单次滑囊内注射与皮质类固醇治疗肩峰撞击综合征的疗效比较:一项随机临床试验

Effectiveness of single intra-bursal injection of platelet-rich plasma against corticosteroid under ultrasonography guidance for shoulder impingement syndrome: a randomized clinical trial.

作者信息

Hewavithana Padma Badra, Wettasinghe Mihiri Chami, Hettiarachchi Gothami, Ratnayaka Manel, Suraweera Hilary, Wickramasinghe Nuwan Darshana, Kumarasiri Pallegoda Vithanage Ranjith

机构信息

Department of Radiology, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka.

Department of Radiology, Teaching Hospital Peradeniya, Kandy, Sri Lanka.

出版信息

Skeletal Radiol. 2024 Jan;53(1):51-58. doi: 10.1007/s00256-023-04373-w. Epub 2023 Jun 2.

Abstract

OBJECTIVE

To compare the effectiveness of intra-bursal injection of single-dose platelet-rich plasma (PRP) against corticosteroids under ultrasonography guidance in shoulder impingement syndrome (SIS).

MATERIALS AND METHODS

This single-blind randomized controlled trial was conducted on 60 participants with a clinical diagnosis of SIS from a selected orthopedic clinic. Thirty participants in each arm were given a single dose of either PRP or triamcinolone acetonide into the subacromial sub-deltoid bursa (SASD) under ultrasonography guidance. The outcome variables assessed were the severity score of pain and the degree of shoulder abduction. Post-treatment follow-up was done in 1 week, 3 months, 6 months, and 1 year.

RESULTS

At 1 week, the triamcinolone arm showed a statistically significant reduction of pain (p = 0.039) when compared to PRP. In the long term, PRP showed statistically significant improvement in shoulder abduction, compared to the triamcinolone injection (p = 0.012).

CONCLUSION

PRP and triamcinolone in the SASD bursa could be considered as safe treatment options for SIS under ultrasonography guidance. While triamcinolone was effective in short-term pain reduction, PRP was effective in long-term improvement in shoulder abduction.

摘要

目的

比较超声引导下向滑囊内注射单剂量富血小板血浆(PRP)与皮质类固醇治疗肩部撞击综合征(SIS)的疗效。

材料与方法

这项单盲随机对照试验针对一家选定骨科诊所中60例临床诊断为SIS的参与者进行。每组30名参与者在超声引导下向肩峰下三角肌下滑囊(SASD)内注射单剂量的PRP或曲安奈德。评估的结果变量为疼痛严重程度评分和肩部外展程度。在治疗后1周、3个月、6个月和1年进行随访。

结果

在1周时,与PRP组相比,曲安奈德组的疼痛程度有统计学意义的降低(p = 0.039)。从长期来看,与注射曲安奈德相比,PRP组在肩部外展方面有统计学意义的改善(p = 0.012)。

结论

在超声引导下,向SASD滑囊内注射PRP和曲安奈德可被视为SIS的安全治疗选择。虽然曲安奈德在短期内能有效减轻疼痛,但PRP在长期改善肩部外展方面效果显著。

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