摘要
目的观察超声引导下粘连松解术联合富血小板血浆(PRP)精准注射治疗轻、中度肩袖损伤的临床疗效及安全性。方法收集2018年1月至2018年12月就诊于上海市第十人民医院麻醉疼痛科的轻、中度肩袖损伤患者30例,年龄、性别不限,对超声引导下粘连松解术联合富血小板血浆精准注射术进行前瞻性的分析研究。比较患者治疗前和治疗后1、3、6个月时的疼痛视觉模拟评分(VAS)、肩关节活动度(ROM,主动外展活动度)、肩关节功能评定(CMS),并记录并发症和不良反应。结果全组中1例患者失访。与治疗前动态痛VAS[(6.3±0.9)分]比较,患者治疗后1个月时为(2.4±0.7)分,3个月时为(2.0±0.6)分,6个月时为(2.1±0.7)分,疼痛均得到明显缓解(P均<0.05);与治疗前肩关节主动外展活动度ROM[(94±13)°]比较,患者术后1个月时为(148±14)°,3个月时为(150±11)°,6个月时为(151±10)°,均明显增加(P均<0.05);与治疗前CMS[(54.1±4.9)分]比较,患者治疗后1个月时为(87.4±2.8)分,3个月时为(87.8±2.9)分,6个月时为(89.1±2.6)分,CMS评分均较治疗前明显改善(P均<0.05)。全组患者中未见严重并发症(伤口红肿、感染、发热、神经损伤)。结论超声引导下粘连松解术联合PRP精准注射治疗轻、中度肩袖损伤具有良好的临床效果且安全可行。
Objective To observe the efficacy and safety of the treatment of patients with mild to moderate rotator cuff tear by ultrasound-guided adhesive release combined with platelet-rich plasma(PRP)precision injection.Methods Thirty patients diagnosed with mild to moderate rotator cuff tear in Department of Anesthesiology and Pain,Shanghai Tenth People's Hospital from January 2018 to December 2018,regardless of age and gender,were prospectively analyzed for the treatment by ultrasound-guided adhesive release combined with PRP precision injection.All patients were assessed by visual analogue scale(VAS),range of motion of shoulder(ROM,active abduction),the Constant-Murley Score(CMS)before the treatment,and 1 month,3 months,6 months after the treatment.Complications and adverse reactions were observed and recorded.Results None of the patients had serious complications(wound redness,infection,fever and nerve injury),but one patient was missing follow-up.VAS of dynamic pain was significantly relieved at 1 month(2.4±0.7),3 months(2.0±0.6)and 6 months(2.1±0.7)after the treatment in all patients,compared with that before the treatment(6.3±0.9)(all P<0.05).Shoulder ROM of active rang of abduction was significantly increased at 1 month(148±14)°,3 months(150±11)°and 6 months(151±10)°after the treatment in all patients,compared with that before the treatment(94±13)°(all P<0.05).CMS was significantly increased at 1 month(87.4±2.8),3 months(87.8±2.9)and 6 months(89.1±2.6)after the treatment in all patients,compared with that before the treatment(54.1±4.9)(all P<0.05).Conclusion The treatment of mild to moderate rotator cuff tear with ultrasound-guided adhesive release combined with PRP precision injection has good clinical effects and safety.
作者
王纪鹰
林福清
齐慧
潘涛
王兴鹏
姚萍
Wang Jiying;Lin Fuqing;Qi Hui;Pan Tao;Wang Xingpeng;Yao Ping(Department of Anesthesiology and Pain,Shanghai Tenth People's Hospital,Shanghai City 200072,China)
出处
《中华疼痛学杂志》
2020年第6期454-460,共7页
Chinese Journal Of Painology
基金
上海市疼痛学青年基金项目(RFSH201711-02)。
关键词
富含血小板的血浆
肩袖损伤
超声检查
介入性
注射
关节内
Platelet-rich plasma
Rotator cuff injuries
Ultrasonography,interventional
Injections,intra-articular
作者简介
王纪鹰,女,1989年2月出生,临床医学硕士,住院医师,工作单位:上海市第十人民医院麻醉疼痛科,专业特长:超声引导下的四肢躯干神经阻滞治疗,肩关节的疼痛治疗,急慢性疼痛治疗,研究方向:糖尿病周围神经病变的分级诊疗以及脊髓电刺激植入术的围术期管理;通信作者:林福清,Email:15800552155@163.com。
