超声引导下富血小板血浆注射治疗肌腱训练伤的应用研究

Ultrasound-guided platelet-rich plasma therapy for tendinopathy caused by military training

目的探讨超声引导下自体血提取富血小板血浆(PRP)注射治疗军事训练肌腱伤的效果。方法选取2018年3月至2019年6月于解放军总医院海南医院就诊的军事训练所致肌腱损伤患者共41例。常规超声检查并评估病变肌腱后,在超声引导下经皮穿刺对肌腱损伤灶多点注射自体PRP。观察并比较治疗前与治疗后2周、1个月的常规超声表现、肢体活动度和疼痛评分。结果41例患者注射PRP剂量为(2.85±0.49)ml。治疗后超声表现为肌腱厚度变小、形态结构改善、周围血管增生减少。患者自觉疼痛症状减轻,治疗后2周、1个月的疼痛评分(4.66±2.43、2.71±1.39)与治疗前(6.53±2.78)相比明显降低,差异有统计学意义(治疗后2周vs治疗前:P=0.008,治疗后1个月vs治疗前:P=0.006)。治疗后患肢的活动幅度增大,治疗后2周、1个月的关节功能评分(72.33±3.34、79.70±5.09)与治疗前(61.84±9.98)相比明显增加,差异有统计学意义(治疗后2周vs治疗前:P=0.006,治疗后1个月vs治疗前:P=0.004)。结论超声引导自体PRP治疗军事训练所致的肌腱伤安全、有效,值得临床推广应用。

Objective To assess the clinical efficacy of ultrasound-guided autologous platelet-rich plasma(PRP)injection into injured tendons caused by military training.Methods Between March 2018 and June 2019,41 patients with tendinopathy caused by military training were enrolled at Hainan Hospital of PLA General Hospital.Conventional ultrasound was used to evaluate the injuried tendons.Under the guidance of ultrasound,the 21G PTC needle was used to percutaneously puncture into the injury site,and autologous PRP was then injected into the lesions in amulti-point manner.Conventional ultrasound,limb mobility score,and pain score were used to evaluate the clinical efficacy.The results were compared between pretreatment and 2 weeks or 1 month after treatment.Results The injection dose of PRP was(2.85±0.49)ml in the 41 patients.After treatment,ultrasound showed that the tendon became thinning,the morphological structure was improved,and the proliferation of peripheral blood vessels was lessened.The pain was alleviated gradually,and the movement range of all affected limbs was expanded.Pain score was significantly decreased at 1 month(2.71±1.39)and 2 weeks(4.66±2.43)after treatment compared with pre-treatment score(6.53±2.78)(P=0.006 and P=0.008,respectively).Limb mobility score was significantly increased at 1 month(79.70±5.09)and 2 weeks(72.33±3.34)after treatment compared with pre-treatment score(61.84±9.98)(P=0.004 and P=0.006,respectively).Conclusion Ultrasound-guided autologous PRP therapy is safe and effective in the treatment of tendinopathy caused by military training.