富血小板血浆联合透明质酸钠治疗老年晚期膝骨关节炎的临床研究

Clinical study of platelet-rich plasma combined with sodium hyaluronate in the treatment of elderly patients with advanced knee osteoarthritis

目的分析富血小板血浆(Platelet-rich plasma,PRP)联合透明质酸钠(hyaluronate,HA)治疗老年晚期膝骨关节炎(knee osteoarthritis,KOA)的可行性。方法选择2018年12月-2019年6月收治的60例老年晚期KOA患者,采用随机数字表法分三组,各20例。A组采用HA膝关节内注射,B组采用PRP膝关节内注射,C组采用PRP联合HA膝关节内注射,比较三组的治疗效果。结果三组治疗后半月板损伤恢复情况比较差异有统计学意义(χ^2=17.37,P<0.01);与A组、B组比较,C组半月板恢复正常例数显著升高(P<0.05或0.01)。三组治疗前KSS评分、VAS评分、SF-36评分比较无差异(P>0.05);治疗后均显著改善,且三组间比较差异有统计学意义(P<0.01),C组各评分改善情况均显著优于A组及B组(P<0.01)。结论PRP联合HA通过膝关节内注射治疗可显著恢复半月板损伤,提高膝关节功能,改善患者生存质量。

Objective To investigate the clinical effect of platelet-rich plasma(PRP)combined with sodium hyaluronate(HA)in the treatment of elderly patients with advanced knee osteoarthritis(KOA).Methods 60 elderly patients with advanced KOA admitted to our hospital from December 2018 to June 2019 were randomly divided into three groups,20 in each group.Group A received intra-knee injection of HA,group B received intra-knee injection of PRP,and group C received intra-knee injection of PRP combined with HA.The therapeutic effects of the three groups were compared.Results The meniscus injury recovery of three groups after treatment was different(2=17.37,P<0.01).Compared with group A and group B,the number of meniscus recovery patients in group C increased significantly(P<0.05 or 0.01).There was no difference in KSS score,VAS score and SF-36 score between three groups before treatment(P>0.05),but after treatment,the KSS score was significantly improved,and the difference among three groups was statistically significant(P<0.01).After treatment,the improvement of each score in group C was significantly better than that in group A and group B(P<0.01).Conclusion PRP combined with HA can significantly restore meniscus injury,improve knee function and improve the quality of life of patients by intra-knee injection.