超声引导下注射PRP联合发散式冲击波治疗NeerⅡ期肩袖损伤的临床疗效观察

Clinical observation of ultrasound guided injection of PRP combined with divergent shock wave in treatment of Neer Ⅱ rotator cuff injury

目的观察超声引导下注射富血小板血浆联合发散式冲击波治疗NeerⅡ期肩袖损伤的临床疗效。方法回顾性分析自2020年2月-2023年2月诊治的74例NeerⅡ期肩袖损伤患者为研究对象,运用信封法分成对照组(37例,发散式冲击波治疗)、研究组(37例,采取超声引导下注射富血小板血浆+发散式冲击波治疗),两组患者在治疗后接受统一的康复治疗方案,并于治疗后1个月时随访记录两组患者疼痛视觉模拟评分(VAS)、炎症因子水平(TNF-α、IL-6)、肩关节主动前屈活动度,对比两组患者组间、组内的治疗差异性。结果研究组治疗后VAS评分(3.39±0.65)分低于对照组(3.89±0.71)分。研究组治疗后炎症因子水平TNF-α(132.72±6.37)pg/ml、IL-6(15.72±2.36)pg/ml低于对照组(151.86±6.83)pg/ml、(20.82±2.43)pg/ml。研究组治疗后肩关节主动前屈活动度(165.72±7.36)°大于对照组(145.82±8.43)°。两组治疗后VAS评分、炎症因子水平(TNF-α、IL-6)、肩关节主动前屈活动度差异均存在统计学意义(P<0.05)。结论对于NeerⅡ期肩袖损伤采取超声引导下注射富血小板血浆联合发散式冲击波治疗较单独采用发散式冲击波治疗可早期更好的抑制肩关节内炎性反应、降低肩关节疼痛、改善肩关节活动度。

Objective To observe the clinical effect of ultrasound guided injection of platelet-rich plasma combined with divergent shock wave in the treatment of Neer Ⅱ rotator cuff injury.Methods A retrospective analysis was performed on 74 patients with Stage Ⅱ rotator cuff injury diagnosed and treated from February 2020 to February 2023.They were divided into control group(37 cases,divergent shock wave therapy)and study group(37 cases,ultrasound guided injection of platelet-rich plasma combined with divergent shockwave therapy)by envelope method.Patients in both groups received unified rehabilitation treatment after treatment,and visual analog scale(VAS),inflammatory factor levels(TNF-α,IL-6)and active forward mobility of shoulder joint of the two groups were followed up at 1 month after treatment,and the differences in treatment between and within the two groups were compared.Results The VAS score of the study group(3.39±0.65)was lower than that of the control group(3.89±0.71).The levels of TNF-α(132.72±6.37)pg/ml and IL-6(15.72±2.36)pg/ml in the study group were lower than those in the control group(151.86±6.83)pg/ml and(20.82±2.43)pg/ml.The active flexor motion of shoulder joint in the study group(165.72±7.36)°was higher than that in the control group(145.82±8.43)°.VAS scores,levels of inflammatory factors(TNF-α,IL-6)and active flexion motion of shoulder between the two groups after treatment were statistically significant(P<0.05).Conclusions For Neer Ⅱ rotator cuff injury,ultrasound guided injection of plateletrich plasma combined with divergent shock wave therapy can better inhibit the inflammatory response in the shoulder joint,reduce shoulder pain,and improve the range of motion of the shoulder joint compared with divergent shock wave therapy alone in the early stage.