关节镜联合富血小板血浆治疗痛风性关节炎的临床应用

Clinical application study of arthroscopy combined with platelet-rich plasma in the treatment of gouty arthritis

目的探讨关节镜联合富血小板血浆治疗痛风性关节炎的临床应用效果。方法以本院2020年8月-2022年9月收治的35例痛风性关节炎患者为研究对象,随机分三组。关节镜组10例,仅使用关节镜清理痛风石;富血小板血浆组13例,直接应用自体富血小板血浆及血凝酶注射;关节镜联合富血小板血浆组12例,在关节镜清理痛风石的同时,采用自体富血小板血浆及血凝酶注射。比较三组患者术前、术后切口愈合等级,ESR、CRP与UA,VAS评分,生活质量。结果三组之间术区切口愈合等级情况对比差异具有明显的统计学意义(P<0.05)。术前、术后,三组红细胞沉降率(ESR)、C反应蛋自(CRP)、血尿酸水平(UA)的水平对比,差异无统计学意义(P>0.05)。术后12个月VAS评分,关节镜联合富血小板血浆组低于同期关节镜组及富血小板血浆组,差异有统计学意义(P<0.05)。三组患者术后的生活质量比较明显大于术前;术后1年观察,关节镜联合富血小板血浆组生活质量评分优于单纯关节镜组(P<0.05)。结论关节镜联合富血小板血浆可降低术区切口感染,降低VAS评分,且生活质量改善,值得临床推广应用。

Objective To explore the clinical application of arthroscopy combined with platelet-rich plasma in the treatment of gouty arthritis.Methods Thirty-five cases of gouty arthritis patients admitted to our hospital from August 2020 to September 2023 were taken as the study subjects and randomly divided into 3 groups.There were 10 cases in the arthroscopy group,in which only arthroscopy was used to clean up gouty stones;13 cases in the platelet-rich plasma group,in which autologous platelet-rich plasma and haemocoagulase injection were directly applied;and 12 cases in the arthroscopy-combined platelet-rich plasma group,in which autologous platelet-rich plasma and haemocoagulase injection were used in conjunction with arthroscopic cleaning up of gouty stones.To compare the preoperative and postoperative incision healing grades,ESR,CRP and UA,VAS scores,and quality of life among the three groups.Results There was a significant difference in the comparison of the healing grade of incision in the operation area between the three groups,and the difference was statistically significant(P<0.05).Preoperatively and postoperatively,the levels of ESR,CRP and UA were compared among the three groups,and the differences were not statistically significant(P>0.05).The VAS score at 12 months after surgery was lower in the arthroscopy combined with platelet-rich plasma group than in the arthroscopy group and platelet-rich plasma group at the same time,and the difference was statistically significant(P<0.05).The postoperative quality of life of the three groups of patients was significantly greater than that of the preoperative period;the quality of life score of the arthroscopy combined with platelet-rich plasma group was better than that of the arthroscopy-only group when observed at 1 year postoperatively(P<0.05).Conclusion Arthroscopy combined with platelet-rich plasma can reduce the incision infection in the operation area,reduce the VAS score,and improve the quality of life,which is worthy of clinical promotion and application.