摘要
目的 观察全膝关节置换术(TKA)术后给予自体富血小板血浆(PRP)联合血凝酶(HCA)治疗的效果,并探讨其对创面愈合的影响。方法 选取2022年7月至2024年5月南阳市中心医院收治的120例行TKA术的膝关节骨性关节炎患者作为研究对象,采用随机抽签法将其分为对照组(HCA治疗)和观察组(自体PRP联合HCA治疗),每组60例。治疗3周后比较两组患者的临床疗效,以及治疗前、治疗3周后的疼痛程度[视觉模拟评分法(VAS)]、膝关节功能恢复情况[Lysholm膝关节功能评分表(LKSS)、西安大略大学和麦克马斯特大学骨关节炎指数量表(WOMAC)]、膝关节活动度[关节活动度(ROM)],并比较两组患者的术后创面愈合情况。结果 治疗后,观察组患者的总有效率为95.00%,明显高于对照组的80.00%,差异有统计学意义(P<0.05);治疗后,观察组患者的VAS评分为(1.51±0.26)分,明显低于对照组的(2.08±0.38)分,LKSS评分为(86.42±9.65)分,明显高于对照组的(75.72±8.19)分,差异均有统计学意义(P<0.05);治疗后,观察组患者的主动关节和被动关节活动度分别为(121.58±13.51)°、(130.51±14.61)°,明显大于对照组的(116.75±12.33)°、(124.62±13.73)°,而WOMAC评分为(92.13±10.14)分,明显低于对照组的(104.52±12.42)分,差异均有统计学意义(P<0.05);治疗后,观察组患者的创面愈合等级优于对照组,但差异无统计学意义(P>0.05)。结论 PRP联合HCA辅助TKA手术治疗膝关节骨性关节炎患者的效果优于单纯HCA治疗,且联合治疗可较好缓解患者术后疼痛,提高膝关节活动,促进膝关节功能恢复,加速术后创面愈合。
Objective To observe the therapeutic effects of autologous platelet-rich plasma(PRP)combined with hemocoagulase(HCA)after total knee arthroplasty(TKA)and explore its impact on wound healing.Methods A total of 120 patients with knee osteoarthritis who underwent TKA at Nanyang Central Hospital from July 2022 to May 2024 were selected as the study subjects.They were randomly divided into a control group(treated with HCA)and an observation group(treated with autologous PRP combined with HCA),with 60 patients in each group.After 3 weeks of treatment,the clinical efficacy,pain level(Visual Analog Scale[VAS]),knee function recovery(Lysholm Knee Scoring Scale[LKSS],Western Ontario and McMaster Universities Osteoarthritis Index[WOMAC]),and knee joint range of motion(ROM)were compared between the two groups before and after treatment.Postoperative wound healing was also evaluated.Results After treatment,the total effective rate in the observation group was 95.00%,significantly higher than 80.00%in the control group(P<0.05).The VAS score in the observation group was(1.51±0.26)points,significantly lower than(2.08±0.38)points in the control group,while the LKSS score was(86.42±9.65)points,significantly higher than(75.72±8.19)points in the control group(P<0.05).The active and passive ROM in the observation group were(121.58±13.51)°and(130.51±14.61)°,respectively,significantly greater than(116.75±12.33)°and(124.62±13.73)°in the control group,while the WOMAC score was(92.13±10.14)points,significantly lower than(104.52±12.42)points in the control group(P<0.05).The wound healing grade in the observation group was better than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion PRP combined with HCA as an adjunct to TKA for knee osteoarthritis patients yields superior outcomes compared to HCA alone.The combined therapy effectively alleviates postoperative pain,improves knee joint mobility,promotes functional recovery,and accelerates wound healing.
作者
王波
王华磊
杨讯
叶向阳
王挺
杨旭
WANG Bo;WANG Hua-lei;YANG Xun;YE Xiang-yang;WANG Ting;YANG Xu(Department of Blood Transfusion,Nanyang Central Hospital,Nanyang 473000,Henan,CHINA;Department of Orthopaedics,Nanyang Central Hospital,Nanyang 473000,Henan,CHINA)
出处
《海南医学》
2025年第11期1581-1584,共4页
Hainan Medical Journal
基金
2023年度河南省南阳市科技发展计划项目(编号:23KJGG094)。
