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| 超声引导下富血小板血浆注射治疗足底筋膜炎的疗效观察 |
| Beneficial effects of ultrasound guided platelet-rich plasma injection treating chronic plantar fasciitis |
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| DOI：10.12089/jca.2018.11.008 |
| 中文关键词: 超声引导 富血小板血浆 足底筋膜炎 |
| 英文关键词: Ultrasound guided Platelet-rich plasma Plantar fasciitis |
| 基金项目: |
| 作者 | 单位 | E-mail | | 程浩 | 210006,南京医科大学附属南京医院,南京市第一医院麻醉科 | | | 陆伟萍 | 210006,南京医科大学附属南京医院,南京市第一医院麻醉科 | | | 高献忠 | 210006,南京医科大学附属南京医院,南京市第一医院麻醉科 | | | 徐晨婕 | 210006,南京医科大学附属南京医院,南京市第一医院麻醉科 | | | 管华 | 210006,南京医科大学附属南京医院,南京市第一医院麻醉科 | | | 鲍红光 | 210006,南京医科大学附属南京医院,南京市第一医院麻醉科 | hongguang_bao@hotmail.com |
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| 中文摘要: |
目的 观察超声引导下局部注射富血小板血浆(PRP)与类固醇激素治疗足底筋膜炎的临床疗效。
方法 选择2016年6月至2017年3月就诊于本院疼痛科的足底筋膜炎患者32例, 男9例, 女23例, 年龄36～73岁, BMI 18～35 kg/m2。随机分为超声引导下富血小板血浆注射治疗组(PRP组)和超声引导下类固醇激素注射治疗组(S组), 每组16例。在超声引导下PRP组将制备出的4 ml PRP注入跖筋膜表面。S组将复方倍他米松1 ml+2%盐酸利多卡因注射液2 ml的混合液注入跖筋膜表面。评估患者注射治疗前(T0)和治疗后1个月(T1)、3个月(T2)、6个月(T3) 时晨起后起步状态、步行10步后状态和当天总体平均状态的VAS评分。采用超声测量T0和T2时患者俯卧位时跟骨-筋膜结合处足底筋膜厚度。观察注射部位有无出血、血肿、感染以及足底筋膜有无撕裂等并发症。
结果 与T0时比较, T1、T2和T3时两组患者晨起后起步状态、步行10步后状态和当天总体平均状态VAS评分均明显降低(P<0.05)。与S组比较, T1和T2时PRP组晨起后起步状态、步行10步后状态和当天总体平均状态VAS评分明显升高(P<0.05), T3时PRP组晨起后起步状态、步行10步后状态和当天总体平均状态VAS评分明显降低(P<0.05)。与T0时比较, T2时两组足底筋膜厚度明显变薄(P<0.05), T0和T2时两组足底筋膜厚度差异无统计学意义。两组患者治疗后均未发现出血、血肿、感染以及足底筋膜撕裂等并发症。
结论 超声引导下局部注射富血小板血浆与类固醇激素均能有效治疗足底筋膜炎, 激素局部注射显效快, 但富血小板血浆疗效相对更稳定持久。 |
| 英文摘要: |
Objective To clinically examine the effects of ultrasound guided platelet-rich plasma (PRP) versus traditional corticosteroid injection in treating chronic plantar fasciitis.
Methods Thirty-two consecutive patients with the final diagnosis of chronic plantar fasciitis,9 males and 23 females, aged 36-73 years, with a BMI of 18-35 kg/m2, were randomly assigned to group PRP (that received PRP, n = 16) and group S (that received corticosteroid, n = 16). In group PRP, 4 ml PRP taken from the patients’ blood was injected in a single dose. In group S, a single dose of diprospan anesthetic was locally injected. The endpoints in the present study were changes in the visual analog scale score from baseline, 1 month, 3 months, and 6 months follow-up. The thickness of the plantar fascia was also assessed by B-mode sonography before and also 3 months after treatment. Complications such as bleeding, hematoma, infection and tearing of plantar fascia at the injection site were observed after treatment.
Results Group PRP had significantly higherpain sever score at 3 time points of before injection, as well as 1 and 3 months after PRP use when compared to group S (P < 0.05). However, group S experienced significantly higher pain severity the group PRP 6 months after interventions. In sonography assessment, the thickness of the posterior plantar fascia of the two groups decreased significantly when compared with that before treatment (P < 0.05), but no difference was revealed at 3 months after treatment. No complications such as hemorrhage, hematoma, infection or plantar fascia tear were found after treatment in both groups.
Conclusion Both ultrasound guided PRP and corticosteroid injection are effective for plantar fasciitis. Corticosteroid injection therapy is superior to PRP in respect to short term effect, but PRP exhibits a longer-lasting effect. |
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