血小板丰富血注射后,不充分的抗凝和高尿血导致膝盖疼痛:一项回顾性研究
Yang Chen1, Hongxun Sang1, Song Wu2
1Department of Orthopedics, Shenzhen Hospital, Southern Medical University, Shenzhen, China.
Journal of orthopaedic surgery (Hong Kong)
|August 19, 2024
概括
使用较低剂量的抗凝血剂,如酸 (SC) 在富血小板血 (PRP) 制备膝关节关节炎可能会减少治疗后的疼痛. SC通常表现出比肝素更好的结果,但疗效随着时间的推移而减弱.
科学领域:
- 整形外科 整形外科 整形外科
- 再生医学是一种再生医学.
- 生物化学 生物化学
背景情况:
- 富血小板血 (PRP) 疗法为膝关节骨关节炎 (OA) 提供了一个潜在的非手术选择,延迟了需要全膝关节置换的需要.
- 标准化PRP制剂,特别是抗凝剂的使用,仍然是一个挑战,可能会影响治疗结果和患者的疼痛.
- 了解不同抗凝剂及其度对PRP疗效和患者报告的疼痛的影响对于临床应用至关重要.
研究的目的:
- 调查PRP制剂中使用的抗凝剂类型和剂量与膝关节OA患者治疗后疼痛之间的关系.
- 评估PRP治疗膝关节OA的中长期和长期疗效.
- 识别可能影响PRP治疗结果的其他因素,如高尿路血.
主要方法:
- 在3个中心对225名膝关节OA患者进行了回顾性研究,从2021年6月至2022年1月接受PRP治疗.
- 患者根据使用的抗凝剂进行分类:4%的酸盐 (SC) 0.6,1或2毫升,或肝素0.1或0.2毫升.
- 分析包括治疗后的疼痛,通过ELISA的炎症标志物 (IL-6,TNF-α,hs-CRP),关节液结晶,以及西部安大略省和麦克马斯特大学关节炎 (WOMAC) 评分.
主要成果:
- 与较高剂量相比,较低剂量的SC (0.6毫升) 和肝素 (0.1毫升) 与PRP后疼痛减少和炎症标志物减少有关.
- 与肝素相比,SC显示中长期治疗结果略有优异.
- 控制不良的高尿路血症患者报告治疗后疼痛增加.
结论:
- 高剂量抗凝剂或PRP在患有失控高尿素血症的患者中可以增加注射后疼痛和输液的风险.
- PRP对于膝关节OA是有效的,但其治疗效益可能会随着时间的推移而减少.
- 酸似乎比肝素更适合在膝盖骨折中使用PRP制剂,尽管需要进一步研究安全性和影响因素.
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