| 摘要: |
| ［摘要］ 目的 观察肌骨超声引导下注射富血小板血浆（PRP）在肱骨外上髁炎（LE）患者术后康复治疗中的应用效果。方法 招募2022年3月至2023年3月在唐山市第二医院行关节镜下射频消融术治疗的106例LE患者，采用随机数字表法将其分为对照组（53例）和观察组（53例）。术后对照组行常规康复训练，观察组在对照组的基础上联合肌骨超声引导下注射PRP治疗，连续4周。于康复治疗前、康复治疗第2周、康复治疗第4周比较两组疼痛程度、血清炎症因子水平、肘关节功能及上肢功能、无痛握力（PFG）及日常生活能力。于术后第6个月比较两组肘关节功能恢复优良率。记录两组术后康复治疗期间并发症发生情况。结果 两组康复治疗第2周、康复治疗第4周前臂外旋、前臂内旋及静息状态下疼痛数字评价量表（NRS）评分显著低于康复治疗前（P<0.05），且观察组显著低于对照组（P<0.05）。两组康复治疗第2周、康复治疗第4周血清C反应蛋白（CRP）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平显著低于康复治疗前（P<0.05），且观察组显著低于对照组（P<0.05）。两组康复治疗第2周、康复治疗第4周Mayo肘关节功能评分系统（MEPS）、PFG和日常生活活动（ADL）评分显著高于康复治疗前（P<0.05），且观察组显著高于对照组（P<0.05）。两组康复治疗第2周、康复治疗第4周上肢功能障碍（DASH）评分显著低于康复治疗前（P<0.05），且观察组显著低于对照组（P<0.05）。观察组肘关节功能恢复优良率显著高于对照组（92.45% vs 77.36%， χ2=4.711，P=0.030）。两组术后康复治疗期间均无切口感染、血管神经损伤、肘关节局部肿胀、疼痛加剧等并发症发生。结论 肌骨超声引导下注射PRP联合常规康复训练能显著改善LE患者术后上肢功能、肘关节功能，减轻疼痛程度，降低炎症状态，安全有效。 |
| 关键词: 肱骨外上髁炎 肌骨超声 富血小板血浆 上肢功能 肘关节功能 炎症状态 |
| DOI：10.3969/j.issn.1674-3806.2025.04.11 |
| 分类号:R 687.4 |
| 基金项目:河北省医学科学研究重点课题计划项目（编号：20210251） |
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| Observation on application effectiveness of musculoskeletal ultrasound-guided injection of platelet-rich plasma in rehabilitation treatment of lateral epicondylitis patients after surgery |
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ZHU Lina, LI Haize, LIU Yajuan, LIU Hongxin
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Department of Function Check, the Second Hospital of Tangshan, Tangshan 063000, China
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| Abstract: |
| ［Abstract］ Objective To observe the application effectiveness of musculoskeletal ultrasound-guided injection of platelet-rich plasma(PRP) in rehabilitation treatment of lateral epicondylitis(LE) patients after surgery. Methods A total of 106 patients with LE who underwent arthroscopic-assisted radiofrequency ablation in the Second Hospital of Tangshan from March 2022 to March 2023 were recruited. The patients were divided into control group(53 cases) and observation group(53 cases) by using random number table method. After surgery, the control group received routine rehabilitation training, while the observation group received the same routine rehabilitation traing in combination with musculoskeletal ultrasound-guided injection of PRP. Both of the two groups were treated for 4 consecutive weeks. The pain intensity, levels of serum inflammatory factors, elbow joint function and upper limb function, pain-free grip strength(PFG) and activities of daily living(ADL) were compared between the two groups before rehabilitation treatment, at the 2nd week of rehabilitation treatment and at the 4th week of rehabilitation treatment. The excellent and good rate of elbow joint function recovery was compared between the two groups at the 6th month after surgery. The occurrence of complications during the postoperative rehabilitation treatment period was recorded in the two groups. Results The Numeric Rating Scale(NRS) scores for assessing pain under forearm external rotation, pain under forearm internal rotation and resting pain in both groups at the 2nd week of rehabilitation treatment and at the 4th week of rehabilitation treatment were significantly lower than those before rehabilitation treatment(P<0.05), and the scores in the observation group were significantly lower than those in the control group after rehabilitation treatment(P<0.05). The levels of serum C-reactive protein(CRP), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in both groups at the 2nd week of rehabilitation treatment and at the 4th week of rehabilitation treatment were significantly lower than those before rehabilitation treatment(P<0.05), and the levels in the observation group were significantly lower than those in the control group after rehabilitation treatment(P<0.05). The Mayo elbow performance scores(MEPS), PFG scores and ADL scale scores in both groups at the 2nd week of rehabilitation treatment and at the 4th week of rehabilitation treatment were significantly higher than those before rehabilitation treatment(P<0.05), and the scores in the observation group were significantly higher than those in the control group after rehabilitation treatment(P<0.05). The disabilities of the arm, shoulder and hand(DASH) scores in both groups at the 2nd week of rehabilitation treatment and at the 4th week of rehabilitation treatment were significantly lower than those before rehabilitation treatment(P<0.05), and the scores in the observation group were significantly lower than those in the control group after rehabilitation treatment(P<0.05). The excellent and good rate of elbow joint function recovery in the observation group was significantly higher than that in the control group(92.45% vs 77.36%, χ2=4.711, P=0.030). During the postoperative rehabilitation treatment period, there were no complications such as incision infection, vascular and nerve damage, local swelling of the elbow joints and pain aggravation in both groups. Conclusion The musculoskeletal ultrasound-guided injection of PRP combined with routine rehabilitation training can significantly improve LE patients′ upper limb function and elbow joint function after surgery, reduce their pain intensity and inflammatory state, and is safe and effective. |
| Key words: Lateral epicondylitis(LE) Musculoskeletal ultrasound Platelet-rich plasma(PRP) Upper limb function Elbow joint function Inflammatory state |
