富含血小板血浆治疗慢性跖筋膜炎疗效分析
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摘要
目的探讨应用富含血小板血浆(platelet-rich plasma,PRP)注射治疗慢性跖筋膜炎的有效性和安全性。方法选取2014年1月至2016年3月于本院治疗的慢性跖筋膜炎患者19例(21足)纳入本研究。每例患者均采集自体静脉血制备PRP,胫后神经阻滞后行跖筋膜穿刺,均匀注入2 ml PRP。记录患者注射后不良反应,采用视觉模拟评分法(visual analogue scale,VAS)、美国足踝外科学会(American Orthopaedic Foot&Ankle Society,AOFAS)踝-后足评分系统评价患者足踝部疼痛及功能改善情况,采用改良Roles and Maudsley评分系统评价患者治疗满意度。结果与治疗前相比,患者治疗后6个月、12个月VAS评分均显著下降(P_均<0.001),AOFAS踝-后足评分均显著上升(P_均<0.001);治疗后12个月,患者治疗满意8例(42.1%),良好8例(42.1%),不满意3例(15.8%)。注射PRP后患者未出现严重不良反应。结论跖筋膜穿刺注射PRP治疗慢性跖筋膜炎安全有效,能有效改善患者足部疼痛及活动受限。
Objective To investigate the e?cacy and safety of platelet-rich plasma(PRP) injection in the treatment of chronic plantar fasciitis. Method 19 patients(21 feet) with chronic plantar fasciitis treated in our hospital from January 2014 to March 2016 were selected for the study. Autologous venous blood was extracted from each patient to prepare PRP. After tibial posterior nerve block, plantaris fascia puncture was performed and 2 ml PRP was injected uniformly. Adverse reactions after injection were recorded, and ankle pain and functional improvement were evaluated by visual analogue scale(VAS) and American Orthopaedic Foot & Ankle Society(AOFAS) ankle hindfoot scale. The modi?ed Roles and Maudsley score were used to evaluate patients' treatment satisfaction. Result Compared with before treatment, VAS scores of the patients were signi?cantly decreased at 6 months and 12 months after treatment(Pall< 0.001), and AOFAS ankle hindfoot scores were signi?cantly increased(Pall< 0.001). 12 months after treatment, the patients' treatment satisfaction was evaluated, including 8 cases(42.1%) who were satis?ed, 8 cases(42.1%) who were good, and 3 cases(15.8%) who were not satis?ed.No serious adverse reactions occurred after PRP injection. Conclusion Plantar fascia puncture injection of PRP is a safe and effective treatment for chronic plantar fascitis, which can effectively improve the patients' foot pain and movement limitation.
Objective To investigate the e?cacy and safety of platelet-rich plasma(PRP) injection in the treatment of chronic plantar fasciitis. Method 19 patients(21 feet) with chronic plantar fasciitis treated in our hospital from January 2014 to March 2016 were selected for the study. Autologous venous blood was extracted from each patient to prepare PRP. After tibial posterior nerve block, plantaris fascia puncture was performed and 2 ml PRP was injected uniformly. Adverse reactions after injection were recorded, and ankle pain and functional improvement were evaluated by visual analogue scale(VAS) and American Orthopaedic Foot & Ankle Society(AOFAS) ankle hindfoot scale. The modi?ed Roles and Maudsley score were used to evaluate patients' treatment satisfaction. Result Compared with before treatment, VAS scores of the patients were signi?cantly decreased at 6 months and 12 months after treatment(Pall< 0.001), and AOFAS ankle hindfoot scores were signi?cantly increased(Pall< 0.001). 12 months after treatment, the patients' treatment satisfaction was evaluated, including 8 cases(42.1%) who were satis?ed, 8 cases(42.1%) who were good, and 3 cases(15.8%) who were not satis?ed.No serious adverse reactions occurred after PRP injection. Conclusion Plantar fascia puncture injection of PRP is a safe and effective treatment for chronic plantar fascitis, which can effectively improve the patients' foot pain and movement limitation.
引文
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[3]Malliaropoulos N,Crate G,Meke M,et al.Success and Recurrence Rate after Radial Extracorporeal Shock Wave Therapy for Plantar Fasciopathy:A Retrospective Study[J].Biomed Res Int,2016,2016(3):1-8.
[4]中国研究型医院学会冲击波医学专业委员会.中国骨肌疾病体外冲击波疗法指南(2019年版)[J].中国医学前沿杂志(电子版),2019,11(4):1-10.
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[6]黄涛,李修成,邹春平,等.胫神经阻滞在老年人足部手术中的应用[J].中国老年学杂志,2013,33(6):1407-1408.
[7]Kalaci A,Cakici H,Hapa O,et al.Treatment of plantar fasciitis using four different local injection modalities:a randomized prospective clinical trial[J].J Am Podiatr Med Assoc,2009,99(2):108-113.
[8]Roles NC,Maudsley RH.Radial tunnel syndrome:resistant tennis elbow as a nerve entrapment[J].J Bone Joint Surg Br,1972,54(3):499-508.
[9]Lemont H,Ammirati KM,Usen N.Plantar fasciitis:a degenerative process(fasciosis)without inflammation[J].J Am Podiatr Med Assoc,2003,93(3):234-237.
[10]Cavazos GJ,Khan KH,D'antoni AV,et al.Cryosurgery for the treatment of heel pain[J].Foot Ankle Int,2009,30(6):500-505.
[11]Leach RE,Seavey MS,Salter DK.Results of surgery in athletes with plantar fasciitis[J].Foot Ankle,1986,7(3):156-161.
[12]Monto RR.Platelet-rich plasma efficacy versus corticosteroid injection treatment for chronic severe plantar fasciitis[J].Foot Ankle Int,2014,35(4):313-318.
[13]Crawford F,Atkins D,Young P,et al.Steroid injection for heel pain:evidence of short-term effectiveness.A randomized controlled trial[J].Rheumatology(Oxford),1999,38(10):974-977.
[14]Acevedo JI,Beskin JL.Complications of plantar fascia rupture associated with corticosteroid injection[J].Foot Ankle Int,1998,19(2):91-97.
[15]Monteagudo M,Maceira E,Garcia-Virto V,et al.Chronic plantar fasciitis:plantar fasciotomy versus gastrocnemius recession[J].Int Orthop,2013,37(9):1845-1850.
[16]Martinelli N,Marinozzi A,CarnìS,et al.Platelet-rich plasma injections for chronic plantar fasciitis[J].Int Orthop,2013,37(5):839-842.
[17]Davies MS,Weiss GA,Saxby TS.Plantar fasciitis:how successful is surgical intervention?[J].Foot Ankle Int,1999,20(12):803-807.
[18]魏芳远,张建中.富血小板血浆及其在足踝外科的应用与点评[J].足踝外科电子杂志,2014,1(1):58-62.
[2]Lafuente Guijosa A,O'mullony Mu?oz I,de La Fuente ME,et al.Plantar Fasciitis:Evidence-Based Review of Treatment[J].Reumatología Clínica,2007,3(4):159-165.
[3]Malliaropoulos N,Crate G,Meke M,et al.Success and Recurrence Rate after Radial Extracorporeal Shock Wave Therapy for Plantar Fasciopathy:A Retrospective Study[J].Biomed Res Int,2016,2016(3):1-8.
[4]中国研究型医院学会冲击波医学专业委员会.中国骨肌疾病体外冲击波疗法指南(2019年版)[J].中国医学前沿杂志(电子版),2019,11(4):1-10.
[5]Hsiao MY,Hung CY,Chang KV,et al.Comparative effectiveness of autologous blood-derived products,shock-wave therapy and corticosteroids for treatment of plantar fasciitis:a network meta-analysis[J].Rheumatology(Oxford),2015,54(9):1735-1743.
[6]黄涛,李修成,邹春平,等.胫神经阻滞在老年人足部手术中的应用[J].中国老年学杂志,2013,33(6):1407-1408.
[7]Kalaci A,Cakici H,Hapa O,et al.Treatment of plantar fasciitis using four different local injection modalities:a randomized prospective clinical trial[J].J Am Podiatr Med Assoc,2009,99(2):108-113.
[8]Roles NC,Maudsley RH.Radial tunnel syndrome:resistant tennis elbow as a nerve entrapment[J].J Bone Joint Surg Br,1972,54(3):499-508.
[9]Lemont H,Ammirati KM,Usen N.Plantar fasciitis:a degenerative process(fasciosis)without inflammation[J].J Am Podiatr Med Assoc,2003,93(3):234-237.
[10]Cavazos GJ,Khan KH,D'antoni AV,et al.Cryosurgery for the treatment of heel pain[J].Foot Ankle Int,2009,30(6):500-505.
[11]Leach RE,Seavey MS,Salter DK.Results of surgery in athletes with plantar fasciitis[J].Foot Ankle,1986,7(3):156-161.
[12]Monto RR.Platelet-rich plasma efficacy versus corticosteroid injection treatment for chronic severe plantar fasciitis[J].Foot Ankle Int,2014,35(4):313-318.
[13]Crawford F,Atkins D,Young P,et al.Steroid injection for heel pain:evidence of short-term effectiveness.A randomized controlled trial[J].Rheumatology(Oxford),1999,38(10):974-977.
[14]Acevedo JI,Beskin JL.Complications of plantar fascia rupture associated with corticosteroid injection[J].Foot Ankle Int,1998,19(2):91-97.
[15]Monteagudo M,Maceira E,Garcia-Virto V,et al.Chronic plantar fasciitis:plantar fasciotomy versus gastrocnemius recession[J].Int Orthop,2013,37(9):1845-1850.
[16]Martinelli N,Marinozzi A,CarnìS,et al.Platelet-rich plasma injections for chronic plantar fasciitis[J].Int Orthop,2013,37(5):839-842.
[17]Davies MS,Weiss GA,Saxby TS.Plantar fasciitis:how successful is surgical intervention?[J].Foot Ankle Int,1999,20(12):803-807.
[18]魏芳远,张建中.富血小板血浆及其在足踝外科的应用与点评[J].足踝外科电子杂志,2014,1(1):58-62.