中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (11): 1856-1859.doi: 10.4103/1673-5374.165322

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

治疗腕管综合征新方法:富血小板血浆单次注射

  

  • 收稿日期:2015-07-27 出版日期:2015-12-07 发布日期:2015-12-07

Single injection of platelet-rich plasma as a novel treatment of carpal tunnel syndrome

Michael Alexander Malahias¹, Elizabeth O. Johnson², George C. Babis¹, Vasileios S. Nikolaou¹,*   

  1. 1 Second Department of Orthopedics, Athens University, Athens, Greece
    2 Department of Anatomy, School of Medicine, Athens University, Athens, Greece
  • Received:2015-07-27 Online:2015-12-07 Published:2015-12-07
  • Contact: Vasileios S. Nikolaou, M.D., Ph.D.,vassilios.nikolaou@gmail.com.

摘要:

体外和体内实验均已证实,富血小板血浆对许多神经病变有治疗作用,但其对腕管综合征的治疗效果仍不明确。为验证富血小板血浆单次注射对腕管综合征患者有正中神经损伤临床症状的改善作用,试验纳入14例轻中度腕管综合征患者,病程均在3个月以上。在超声引导下给予患者正中神经周围的腕管近边注射富血小板血浆1-2 mL。富血小板血浆单次注射1个月后,视觉类比量表评估显示8例患者疼痛(几乎)消失,3例患者疼痛明显减轻。上肢功能问卷评估显示患者上肢功能明显改善。超声检测正中神经宽度时可见,5例患者无腕管综合征超声表现。3个月的随访中,3例患者疼痛改善不明显。说明富血小板血浆单次注射对于腕管综合征有周围神经损伤的中期治疗效果是值得肯定的。

关键词: 神经再生, 腕管综合征, 富血小板血浆, 超声引导, 初步研究

Abstract:

Both in vitro and in vivo experiments have confirmed that platelet-rich plasma has therapeutic effects on many neuropathies, but its effects on carpal tunnel syndrome remain poorly understood. We aimed to investigate whether single injection of platelet-rich plasma can improve the clinical symptoms of carpal tunnel syndrome. Fourteen patients presenting with median nerve injury who had suffered from mild carpal tunnel syndrome for over 3 months were included in this study. Under ultrasound guidance, 1–2 mL of platelet-rich plasma was injected into the region around the median nerve at the proximal edge of the carpal tunnel. At 1 month after single injection of platelet-rich plasma, Visual Analogue Scale results showed that pain almost disappeared in eight patients and it was obviously alleviated in three patients. Simultaneously, the disabilities of the arm, shoulder and hand questionnaire showed that upper limb function was obviously improved. In addition, no ultrasonographic manifestation of the carpal tunnel syndrome was found in five patients during ultrasonographic measurement of the width of the median nerve. During 3-month follow-up, the pain was not greatly alleviated in three patients. These findings show very encouraging mid-term outcomes regarding use of platelet-rich plasma for the treatment of carpal tunnel syndrome.
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Key words: nerve regeneration, carpal tunnel syndrome, platelet-rich plasma, ultrasound guidance, pilot study, neural regeneration