2020 年第 5 期 第 15 卷

自体富血小板血浆治疗正中神经损伤的临床效果

Clinical effect of autologous platelet-rich plasma on median nerve injury

作者：王辉1;王贺2;赵峰1;高宏阳1;裴宏磊1;吕亚军1

英文作者：Wang Hui1 Wang He2 Zhao Feng1 Gao Hongyang1 Pei Honglei1 Lyu Yajun1

单位：1河北医科大学第一医院骨科，石家庄050031；2河北医科大学病原生物教研室，石家庄050017

英文单位：1Department of Orthopedics the First Hospital of Hebei Medical University Shijiazhuang 050031 China; 2Teaching and Research Section of Pathogenic Organism Hebei Medical University Shijiazhuang 050017 China

关键词：正中神经损伤；自体富血小板血浆；神经再生

英文关键词：Mediannerveinjury;Autologusplatelet-richplasma;Neuralregeneration

• 摘要：

• 目的 观察自体富血小板血浆（PRP）治疗正中神经损伤的临床效果。方法 选取2016年3月至2018年3月在河北医科大学第一医院骨科治疗的腕部周围正中神经完全断裂的患者35例，完全随机分为对照组（18例）和观察组（17例）。对照组行常规正中神经吻合术；观察组在行正中神经吻合术后于吻合口周围注射PRP。观察比较2组患者感觉、肌力及肌电图指标恢复情况。结果 2组患者均随访 12个月以上，对照组失访4例、观察组失访2 例。观察组术后1、3、6、12个月的疼痛视觉模拟量表评分、肌电图感觉神经传导速度高于对照组［传导速度：（21±6）m/s比（12±4）m/s、（33±4）m/s比（25±10）m/s、（43±3）m/s比（37±6）m/s、（63±5）m/s比（49±5）m/s］，术后1、3、6个月的肌力及肌电图运动神经传导速度高于对照组，差异均有统计学意义（均P＜0.05），术后12个月的肌力及肌电图运动神经传导速度2组比较差异均无统计学意义（均P>0.05）。结论PRP注射可以作为促进正中神经吻合术后神经功能恢复的方法 之一，且正中神经感觉功能的恢复优于运动功能的恢复。

• Objective To observe the clinical effect of autologous platelet-rich plasma(PRP) on median nerve injury. Methods Totally 35 patients with median nerve injury in the First Hospital of Hebei Medical University, from March 2016 to March 2018, were randomly divided into control group(18 cases) and the observation group(17 cases). The control group had conventional median nerve anastomosis, observation group had peripheral injection of PRP after median nerve anastomosis. The recovery of sensation and muscle strength were observed. Results The patients in both groups were followed up for more than 12 months. Four cases in the control group and 2 cases in the observation group were lost follow-up. After 1, 3, 6 and 12 months, visual analogue scales score and sense nerve conduction velocity(SNCV) in observation group were higher than those in control group［SNCV:（21±6）m/s vs （12±4）m/s, （33±4）m/s vs （25±10）m/s, （43±3）m/s vs （37±6）m/s, （63±5）m/s vs （49±5）m/s］(all P＜0.05).  After 1, 3 and 6 months, muscle strength and motor nerve conduction velocity(MNCV) in observation group were higher than that in control group(all P＜0.05). After 12 months, there were no significant differences in muscle strength and MNCV difference(all P>0.05). ConclusionPRP can promote the recovery of nerve function after median nerve anastomosis. The recovery of sensory function is better than that of motor function.