富血小板血浆联合深层肌肉刺激对早期膝骨关节炎患者平衡功能及炎症水平的影响.pdf
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1、临床和实验医学杂志2 0 2 3年9月第2 2 卷第17 期得机体及时水解蓄积的乙酰胆碱,消除患者脏器损伤及中枢神经功能症状等,且树脂血液灌流对血液中的解毒剂也有吸附作用,降低救治过程中因解毒剂过量而造成的中间综合征等发生率2 0 4结论综上所述,树脂血液灌流可明显缩短AOPP患者昏迷及住院时间,提高患者治愈率,加快ChE活力恢复速度,降低血清CRP、W BC 及NEUT水平,减轻患者氧化应激及炎症反应,降低并发症发生风险。参考文献1王歌今,马进强。淄博市博山区某三甲医院急诊科有机磷农药中毒患者流行病学调查分析J山东医药,2 0 18,58(46):7 2 7 4.2Dong N,Wang S
2、,Li X,et al.Prognostic nomogram for the severity ofacute organophosphate insecticide self-poisoning:a retrospective obser-vational cohort studyJ.BMJ Open,2021,11(5):e042765.3 张济之,鱼静,马丽留置胃管反复洗胃联合氯磷定注射液及阿托品在急性有机磷农药中毒中应用效果观察J贵州医药,2 0 2 2,46(5):783-784.4 Yu G,Li Y,Jian T,et al.Clinical analysis of acute
3、 organophosphoruspesticide poisoning and successful cardiopulmonary resuscitation:A caseseriesJ.Front Public Health,2022,10(1):866376.5蔡婷婷,陶宁,涂贵新,等。早期血液灌流对急性有机磷农药中毒患者血清ALTcTnI和AMS水平的影响J西部医学,2 0 2 2,34(5):748 752.6 中国医师协会急诊医师分会急性有机磷农药中毒诊治临床专家共识(2 0 16)J:中国急救医学,2 0 16,36(12):10 57 10 6 5.7 崔书章,陆再英,钟南山
4、,等内科学M.7版北京:人民卫生出版社,2 0 0 8:9 2 5.8尚红,王毓三,申子瑜全国临床检验操作规程M4版北京:人民卫生出版社,2 0 15:6 2 97 90.9唐雪梅,李勇,李婷婷有机磷农药中毒致患者呼吸功能衰竭的急.1869.救措施与疗效J昆明医科大学学报,2 0 18,39(6):7 1-7 5.10 黄玲菊。有机磷农药中毒的急救措施及预后效果观察J中国急救医学,2 0 18,38(2 2):2 1-2 3.11 Liu D,Wang P,Tang R,et al.Clinical diagnosis and treatment strate-gy of oral organ
5、ophosphorus pesticide poisoning J.Panminerva Med,2022,64(2):306-308.12李媛媛,苟欣鹏血液灌流联合连续性肾脏替代治疗对急性有机磷农药中毒患者炎性因子水平及治疗效果临床观察J山西医药杂志,2 0 2 0,49(3):2 7 3-2 7 5.13纪海明。血液灌流联合解磷定治疗有机磷农药中毒的疗效及预后分析J皖南医学院学报,2 0 18,37(1):5456.14薛维亮,张玲老年重度有机磷农药中毒患者血液灌流临床疗效及对血清 CHE、D A、T G F-I及TNF-水平的影响J中国老年学杂志,2 0 19,39(2):351-354
6、.15 Dungdung A,Kumar A,Kumar B,et al.Correlation and prognosticsignificance of serum amylase,serum lipase,and plasma cholinesterasein acute organophosphorus poisoning J.J Family Med Prim Care,2020,9(4):1873-1877.【16 吴嘉荔,冀晓静,李博,等不同血液灌流策略对重度急性有机磷农药中毒患者胆碱酯酶活力的影响J中华急诊医学杂志,2021,30(3):272277.17 】李睿杰,杨一红,王
7、海梅,等急性有机磷农药中毒患者血糖、白细胞、CRP和乙酰胆碱酯酶的变化及其临床意义J.标记免疫分析与临床,2 0 2 0,2 7(4):6 14-6 17.18 Mu Y,Hu B,Gao N,et al.Prognostic value of the neutrophil-to-lymphocyte ratio in acute organophosphorus pesticide poisoning J.Open Life Sci,2021,16(1):703-710.19 Xiao Q,Wang W,Qi H,et al.Continuous hemoperfusion relieves
8、 pul-monary fibrosis in patients with acute mild and moderate paraquat poi-soning J.J Toxicol Sci,2020,45(10):611-617.20崔少华,耿立霞血必净注射液联合血液灌流治疗急性有机磷农药中毒的疗效观察J中国中西医结合急救杂志,2 0 2 1,2 8(4):470-473.(收稿日期:2 0 2 3-0 4-2 8)D0I:10.3969/j.issn.1671-4695.2023.17.021富血小板血浆联合深层肌肉刺激对早期膝骨关节炎患者平衡功能及炎症水平的影响刘志刚刘晋平李正南*(
9、忻州市人民医院骨科山西忻州0 340 0 0)【摘要】目的观察富血小板血浆联合深层肌肉刺激对早期膝骨关节炎患者平衡功能及炎症水平的影响。方法前瞻性选取2 0 2 1年10 月至2 0 2 2 年10 月忻州市人民医院收治的6 0 例早期膝骨关节炎患者为研究对象,采用奇偶数分组法将患者分为两组:肌肉刺激组2 8 例和联合组32 例。两组均进行常规康复治疗,肌肉刺激组给予深层肌肉刺激干预,联合组在肌肉刺激组基础上联合富血小板血浆治疗。比较两组患肢平均肌电值(AEMG)、Be r g 评分、西大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及炎症因子红细胞沉降率(ESR)、超敏C反应蛋白(hs=C
10、RP)、白细胞介素(IL)-6、IL-1水平差异,计算两组足底不同部位最大压力差值。结果治疗后,两组ESR、h s-CRP、IL-6、IL-1水平均较治疗前明显下降,且联合组ESR、h s=C RP、I L-6、I L-1水平分别为(13.112.0 8)mm/h、(3.6 50.57)mg/L、(58.2 59.2 2)p g/mL、(38.8 94.7 7)n g/L,均低于肌肉刺激组(16.58 3.2 2)mm/h、(5.52 1.0 4)mg/L、(7 9.0 511.33)p g/mL、(44.52 5.8 5)n g/L),差异均有统计学意义(P0.05)。治疗后,两组患肢股外侧
11、肌(VL)、股直肌(RF、股内侧肌(VMO)及股二头肌(BF)的AEMG均明显较治疗前升高,且联合组分别为(6 2.47 13.0 5)、基金项目:山西省自然科学基金面上项目(编号:2 0 18 0 1D121353)*通讯作者:李正南,E-mail:文章编号:16 7 1-46 9 5(2 0 2 3)17-18 6 9-0 5:1870(7 9.6 6 10.17)、(7 0.2 113.6 5)、(7 0.6 6 13.6 5)m V,均高于肌肉刺激组(51.0 2 10.33)、(6 8.47 9.8 5)、(6 2.9814.17)、(6 4.2 515.0 2)m V ,差异均有统
12、计学意义(P0.05)。治疗后,两组Berg评分较治疗前均明显升高,WOMAC评分较治疗前均明显下降,且联合组Berg评分为(53.314.0 3)分,高于肌肉刺激组(49.953.6 7)分,WOMAC评分为(10.7 7 1.6 8)分,低于肌肉刺激组(14.2 32.11)分,差异均有统计学意义(P0.05)。治疗后,联合组足底不同部位最大压力差值均小于肌肉刺激组,差异均有统计学意义(P0.05)。结论富血小板血浆联合深层肌肉刺激可改善早期膝骨关节炎患者平衡功能,促进膝关节功能的恢复,可能与调节血清因子的表达有关。【关键词】富血小板血浆骨关节炎,膝深层肌肉刺激平衡功能膝关节功能Effec
13、ts of platelet-rich plasma combined with deep muscle stimulation on balance function and inflammation level in patients with early kneeosteoarthritis.LIU Zhi-gang,LIU Jin-ping,LI Zheng-nan.Department of Bone,Xinzhou Peoples Hospital,Xinzhou Shanxi 034000,China.Abstract Objective To observe the effec
14、ts of platelet-rich plasma combined with deep muscle stimulation on balance function and in-flammation level in patients with early knee osteoarthritis.MethodsSixty patients with early knee osteoarthritis admitted to Xinzhou Peoples Hos-pital from October 2021 to October 2022 were retrospectively se
15、lected as subjects and divided into two groups by odd-even grouping method:28cases in the muscle stimulation group and 32 cases in the combination group.Both groups received routine rehabilitation treatment,the musclestimulation group was given deep muscle stimulation intervention,and the combinatio
16、n group was combined with platelet-rich plasma therapy onthe basis of the muscle stimulation group.The averaged electromyography(AEMG),Berg score,Western Ontario and McMaster University Osteo-arthritis Index(WOMAC)score and the levels of inflammatory factors erythrocyte sedimentation rate(ESR),hyper
17、sensitive C-reactive protein(hs-CRP),interleukin(IL)-6 and IL-1 were compared between the two groups,and the maximum pressure difference in different parts ofthe plantar between the two groups was calculated.ResultsAfter treatment,thelevels ofESR,hs CRP,IL-6,IL of the two groups weresignificantly lo
18、wer than those before treatment,and those in the combination group were(13.11 2.08)mm/h,(3.65 0.57)mg/L,(58.25 9.22)pg/mL,and(38.89 4.77)ng/L,respectively,which were lower than those in the muscle stimulation group(16.58 3.22)mm/h,(5.52 1.04)mg/L,(79.05 11.33)pg/mL,and(44.52 5.85)ng/L,the difference
19、s were statistically significant(P 0.05).Aftertreatment,the AEMG of the lateral thigh muscle(VL),rectus femoris muscle(RF),vastus medialis(VMO)and biceps femoris muscle(BF)of the affected limbs in both groups were significantly higher than those before treatment,and the AEMG of the combination group
20、 were(62.47 13.05),(79.66 10.17),(70.21 13.65),(70.66 13.65)mV respectively,which were higher than those of the muscle stimulation group(51.02 10.33),(68.47 9.85),(62.98 14.17),(64.25 15.02)mV,the differences were statistically significant(P 0.05).After treatment,the Berg score of the two groups wer
21、e significantly higher than those before treatment,while the WOMAC score were significantlylower than thoset before treatment,the Berg score of the combination group was(53.31 4.03)points,which was higher than that of the musclestimulation group(49.95 3.67)points,while the WOMAC score was(10.77 1.68
22、)points,which was lower than that of the muscle stimu-lation group(14.23 2.11)points,and the differences were statistically significant(P 0.05).The maximum pressure differences of differ-ent parts of plantar in combination group were lower than those in muscle stimulation group,and the differences w
23、ere statistically significant(P 0.05)。见表1。表1两组一般资料比较体重指数(岁,xs)(kg/m,x s)56.39 10.2324.12 2.0657.11 9.8524.20 2.170.2770.1460.7820.885患病侧别例(%)左侧右侧14(50.00)14(50.00)17(53.13)15(46.88)0.0580.809临床和实验医学杂志2 0 2 3年9月第2 2 卷第17 期1.2纳入与排除标准纳人标准:(1)符合骨关节炎诊疗指南(2 0 18 年版)5 制定的膝骨关节炎标准,根据临床症状和X线片确诊;(2)年龄40 7 5 岁;
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- 血小板 血浆 联合 深层 肌肉 刺激 早期 骨关节炎 患者 平衡 功能 炎症 水平 影响