慢性萎缩性胃炎是常见的胃癌前病变,不仅治疗过程漫长,治疗难度大,而且患者依从性欠佳。不仅会对患者的生理、心理健康和生活质量造成严重不良的影响,还会给患者家属造成负担,成为临床上不可忽视的难题。但是本病发病机制目前尚未完全明确,临床治疗还未达成共识。文章综述了近10年基于Hedgehog信号通路的中医药干预慢性萎缩性胃炎的研究概况。中医药调控Hedgehog信号通路辨证论治是治疗慢性萎缩性胃炎的一种独具特色的疗法,近年来有关基于Hedgehog信号通路的中医药干预治疗慢性萎缩性胃炎的报道越来越多。文章主要通过遵循疾病本虚标实的病性,以脾胃虚弱为本,瘀血、气滞、湿热、痰浊等为标,探讨选方治疗对慢性萎缩性胃炎的影响,认为中医药联合Hedgehog信号通路实行现代化发展能够有效干预治疗慢性萎缩性胃炎,以期为进一步临床研究与应用提供参考。

Chronic atrophic gastritis,a common precancerous lesion of gastric cancer,requires a long-term treatment and is difficult to cure．Therefore,it usually leads to decreased patient compliance．It will not only have a serious adverse impact on the patient’s physical and mental health and quality of life,but also cause a burden to the patient’s family,which has become a difficult problem that can not be ignored clinically．However,the pathogenesis has not yet been totally clarified,not to mention a consensus on the clinical treatment．This paper reviews the research revolving around Chinese medicine intervention in chronic atrophic gastritis based on the Hedgehog signaling pathway in the last decade．It’s creative therapy of chronic atrophic gastritis that utilizing Traditional Chinese Medicine to regulate and control Hedgehog signaling pathway,which has been increasingly reported in recent years．This paper is based on “deficiency in origin” and “excess in superficiality” principle．Concretely,spleen-stomach vacuity is characterized by deficiency in origin,and excess in superficiality manifests blood stasis,qi stagnation,dampness-heat and phlegm turbidity as excess in superficiality．By this way,the paper explores the effect of prescription selection on chronic atrophic gastritis．It is believed that the modern therapy that combines traditional Chinese medicine with Hedgehog signaling pathway can tackle chronic atrophic gastritis,thus providing a reference for further clinical trials and practices．

目的 探讨超声监测导向下早期肠内营养（EEN）在重症脓毒血症（SS）有创通气（IV）患者中的应用效果。方法 选取2021年2月—2023年11月连州市人民医院收入的115例SS-IV患者,依据随机数字表法分为对照组（n=57）、超声监测组（n=58）。所有患者均予重症监护病房（ICU）综合治疗,在此基础上对照组实施临床经验的传统肠内营养（EN）干预,超声监测组实施超声监测导向下EEN干预,均监测至治疗结束。统计两组IV时间、ICU停留时间、EN达标时间、EN不耐受发生率、相关并发症发生率,比较干预前、EN结束时营养状况[白蛋白（ALB）、总蛋白（TP）、前白蛋白（PA）]、序贯器官衰竭评分（SOFA）、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分。结果 对照组剔除放弃治疗1例,死亡2例,纳入54例;超声监测组剔除放弃治疗1例,死亡1例,纳入56例。超声监测组EN达标时间[（40.18±8.46）h]、IV时间[（7.12±1.44）d]、ICU停留时间[（9.21±1.63）d]短于对照组[（46.03±10.15）h、（8.02±1.62）d、（10.18±1.54）d]（t=3.288、3.082、3.206,均P<0.05）。EN结束时超声监测组SS-IV患者血清ALB[（32.05±3.13）g/L]、TP[（65.36±3.62）g/L]、PA[（0.24±0.06）g/L]高于对照组[（30.28±2.24）g/L、（63.28±4.24）g/L、（0.21±0.05）g/L]（t=3.400、2.770、2.843,均P<0.05）。EN结束时超声监测组APACHEⅡ评分[（15.85±1.93）分]、SOFA评分[（7.42±1.64）分]低于对照组[（17.02±2.04）分、（8.35±2.03）分]（t=3.091、2.648,均P<0.05）。超声监测组EN不耐受发生率[12.50%（7/56）]低于对照组[29.63%（16/54）],超声监测组相关并发症发生率[8.93%（5/56）]低于对照组[24.07%（13/54）]（χ²=4.878、4.608,均P<0.05）。结论 超声监测导向下EEN干预应用于SS-IV患者,可改善患者病情与营养状况,降低EN不耐受及相关并发症发生风险,缩短恢复时间。

Objective To investigate the effect of ultrasound monitoring guided early enteral nutrition（EEN）in patients with severe sepsis（SS）and invasive mechanical ventilation（IV）．Methods A total of 115 SS-IV patients admitted to Lianzhou People's Hospital from February 2021 to November 2023 were randomly divided into control group（n=57）and ultrasound monitoring group（n=58）．All patients were given comprehensive treatment in intensive care unit（ICU）．On this basis,traditional enteral nutrition（EN）intervention with clinical experience was implemented in control group,and EEN intervention guided by ultrasonic monitoring was implemented in ultrasound monitoring group．All patients were monitored until the end of treatment．IV time,ICU stay time,EN compliance time,incidence of EN intolerance,and incidence of related complications were analyzed in the 2 groups．Nutritional status [albumin（ALB）,total protein（TP）,prealbumin（PA）],sequential organ failure assessment（SOFA）,acute physiology and chronic health evaluation Ⅱ（APACHEⅡ）were compared before intervention and at the end of EN．Results In control group,1 cases gave up,2 cases died,and 54 cases were included．In ultrasound monitoring group,1 case gave up,1 case died,and 56 cases were included．The EN compliance time [（40.18±8.46）h],IV time [（7.12±1.44）d] and ICU stay time [（9.21±1.63）d] of ultrasound monitoring group were shorter than those of control group [（46.03±10.15）h,（8.02±1.62）d,（10.18±1.54）d]（t=3.288,3.082,3.206,all P<0.05）．At the end of EN,serum ALB[（32.05±3.13）g/L],TP[（65.36±3.62）g/L],PA[（0.24±0.06）g/L] of SS-IV patients in ultrasound monitoring group were higher than those in control group [（30.28±2.24）g/L,（63.28±4.24）g/L,（0.21±0.05）g/L]（t=3.400,2.770,2.843,all P<0.05）．At the end of EN,APACHEⅡ scores [（15.85±1.93）points] and SOFA scores [（7.42±1.64）points] of ultrasound monitoring group were lower than those of control group [（17.02±2.04）points and（8.35±2.03）points]（t=3.091,2.648,all P<0.05）．The incidence of EN intolerance in ultrasound monitoring group [12.50%（7/56）] was lower than that in control group [29.63%（16/54）],and the incidence of related complications in ultrasound monitoring group [8.93%（5/56）] was lower than that in control group [24.07%（13/54）]（χ²=4.878,4.608,all P<0.05）．Conclusions EEN intervention guided by ultrasonic monitoring in SS-IV patients can improve the nutritional status of patients,reduce the risk of EN intolerance and related complications,shorten the recovery time,and reduce the progression of patients' disease．

目的 探讨真武汤联合八段锦在老年冠状动脉粥样硬化性心脏病（冠心病）患者中的应用效果。方法 将96例75岁以上冠心病患者按照随机数字表法分为对照组与干预组,每组各48例。在12周的临床研究期间,对照组用规范的冠心病二级预防药物治疗;干预组在规范的冠心病二级预防药物治疗基础上,增加真武汤以及八段锦运动处方。结果 治疗后干预组中医临床疗效（P=0.023）和中医证候积分（P<0.001）均优于对照组。两组患者的心肺运动试验指标均有改善,且干预组在升高峰值摄氧量（Peak VO₂,P=0.005）、最大摄氧量（VO₂max,P=0.001）、氧脉搏（VO₂/HR,P=0.002）和无氧阈值时最大代谢当量（MET,P=0.001）,以及降低无氧阈值（AT,P<0.001）和二氧化碳通气当量（VE/VCO₂,P=0.020）方面比对照组更明显。两组患者在36项简明健康状态调查表（SF-36）评分的8个维度中评分均有所升高,其中在生理机能（P=0.001）、生理职能（P<0.001）、一般健康状况（P=0.018）、精力（P=0.007）、社会职能（P=0.010）、精神健康（P=0.004）方面,干预组效果优于对照组;而在躯体疼痛、情感职能维度改善方面,两组间结果相近,差异无统计学意义（P>0.05）。两组患者的匹兹堡睡眠质量指数（PSQI）均有所改善,且干预组效果优于对照组（P<0.001）。结论 真武汤联合八段锦能够进一步增强老年冠心病患者中医证候疗效,改善心肺运动试验Peak VO₂、VO₂max、VO₂/HR、MET、AT、VE/VCO₂等指标,并提高SF-36评分多个维度的生活质量及睡眠质量。

Objective To explore the therapeutic effects of Zhenwu Decoction combined with Baduanjin Qigong in older adults with coronary heart disease（CHD）．Methods Ninety-six patients with CHD aged ≥75 years were randomly divided into a treatment group and a control group,with 48 patients in each group．Within the 12-week period,the control group received standard secondary prevention therapy for CHD,while the treatment group received Zhenwu Decoction and Baduanjin Qigong prescription,in addition to the standard treatment．Results After treatment,both groups showed improvement in the traditional Chinese medicine（TCM）clinical efficacy,TCM syndrome,SF-36 scores and Pittsburgh Sleep Quality Index（PSQI）scores;increase in Peak VO₂,VO₂max,VO₂/HR,and metabolic equivalent（MET）;and decrease in AT and VE/VCO₂．However,the treatment group had a more pronounced improvement in the TCM clinical efficacy（P=0.023）,TCM syndrome（P<0.001）,PSQI scores（P<0.001）,and cardiopulmonary exercise testing（CPET）indicators including Peak VO₂（P=0.005）,VO₂max（P=0.001）,VO₂/HR（P=0.002）,MET（P=0.001）,AT（P<0.001）and VE/VCO₂（P=0.020）,compared to their control counterparts． For the SF-36 scores,in comparison to the control group,the treatment group presented better outcomes in enhancing physical functioning（P=0.001）,role limitations due to physical health（P<0.001）,general health（P=0.018）,vitality（P=0.007）,social functioning（P=0.010）and mental health（P=0.004）,but not in pain or role limitations due to emotional problems．Conclusions The Zhenwu Decoction combined with Baduanjin Qigong can enhance the TCM syndrome,improve various CPET indicators such as Peak VO₂、VO₂max、VO₂/HR、MET、AT and VE/VCO₂,and elevate both quality of life and sleep quality among older adults with CHD．

目的 利用靶向二代测序技术探究天津市发热呼吸道症候群病原特征,分析病原流行特征,总结规律,为发热伴呼吸道症候群患者治疗策略提供指导。方法 收集2023年1月—2023年12月天津地区某四家医院初诊为发热伴呼吸道症候群的4 039例病例,通过tNGS技术检测,分析鉴定病原微生物,研究不同标本类型病原微生物分布、年龄分布、性别分布、不同时间季节感染分布、微生物类型分布趋势等。结果 4 039例经tNGS技术检测,共检测出90种潜在病原体,总阳性率为94.80%（3 829/4 039）。包括36种细菌、29种病毒、5种非典型病原体和20种真菌。不同种类病原体检出频次排序：革兰阴性细菌（G-细菌）>RNA病毒>DNA病毒>革兰阳性细菌（G+细菌）>真菌>非典型病原体。男女性别阳性检出率比较差异无统计学意义（χ²=0.249,P=0.618）;不同年龄段人群病原体谱有异质性,且阳性患者多分布在0~10岁和>60岁,阳性也集中在该两类人群,阳性率分别为47.90%（1 834/3 829）和31.24%（1 196/3 829）。在单一感染中,肺炎支原体占比最高,为4.91%,其次为新型冠状病毒,占1.59%,再次为呼吸道合胞病毒,占1.23%。不同季节不同感染类型具有差异,整体呈现夏冬季混合感染率高的特点,即夏季新冠病毒合并细菌（鲍曼不动杆菌、肺炎链球菌）,冬季肺炎支原体合并甲型、乙型流感病毒多见。肺炎支原体对大环内酯类药物耐药率随月份呈现增加趋势。结论 tNGS 技术在天津市发热呼吸道症候群样本中获得了较高的病原体检出率,病原体覆盖面广,通过提供更多的病原体信息,可以有效辅助鉴别混合感染和耐药信息。

Objective Using targeted next-generation sequencing technology to explore the composition of the pathogenic spectrum of febrile respiratory syndrome ,analyze the epidemic characteristics of the pathogen,summarize the rules,and provide accurate guidance for the treatment strategy of patients with febrile respiratory syndrome．Methods By tNGS detection of 4039 cases with fever with respiratory diseases in four hospitals in Tianjin in 2023,pathogenic microorganisms were analyzed and identified,and the distribution of pathogenic microorganisms,age distribution,gender distribution,infection distribution in different times and seasons,and distribution trend of microbial types in different specimen types were studied．Results In 4039 cases,90 potential pathogens were detected,the total positive rate was 94.80%（3 829/4 039）,including 36 kinds of bacteria,29 kinds of viruses,5 kinds of atypical pathogen and 6 kinds of fungi．The order of detection frequency of different types of pathogens：G-bacteria > RNA virus > DNA virus > G+ bacteria > fungi > atypical pathogens．There was no significant difference in the positive rate of male and female between the two groups（χ²=0.249,P=0.618）．The pathogen spectrum of different age groups was heterogeneous． The positive patients were mostly distributed in 0-10 years old [47.90%（1 834/3 829）] and >60 years old [31.23%（1 196/3 829）]．Among the single infection,Mycoplasma pneumoniae accounted for the highest proportion,4.91%（188/3829）,followed by 2019-nCoV,1.59%（61/3 829）,and respiratory syncytial virus,1.23%（47/3 829）．There were differences in different infection types in different seasons,and the overall characteristics of mixed infection rate in summer and winter were high． In summer,the new coronavirus was combined with bacteria（Acinetobacter baumannii,Streptococcus pneumoniae）,and in winter,Mycoplasma pneumoniae was combined with influenza A and B viruses．The resistance rate of Mycoplasma pneumoniae to macrolides showed an increasing trend with the time．Conclusions The tNGS technology had obtained a high pathogen detection rate in the samples of febrile respiratory syndrome in Tianjin．By providing more pathogen information,it can be effectively applied to the etiological diagnosis of respiratory infectious diseases and assist in the identification of mixed infections and drug resistance information．

目的 探讨Yes1相关蛋白（YAP）及p65在弥漫大B细胞淋巴瘤（DLBCL）中与临床特征的相关性及对DLBCL治疗和预后的意义。方法 收集65例DLBCL和10例反应性增生淋巴结患者组织进行免疫组织化学染色,分析两组差异;对多种临床特征与YAP、p65的相关性进行统计学和生存差异性分析。结果 YAP、p65染色评分在两组间比较差异有统计学意义（P<0.05）;YAP评分与疗效分组呈正相关,与治疗前乳酸脱氢酶（LDH）、Ann-Arbor分期、国际预后指数（IPI）呈负相关（P<0.05）;p65表达与疗效分组呈负相关,与治疗前LDH水平、Ann-Arbor分组、美国东部肿瘤协作组活动状态评分（ECOG）ECOG分组、结外侵犯、IPI评分、巨大包块呈正相关（P<0.05）。IPI及p65评分是DLBCL患者总生存期（OS）的独立危险因素（P<0.05）。共表达分层中YAP-/p65⁺组患者OS均值最低。结论 对于DLBCL,YAP低表达或p65高表达提示患者瘤荷较大、较差的疗效和预后。

Objective To investigate the correlation of YAP and p65 with clinical features in diffuse large B-cell lymphoma（DLBCL）and the significance for treatment and prognosis．Methods Tissues from 65 patients with DLBCL and 10 patients with reactive hyperplasia lymph node were collected for immunohistochemistry staining to analyze the differences between the two groups;statistical analysis and survival difference analysis of the correlation between various clinical features and YAP,p65 were performed．Results YAP and p65 staining scores were significantly different between the two groups（P<0.05）．YAP scores were positively correlated with efficacy subgroups,and negatively correlated with LDH levels before treatment,Ann-Arbor staging,and International Prognostic Index（IPI）scores before treatment（P<0.05）;p65 expression was negatively correlated with efficacy subgroups,and positively correlated with pretreatment LDH levels,Ann-Arbor subgroup,ECOG subgroup,extra-nodal invasion,IPI scores,and huge mass（P<0.05）．IPI and p65 score were independent prognostic risk factors for overall survival（OS） in DLBCL patients（P<0.05）．The mean value of OS was the lowest in patients in the YAP-/p65⁺ group in the co-expression stratification．Conclusions Low expression of YAP or high expression of p65 suggests larger tumor load and poorer outcome and prognosis in patients for DLBCL．

目的 通过分析2019—2021年广州地区保密性弃血工作情况,完善献血者献血后回告受理和保密性弃血管理。方法 通过分析广州市血液中心2019年1月—2021年12月期间受理的无偿献血者献血后保密性弃血回告记录,统计分析无偿献血者要求保密性弃血的各种原因,以及保密性弃血施行程序中出现的新情况。结果 2019年、2020年、2021年保密性弃血人数分别占当年献血人数的0.156‰,0.090‰,0.091‰。2020年之后出现接触或疑似接触新型冠状病毒患者的回告案例;在这3年间,87.6%的保密性弃血在72小时内完成回告。结论 无偿献血者保密性弃血回告以及血液屏蔽是保障血液用血安全的重要举措之一,目前广州市回告率相对较低,提示要强化血液保密性弃血回告及方法途径指引宣传,注意对新回告原因的收集以有针对性开展献血前征询工作,从源头筛选出合格、低风险的无偿献血者,同时完善长时间(72小时以上)才回告的血液保密性弃血处理程序。

目的 探讨胎儿颈部软组织(NT)超声检查联合血清甲胎蛋白(AFP)水平检测对产前胎儿神经管畸形诊断中的应用价值。方法 选取684例我院2018年4月—2021年4月接受产前检查的孕妇,所有孕妇分别采用NT超声检查、血清AFP水平检查,以引产结果为“金标准”,比较NT超声、血清AFP水平及联合检查诊断结果、诊断效能及对不同类型神经管畸形诊断符合率的影响。结果 经引产结果显示共48例神经管畸形胎儿;经NT超声检查共36例神经管畸形胎儿;经血清AFP水平检查共34例神经管畸形胎儿;经联合检查共47例神经管畸形胎儿;与NT超声、血清AFP水平单独检查相比,联合检查灵敏度89.58%、准确率98.68%、阴性预测值99.22%较高,漏诊率10.42%较低(P＜0.05);与NT超声、血清AFP水平单独检查相比,联合检查对于脑膨出、隐形脊柱裂胎儿检出率较高(P＜0.05)。结论 NT超声检查、血清AFP联合诊断准确率显著高于单独检查,可有效提高诊断效能,为临床筛查胎儿神经管畸形提供有效手段。

目的 探讨分析利用坐式DR轮椅辅助精神发育迟滞患儿胸部DR体检的图像质量。方法 2020年7月—2021年2月,共80例精神发育迟滞患儿纳入本研究。根据协助拍片的方式不同,分为坐式DR轮椅协助组(实验组)和医护人员抓扶协助组(对照组)。采用SPSS 20.0秩和检验分析2组图像质量的差异。结果 2组摄片图像差异有统计学意义(P<0.001)。坐式DR轮椅协助精神发育迟滞患者的胸部DR体检图片质量较高,废片率低。结论 坐式DR轮椅协助精神发育迟滞患儿胸部DR摄片图片的质量高,避免重复拍片的几率,为精神发育迟滞患儿及家属减少不必要的辐射风险提供了可靠方案。

Objective To explore and analyze the image quality of chest DR examination of children with mental retardation using DR wheelchair. Methods From July 2020 to February 2021, a total of 80 children with mental retardation were included in this study.According to different ways of assistance in examination, they were divided into seated DR wheelchair assisting group (experimental group) and medical staff assisting group (control group).The SPSS 20.0 rank sum test was used to analyze the difference in image quality between the two groups. Results The difference of radiographic images between the two groups was statistically significant (P<0.001).Seated DR wheelchairs assisted patients with mental retardation were with high quality and low rejection rate in their chest DR examination pictures. Conclusions DR wheelchair could help children with mental retardation to take chest DR pictures with high quality, avoid the probability of repeated examination, and provide a reliable method for children with mental retardation and their families to reduce the risk of unnecessary radiation.

目的 通过多种生物信息学方法分析MAML1在GC患者中的表达及与临床特征、预后和免疫治疗疗效的相关性。方法 利用TCGA数据库分析胃癌组织与正常胃黏膜组织中的MAML1表达水平;Kaplan-Meier在线工具对胃癌数据集GSE15459进行分析,阐明MAML1与患者临床特征及分期、治疗疗效的相关性;STRING软件预测与MAML1表达相关的基因,并用FUNRICH软件评估其富集的分子生物学功能和信号通路;TIMER和GEPIA数据库探索MAML1表达水平与肿瘤浸润免疫细胞及其相应基因标记集之间的关系。结果 MAML1在GC组织中的表达水平高于正常组织(P<0.001),且其表达水平与III期、有淋巴结转移、无远处转移的患者生存期相关(P<0.05),而与I、II和IV期、无淋巴结转移和有远处转移的患者生存期无相关性(P>0.05)。MAML1的相关作用基因主要分布在细胞核、参与转录调控,并且主要富集在雄激素受体、C-MYB转录因子和HIF-2α转录调控等相关的信号通路。MAML1表达水平与B细胞、CD4⁺ T细胞、巨噬细胞的表达水平存在正相关关系(P<0.05),但与肿瘤纯度、CD8⁺ T细胞、中性粒细胞、树突状细胞无相关性(P>0.05)。结论 MAML1有可能成为GC患者较差的临床预后标志物之一,其潜在分子机制可能与转录调控调节肿瘤微环境有关。

Objective To investigate the expression of MAML1 and its relationship with clinical characteristics, prognosis and the efficiency of immunotherapy in patients with GC. Methods MAML1 expression profile was observed by TCGA database. Kaplan-Meier survival analysis was applied to evaluate the correlation between the expression of MAML1 and clinical characteristics, prognosis and treatment efficiency of patients in GSE15459 dataset. MAML1-associated genes were predicted by STRING and were enriched in GO and KEGG by FUNRICH software. The relationship between MAML1 expression and markers of tumor infiltrated cells were explored by TIMER and GEPIA database. Results MAML1 was abnormally upregulated in GC tissues compared to normal gastric tissues (P<0.001). MAML1 expression was significantly associated with the overall survival of patients in stage III, with lymph node metastasis and without distant metastasis (P<0.001). There was no significant difference between MAML1 expression and the overall survival of patients in stage I, II, IV, without lymph node metastasis and with distant metastasis (P>0.05). MAML1-assoicated genes were mainly located at the nucleus, mediating transcriptional regulation and mainly enriching in androgen receptor, C-MYB transcription factor and HIF-2α transcription regulation and other related signaling pathways. MAML1 expression was positively related with the expression of B cell, CD4⁺ T cell and macrophages (P<0.05), but without significant difference with tumor purity, CD8⁺ T cell, neutrophils and dendritic cells (P>0.05). Conclusions MAML1 could be used as a marker of clinical prognosis of patients with GC. The potential molecular mechanism might be associated with its function in transcriptional regulation and changes in tumor microenvironment.

目的 探讨透明质酸钠注射联合富含血小板的血浆治疗膝骨关节炎患者的效果。方法 收集2019年7月—2021年7月在本院就诊的膝骨关节炎患者120例,采用随机数字表法分组,即对照组、观察组,均60例。对照组患者注入富含血小板的血浆(4 mL),观察组患者注射透明质酸钠(2 mL)联合富含血小板的血浆(3.5 mL),1次/周,3次为1个疗程,共2～3疗程。统计2组患者膝关节功能、临床疗效及并发症发生率。结果 ①组内比较:治疗后2月、3月及6月平均Lysholm膝关节评分均升高,P<0.05;②组间比较:治疗前及治疗后2月,2组患者平均Lysholm膝关节评分比较,P>0.05,治疗后3月、6月,2组平均Lysholm膝关节评分比较,P<0.05。2组患者Lysholm膝关节评分均较治疗前有所改善,P<0.05;观察组疼痛评分(18.92±4.11、17.61±3.83)分、肿胀度评分(10.64±2.82、9.66±1.21)分均高于对照组疼痛评分(14.02±3.52、13.54±3.21)分、肿胀度评分(9.62±2.63、8.71±1.93)分(P<0.05)。观察组临床总有效率98.33%高于对照组临床总有效率88.33%(χ²=4.821,P=0.028)。经过6个月的随访后,2组均1例出现局部肿胀,未发生其他并发症。结论 透明质酸钠注射联合富含血小板的血浆治疗膝骨关节炎患者,可以有效改善患者膝关节功能,减轻患者疼痛及肿胀程度等,安全性高,值得推广应用。

Objective To investigate the effect of sodium hyaluronate injection combined with platelet-rich plasma in the treatment of patients with knee osteoarthritis. Methods A total of 120 patients with knee osteoarthritis who were treated in our hospital from July 2019 to July 2021 were collected and randomly divided into control group and observation group,60 cases each.The patients in the control group were injected with platelet-rich plasma(4 mL),and the patients in the observation group were injected with sodium hyaluronate(2 mL)combined with platelet-rich plasma(3.5 mL),once a week,3 times as a course of treatment,total 2-3 courses of treatment.The knee joint function,clinical efficacy and complication rates of the two groups were compared. Results ①Intra-group comparison:the average Lysholm knee joint scores were significantly increased in 2 months,3 months and 6 months after treatment,P<0.05. ②Comparison between groups:before and 2 months after treatment,the average Lysholm knee joint scores of the two groups were significantly increased (P<0.05). After 3 months and 6 months treatment,the comparison of the average Lysholm knee score between the two groups were statistic significant (P<0.05).The Lysholm knee joint scores in both groups were improved compared with those before treatment (P<0.05). Three months after treatment,the pain score(18.92±4.11, 17.61±3.83)and swelling score(10.64±2.82, 9.66±1.21)in the observation group were significantly higher than those in the control group(14.02±3.52, 13.54±3.21, 9.62±2.63, 8.71±1.93, P<0.05).The total clinical effective rate of the observation group was 98.33%,which was significantly higher than that of the control group (88.33%, χ²=4.821,P=0.028).After 6-month follow-up,local swelling occurred in 1 case in both groups,and no other complications occurred. Conclusions Sodium hyaluronate injection combined with platelet-rich plasma in the treatment of patients with knee osteoarthritis can effectively improve the knee joint function and reduce the pain and swelling of the patients.It is safe and worthy of popularization and application.