探讨富血小板血浆用于距骨软骨损伤治疗中的效果。

纳入2018年1月至2021年1月威海卫人民医院100例成年单侧距骨软骨损伤患者作为研究对象，纳入标准：确诊单侧距骨软骨损伤；18岁≤年龄<60岁；神志保持清醒。排除标准：合并严重感染、自身免疫系统疾病；合并凝血功能障碍；合并其他骨科疾病；合并慢性基础疾病；合并精神障碍、认知障碍。依据随机数字表法将患者随机分为对照组50例、观察组50例。对照组实施关节镜下踝关节清理术，观察组在对照组基础上采用富血小板血浆治疗。比较两组患者的血清炎症因子指标、并发症发生率、踝关节活动度、踝关节评分、足踝功能评分、疼痛评分、舒适度评分、生活质量评分，并发症发生率行卡方检验，血清炎症因子指标、踝关节活动度、踝关节评分、足踝功能评分、疼痛评分、舒适度评分、生活质量评分行t检验。

治疗后，与对照组相比，观察组的白介素-6、C反应蛋白、降钙素原、疼痛评分均更低(t＝5.145、5.621、5.855、5.214，均为P<0.01)，观察组的踝关节跖屈曲、背伸、以及踝关节评分、足踝功能评分、舒适度评分更高(t＝5.763、6.099、5.465、6.115、5.918，均为P<0.01)，观察组的生理、心理、环境、社会关系等维度的生活质量评分更高(t＝6.037、6.277、5.448、5.383，均为P<0.01)。观察组的并发症发生率低于对照组(χ²＝4.396，P<0.05)。

关节镜下踝关节清理术联合富血小板血浆治疗可有效减轻距骨软骨损伤患者的炎症反应，减少并发症，有利于改善踝关节功能和踝关节活动度，还可减轻疼痛感，改善生活质量。

To investigate the effect of platelet rich plasma in the treatment of talus cartilage injury.

According to the inclusion and exclusion criteria, 100 cases of adult unilateral talus cartilage injury in Weihaiwei people′s Hospital from January 2018 to January 2021 were included as the research objects. Inclusion criteria: unilateral talar cartilage injury was diagnosed; age 18 years ≤age <60 years; consciousness remained awake. Exclusion criteria: severe infection, autoimmune diseases, coagulation dysfunction, other orthopedic diseases, chronic basic diseases, mental disorders and cognitive impairment. The patients were randomly divided into control group and observation group according to random number table method. Arthroscopic ankle debridement was performed in the control group, while platelet-rich plasma was used in the observation group based on the control group. Serum inflammatory factors, complication rate, ankle range of motion, ankle score, ankle function score, pain score, comfort score and quality of life score were compared between the two groups, the incidence of complications was tested by chi square test, and the inflammatory factor index, ankle range of motion, ankle score, foot and ankle function score, pain score, comfort score and quality of life score were analyzed by t test.

After treatment, compared with the control group, the scores of interleukin-6, C-reactive protein, procalcitonin and pain in the observation group were lower (t=5.145, 5.621, 5.855 and 5.214, all P<0.01); the ankle plantar flexion, ankle back extension, ankle score, foot and ankle function score and comfort score in the observation group were higher (t=5.763, 6.099, 5.465, 6.115 and 5.918, all P<0.01). The scores of quality of life in the dimensions of physiology, psychology, environment and social relations in the observation group were higher (t=6.037, 6.277, 5.448 and 5.383, all P<0.01). The incidence of complications in the observation group was lower than that in the control group (χ²=4.396, P<0.05).

Arthroscopic ankle debridement combined with platelet-rich plasma treatment can effectively reduce the inflammatory reaction, reduce complications, improve ankle function and ankle range of motion, relieve pain and improve quality of life.