一位退化性膝關節炎患者使用高濃度血小板血漿之實證照護經驗

Evidenced- Base Care of Platelet-Rich Plasma in a Knee Osteoarthritis Patient

退化性膝關節炎病患常因關節疼痛，導致行走不便，影響日常活動及生活品質，其治療方法除手術治療外，也有其他非手術療法可減輕膝關節疼痛並改善其身體功能活動度，關節內注射玻尿酸及高濃度血小板血漿為常見之保守性療法。因退化性膝關節炎個案拒絕手術並要求高濃度血小板血漿治療，故引發動機以實證方法搜尋相關文獻，探討退化性膝關節炎患者使用關節內注射玻尿酸及高濃度血小板血漿之成效，並應用於本文個案。實證結果發現針對中低程度退化性膝關節炎患者，使用關節內注射高濃度血小板血漿比玻尿酸更能減輕疼痛及改善身體活動功能，且副作用少，針對於高度排斥手術之患者，關節內注射高濃度血小板血漿亦是一種選擇，期能藉此案例經驗供臨床醫護人員照護退化性膝關節炎病患之參考。

Knee osteoarthritis patients often suffer from knee pain, resulting in difficulty of walking. Those symptoms could affect their daily life and quality of life. In addition to surgical treatment, non-surgical treatment could also relieve knee pain and improve physical function. Intra-articular platelet-rich plasma (PRP) and hyaluronic acid (HA) are the alternative treatments used widely. The author took care of a degenerative knee osteoarthritis patient, who refused surgical treatment and requested PRP injection, which motivated the author to explore the effects between PRP and HA among patients with knee osteoarthritis. Evidenced base methodology was used and the result was also applied to the patient. The result showed intra-articular PRP was more effective for low to moderate degenerative knee osteoarthritis. PRP could reduce more knee pain and improve more physical function than HA. In addition, less adverse effects were also found. Thus, intra-articular PRP would be another choice for patients who refused surgery. We also expected this clinical case experience could provide more information to health care professionals.