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姜宜妮 女性應力性尿失禁的前瞻性療法─自體濃厚血小板再生術 2021/12/2 下午 03:51:00 0
原 文 題  目 A pilot study: effectiveness of local injection of autologous platelet-rich plasma in treating women with stress urinary incontinence
作  者 Cheng-Yu Long, Kun-Ling Lin, Chin-Ru Shen, Chin-Ru Ker, Yi-Yin Liu, Zi-Xi Loo, Hui-Hua Hsiao, Yung-Chin Lee
出  處 Scientific Reports. 2021 Jan 15;11(1):1584. doi: 10.1038/s41598-020-80598-2.
出版日期 2021 Jan
評 論

血小板,是人體血球的重要成分,人體受到外力傷害時,血小板在止血、免疫反應和傷口修復都扮演很關鍵的角色。血小板內富含許多生長因子,能促進組織再生,因此自1970年起,自體濃厚血小板再生術開始被應用於顱顏重建手術,之後又陸續被應用於各大醫學領域。進行自體濃厚血小板再生術,首先抽取適量患者的血液,經過純化濃縮和離心處理,得到高濃度的自體血小板血漿,再由醫師施打或合併手術應用於治療部位。

本研究的主題是使用自體濃厚血小板注射於尿道周圍,觀察其對女性應力性尿失禁的療效。應力性尿失禁的定義是,患者在咳嗽、笑、或是動作時發生不自主的漏尿,這個症狀對於女性朋友們的運動、生活品質和社交生活有很大的影響。研究者招募二十四位女性受試者,將抽取的血液處理成自體濃厚血小板治療液,在注射至前陰道壁的中段尿道周圍。以問卷在注射前、注射後一個月、注射後六個月評估尿失禁的改善程度和性功能變化。

本研究經統計分析,發現自體血小板再生術對於女性應力性尿失禁有顯著的治療效果,沒有觀察到重大副作用,也不影響性功能。後續,希望能有更大規模且長時間的研究,來確認自體濃厚血小板再生術對於應力性尿失禁的功效與長期療效。

abstract

The study aims to evaluate the effectiveness of local injection of autologous platelet rich plasma (A-PRP) as a treatment for women suffering from stress urinary incontinence (SUI). In a prospective intervention study, twenty consecutive women suffering from SUI were treated with A-PRP injection at anterior vaginal wall where mid-urethra locates. Self-reported questionnaires were used to measure pre-treatment, 1 month and 6 months post-treatment symptom severity. Secondary outcomes of sexual function and treatment effect sorted by age were analyzed with valid statistical methods. A-PRP is effective in relieving SUI symptoms at both 1 month and 6 months post-treatment without significant adverse reactions reported. It seems to have a trend that treatment success rate with cured and improved symptoms was slightly higher in the younger group, although it did not reach statistical significance (P = 0.07). No significant changes in sexual function before and after the treatment were reported by the patients. This pilot study is the first to report A-PRP treatment effect for SUI in women. The result suggested that A-PRP is a considerable treatment option for mild to moderate SUI cases. It also opens up further research opportunities for A-PRP's clinical applications.

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