OBJECTIVE To systematically review and evaluate the efficacy and complication profile of platelet-rich plasma (PRP) injection into the carpal tunnel for management of carpal tunnel syndrome (CTS). DATA SOURCES PubMed, MEDLINE, SCOPUS, EMBASE, Google Scholar, Cochrane Central Register of Controlled Trials, and Web of Sciences (from inception to January 1st, 2019). STUDY SELECTION Controlled trials addressing PRP for CTS. DATA EXTRACTION Two reviewers independently screened the titles, abstracts, and full texts, extracting data from eligible studies. The outcomes of interest were the visual analog score (VAS) for pain and the Boston Carpal Tunnel Questionnaire (BCTQ), including the subscales of the symptom severity scale (SSS) and the functional status scale (FSS). Other reported outcome measures and complications were analyzed descriptively. DATA SYNTHESIS Four randomized control studies satisfied the inclusion criteria and analyzed a total of 191 cases with a final follow-up of either 3 or 6-months. Control groups included splinting in two studies, corticosteroid injection in one study, and saline injection in one study. There was a statistically and clinically significant improvement in the BCTQ {Std. Mean Difference(95%CI) = -2.06[-3.41, -0.70], p=.003} between groups. Subgroup analysis showed significant improvement in SSS {Std. Mean Difference(95%CI) = -1.95[-3.65, -0.25], p=.02} but not for FSS {Std. Mean Difference(95%CI) = -2.19[-4.77, 0.40], p=.10}. There was a similar improvement in VAS and nerve conduction studies in those receiving PRP compared to controls. Complication rate in the included studies was low with 4/97 participants receiving PRP injections experiencing transient pruritis, burning and/or tingling. CONCLUSION PRP represents a promising therapy for patients with mild to moderate CTS; however, included studies were limited as follow-up was short, included patients were heterogeneous, and the number of included studies was low. Further investigation is necessary to determine its true efficacy and effect and to better delineate the long-term results in patients with CTS.

中文翻译：

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富血小板血浆注射对腕管综合征非手术治疗的有效性：随机对照试验的系统评价和荟萃分析

目的 系统地评价和评估富血小板血浆 (PRP) 注射到腕管治疗腕管综合征 (CTS) 的疗效和并发症情况。数据来源 PubMed、MEDLINE、SCOPUS、EMBASE、Google Scholar、Cochrane Central Register of Controlled Trials 和 Web of Sciences（从成立到 2019 年 1 月 1 日）。研究选择 针对 CTS 的 PRP 的对照试验。数据提取 两名评价员独立筛选标题、摘要和全文，从符合条件的研究中提取数据。感兴趣的结果是疼痛的视觉模拟评分 (VAS) 和波士顿腕管问卷 (BCTQ)，包括症状严重程度量表 (SSS) 和功能状态量表 (FSS) 的分量表。对其他报告的结果测量和并发症进行了描述性分析。数据综合 四项随机对照研究符合纳入标准，共分析了 191 例病例，最终随访时间为 3 个月或 6 个月。对照组包括两项研究中的夹板、一项研究中的皮质类固醇注射和一项研究中的盐水注射。在 BCTQ {Std. 组间平均差异 (95% CI) = -2.06[-3.41, -0.70], p=.003}。亚组分析显示 SSS {Std. 平均差异 (95%CI) = -1.95[-3.65, -0.25], p=.02} 但不是 FSS {Std. 平均差异 (95% CI) = -2.19[-4.77, 0.40], p=.10}。与对照组相比，接受 PRP 的患者的 VAS 和神经传导研究也有类似的改善。纳入研究的并发症发生率较低，4/97 名接受 PRP 注射的参与者出现短暂的瘙痒、灼痛和/或刺痛。结论 PRP 是轻中度 CTS 患者的一种有前景的治疗方法；然而，纳入的研究有限，因为随访时间短，纳入的患者具有异质性，纳入研究的数量很少。需要进一步研究以确定其真正的疗效和效果，并更好地描述 CTS 患者的长期结果。