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富血小板血浆治疗慢性难愈性创面的临床疗效
Clinical efficacy of platelet rich plasma in the treatment of chronic refractory wounds
投稿时间:2021-12-19  修订日期:2022-04-28
DOI:
中文关键词:  富血小板血浆  生长因子  难愈性创面
英文关键词:Platelet rich plasma  Growth factor  Refractory wound surface
基金项目:云南省卫健委临床中心建设重大项目(ZX20191001)
作者单位E-mail
郭孝菊 解放军联勤保障部队第920医院 625529907@qq.com 
万值颖 解放军联勤保障部队第920医院  
林文华 解放军联勤保障部队第920医院  
姚玲 解放军联勤保障部队第920医院  
戴莹 解放军联勤保障部队第920医院  
李军* 解放军联勤保障部队第920医院 ljkmzyy@163.com 
徐永清 解放军联勤保障部队第920医院  
treatment 基金:云南省卫健委临床中心建设重大项目 
the key project of construction of clinical center of Yunnan Provincial Health Commission 
ZX20191001 
 
chronic 基金:云南省卫健委临床中心建设重大项目 
the key project of construction of clinical center of Yunnan Provincial Health Commission 
ZX20191001 
 
refractory 基金:云南省卫健委临床中心建设重大项目 
the key project of construction of clinical center of Yunnan Provincial Health Commission 
ZX20191001 
 
wounds 基金:云南省卫健委临床中心建设重大项目 
the key project of construction of clinical center of Yunnan Provincial Health Commission 
ZX20191001 
 
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中文摘要:
      目的 观察富血小板血浆(PRP)治疗慢性难愈性创面的临床疗效。方法 选取中国人民解放军联勤保障部队第九二〇医院2019年12月至2020年12月因创伤、压疮、糖尿病等所致慢性难愈性创面的52例患者为研究对象,根据患者是否接受PRP治疗将研究对象分为PRP组和常规组两组,其中PRP组32例,常规组20例。所有患者均给予门诊手术彻底清创,PRP组术后给予PRP凝胶覆盖创面,3 d更换1次凝胶,3次为1个疗程;常规组术后常规换药,根据创面愈合情况选择植皮或皮瓣转移加速创面愈合。1个月后观察两组创面的愈合效果。结果 PRP组32例患者创面经过2 ~ 4次PRP凝胶治疗后,均获得痂下愈合,创面愈合时间(25.25±4.93)d,平均换药(5.09±3.21)次。常规组16例经常规换药后愈合,3例植皮后愈合,1例行带蒂皮瓣转移术后愈合,创面愈合时间(42.95±7.97) d,平均换药(24.70±5.70)次。PRP组创面内表皮生长因子(EGF)、胰岛素样生长因子(IGF)、血小板衍生生长因子(PDGF)、转化生长因子β(TGF-β)、血管内皮生长因子(VEGF)的浓度明显高于常规组(P<0.05)。结论 与传统的治疗方式相比,富血小板血浆能显著增加创面生长因子浓度,加速伤口愈合,缩短治疗时间,减少治疗费用,减轻患者痛苦。
英文摘要:
      Objective To observe the clinical efficacy of platelet rich plasma (PRP) in the treatment of chronic refractory wounds.Methods A total of 52 patients with chronic refractory wounds caused by trauma, pressure ulcers and diabetes were selected from the 920 Hospital of PLA Joint Logical Support Force from December 2019 to December 2020. According to whether patients received PRP treatment, the study subjects were divided into PRP group (32 cases) and normal group (20 cases). All patients received outpatient surgery for complete debridement, and the PRP group was given PRP gel to cover the wound after surgery. The gel was replaced once every 3 days, 3 times as a course of treatment. In the normal group, dressing was routinely changed after surgery, and skin grafting or flap transfer was selected according to the wound healing to accelerate the wound healing. The wound healing effect of the two groups was observed 1 month later.Results Statistics showed that 32 patients in the PRP group received healing under the scab after 2-4 times of PRP gel treatment, with an average of (25.25±4.93) d of complete wound healing and an average of (5.09±3.21) times of dressing change. In the normal group, 16 cases healed after routine dressing change, 3 cases healed after skin grafting, and 1 case healed after pedicled skin flap transfer. The mean time of complete wound healing was (42.95±7.97) d, and the mean dressing change was (24.70±5.70) times. The epidermal growth factor, insulin-like growth factor, platelet derived growth factor, transforming growth factor β and vascular endothelial growth factor in the PRP group were significantly higher than those in the normal group (P<0.05).Conclusion Compared with the traditional treatment, platelet rich plasma can significantly increase the concentration of growth factors in the wound, accelerate the wound healing, shorten the treatment time, reduce the cost of treatment, and alleviate the pain of patients.
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