富血小板血浆局部应用对皮瓣成活的影响  

Effect of platelet-rich plasma on flap graft survival

作　　者：郑健生[1] 王彪[1] 耿秋华[1] 胡君玲 蔡少甫[1] 邵建川 

机构地区：[1]厦门大学附属东南医院解放军第一七五医院烧伤整形科,福建漳州363000

出　　处：《中华医学美学美容杂志》2017年第2期129-132,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：南京军区2011军区医学科技创新经费资助项目（11MA079）

摘　　要：目的 探讨局部应用富血小板血浆（PRP）对皮瓣成活的影响.方法 取新西兰大白兔15只,将每只兔子背部两侧对称各取一块随意皮瓣,随机选择一侧为观察组,给予皮瓣基底部均匀涂抹PRP,另一侧为空白对照组,皮瓣基底均匀涂抹等量的0.9％氯化钠注射液.于术后3,7,14d计算皮瓣成活率,取皮瓣标本行大体观察及苏木精-伊红（HE）染色观察、免疫组织化学检测CD34计算血管密度.结果 皮瓣成活率：3d观察组（74.4±4.7）％,空白对照组（65.8±6.8）％;7 d观察组（72.4±7.5）％,空白对照组（58.5±7.0）％;14 d观察组（74.5±5.0）％,空白对照组（65.0±5.4）％.HE染色,可见皮瓣远端和蒂部组织随着时间的延长,炎症反应越来越轻,血管密度增加,14 d炎症反应最轻,血管密度最大.观察组炎症反应均较空白对照组轻.CD34阳性计数,3d观察组血管密度（13.9±2.0）个/高倍视野,空白对照组（11.1±1.3）个/高倍视野;7d观察组血管密度（15.7±1.5）个/高倍视野,空白对照组（12.1±1.2）个/高倍视野;14 d观察组血管密度（19.6±1.2）个/高倍视野,空白对照组（12.7±0.8）个/高倍视野,观察组与空白对照组差异均有统计学意义.结论 PRP能够促进兔随意皮瓣成活.Objective To explore the effect of platelet-rich plasma （PRP） on flap graft survival.Methods Two random skin flaps were elevated on the back of the rabbits with spinal symmetry in fifteen healthy rabbits.We selected randomly one side as PRP side,another side as blank control side.And then the autologous PRP was daubed to the basement of the skin flap in PRP side,while the blank control side was treated with normal saline of the same volume.At 3 d,7 d,and 14 d after the surgical operation,the immunohistochemistry was conducted to detect the microvessel density by CD34,and the the flap graft survival rate was tested and the histological changes of the flaps were observed by HE staining.Results The survival rates of skin flap graft were that the PRP side in 3 d （74.4±4.7） %,while the control side （65.8＋6.8）%;the PRP side in 7 d （72.4±7.5）%,while the control side （58.5＋7.0）%;the PRP side in 14 d （74.5±5.0）%,while the control side （65.0±5.4） %.The inflammatory reaction became declining with the extension of time,while density of blood vessels was increasing.In 14 d inflammatory reaction was the lowest and blood vessels＇ density was the largest.In all the control sides inflammatory response was obvious than that of the PRP side.CD34 positive count in 3 d PRP side microvascular density （MD） was （13.9±2.0）/HP,controlled side （11.1±1.3）/HP;in 7 d PRP MD was （15.7±1.5）/HP,controlled side （12.1±1.2）/HP;in 14 d PRP MD was （19.6±1.2）/HP,controlled side （12.7±0.8）/HP.There were significant differences in the MD at 3 d,7 d,and 14 d （P〈0.05） between PRP side and control side.Conclusions Platelet-rich plasma is able to promote the survival of random rabbit flap.

关 键 词：富血小板血浆 皮瓣 Platelet-rich plasma (PRP) 

分 类 号：R622[医药卫生—整形外科]