自体富血小板血浆联合负压封闭引流在糖尿病足溃疡治疗中应用  

Vacuum sealing drainage combined with platelet-rich plasma implant in the treatment of diabetes foot ulcer

作　　者：张学成[1] 孟凡军[1] 战大川[1] 赵月荣[1] 赵振德[1] 

机构地区：[1]赤峰市医院烧伤整形科,内蒙古赤峰024000

出　　处：《临床军医杂志》2017年第12期1261-1263,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨自体富血小板(PRP)血浆在负压封闭引流(VSD)治疗糖尿病足溃疡治疗中应用的方法及疗效。方法回顾性分析赤峰市医院自2013年9月至2017年9月收治的87例糖尿病足溃疡患者的临床资料。将87例患者随机分为VSD组(44例)与VSD+PRP组(43例)。VSD组患者创面持续行VSD治疗,每10 d更换1次敷料。VSD+PRP组患者首先行VSD治疗10 d,然后,应用患者自体PRP外敷创面3 d,再行VSD治疗7 d。两组患者均待创面达到皮瓣移植条件后,行皮瓣移植术。两组患者均行抗感染、控制血糖、改善微循环等处理。治疗2个周期后,记录并比较两组患者创面愈合时间及创面愈合率。结果 VSD组与VSD+PRP组的创面愈合时间分别为(43.0±1.5)d及(36.0±1.1)d,两组比较,差异有统计学意义(P<0.05)。治疗2个周期后,PRP+VSD组创面愈合率为95.3%(41/43),明显高VSD组的45.5%(20/44),两组比较,差异有统计学意义(P<0.05)。结论应用自体PRP可以促进糖尿病足溃疡的创面愈合,缩短VSD治疗的创面愈合时间,提高创面愈合率。Objective To investigate the methods and effect of combinative application of vacuum sealing drainage（ VSD） and platelet-rich plasma（ PRP） implant for the repair and reconstruction of diabetes foot ulcer. Methods A retrospective study was performed on 87 cases of patients with diabetes foot ulcer received in our department from September 2013 to September 2017. All cases were divided into VSD group（ n = 44） and VSD ＋ PRP group（ n = 43）,respectively. Patients in VSD group were treated with a consecutive VSD management,with a dressing change per 10 days. While,patients in VSD ＋ PRP group were treated with a consecutive VSD management for 10 days primarily,implanted with PRP cover secondarily for 3 days,and VSD for 7 days at last. Skin flaps graft was carried out after wound healing,and anti-infection,glucose control and improving minicirculation were also under control in all cases.Results Wound healing cost less time in VSD ＋ PRP group when compared with VSD group [（ 36. 0 ± 1. 1） days versus（ 43. 0 ±1. 5） days,P〈0. 05]. At 2 weeks postoperatively,wound healing rate was higher in VSD ＋ PRP group than that in VSD group（ 95. 3% versus 45. 5%,P〈0. 05）. Conclusion Application of PRP can promote the curative effect of wound healing of diabetes foot ulcer treated with VSD,with less healing time and higher healing rate.

关 键 词：糖尿病足 足溃疡 富血小板血浆 负压封闭引流 

分 类 号：R318[医药卫生—生物医学工程]