自体富血小板血浆凝胶联合皮瓣移植修复对难愈性创面的治疗效果  

Clinical effect of platelet-rich plasma combined with flap transplantation in treatment of refractory wounds

作　　者：高文华[1] 张宏亮 胡玉庆 樊安末 刘景焕 刘学亮[1] 

机构地区：[1]冀中能源邢台矿业集团总医院骨三科,河北邢台054000

出　　处：《局解手术学杂志》2018年第2期88-92,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：邢台市科技支撑计划课题(2017zc050)

摘　　要：目的探讨自体富血小板血浆凝胶(PRP)联合皮瓣移植修复对难愈性创面的治疗效果。方法选择本院2016年4月至2017年2月收治的60例骨外伤难愈性创面患者作为观察组,另选择2016年4月前已出院的60例骨外伤难愈性创面患者作为对照组。所有患者于入院时均进行清创、消毒,观察组采用PRP贴敷,之后进行皮肌瓣移植,对照组未采用PRP治疗,直接进行皮肌瓣移植。观察所有患者创面的换药次数、创周炎症反应、创面平均愈合时间及后期手术成功率。计量资料采用t检验与方差分析,计数资料采用χ~2检验,重复观察资料采用重复方差分析。结果观察组渗湿纱布层数(20.5±1.6)层,低于对照组的(23.3±6.1)层,2组比较差异具有统计学意义(t=-3.439,P=0.001);观察组平均愈合时间(25±2)d,低于对照组的(43±5)d,2组比较差异具有统计学意义(t=-25.891,P=0.000);观察组换药次数(7.1±1.0)次,低于对照组的(9.3±1.4)次,差异有统计学意义(t=-9.905,P=0.000);观察组有5例发生创周炎症反应,低于对照组的18例,2组比较差异有统计学意义(χ~2=9.090,P=0.003);观察组皮肌瓣存活数为55例,高于对照组的41例,2组比较差异有统计学意义(χ~2=10.208,P=0.001)。观察组与对照组的平均愈合率在不同时间点呈上升趋势。观察组的平均愈合率在各时间点均高于对照组,2组比较差异有统计学意义(P<0.05)。结论 PRP联合皮瓣移植对难愈性创面具有较好的治疗效果。Objective To investigate the clinical effect of platelet-rich plasma combined with flap transplantation in treatment of refractory wounds. Methods Sixty patients of refractory wounds who were admitted into our hospital from April 2016 to February 2017 were enrolled in the observation group ,and another sixty patients with refractory wounds who had been discharged from the hospital before April 2016 were treated as the control group. All the patients accepted debridement and disinfection. Then the observation group were managed with PRP and flap transplantation,while the control group were treated with flap transplantation directly without PRP. Observed the frequency of dressing changes, rate of wound infection, healing time and recovering rate of the two groups. Measurement data were analyzed with t inspection and analysis of vafiance, and count data were compared by χ^2 test,and repeat data was analyzed with repeat data variance analysis. Results After one weeks＇ treatment,the number of wet gauze layers were （20.5 ± 1.6） in the observation group,which was less than （23.3 ± 6.1 ） in the control group with statistically significant difference （t = -3. 439 ,P = 0.001 ）. The healing time of the observation group was （25 ± 2 ）d, which was shorter than （43 ± 5 ）d in the control group （t = -25. 891 ,P = 0. 000）. The frequency of dressing changes was（7.1 ± 1. 0）times in observation group, which was less than （9.3 ± 1.4 ） times in the control group （ t = - 9.905, P = 0.000）. There were 5 cases of inflammation reaction in the observation group,which was less than 18 cases in the control group （χ^2 =9.090,P =0. 003）. The cases of the skin flap survival in the observation group was 55 ,which was more than 41 cases in the control group, and the difference of the two groups was statistically significant （χ^2 = 10. 208, P = 0.001 ） . The average healing rate of the two groups both increased at different time points. And the average healing rate of the observation group was

关 键 词：富血小板血浆 PRP 难愈性创面 皮瓣移植 

分 类 号：R649.9[医药卫生—外科学] R687.36[医药卫生—临床医学]