富血小板血浆联合负压伤口疗法对骨科难愈性创面的治疗效果  

Effect of platelet-rich plasma combined with negative pressure wound therapy on orthopedic refractory wound

作　　者：张宏亮 高文华[1] 刘学亮[1] 樊安末 胡玉庆 刘景焕 

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：《新乡医学院学报》2018年第1期45-49,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨富血小板血浆(PRP)联合负压伤口疗法(NPWT)对骨科难愈性创面的治疗效果。方法选取2014年1月至2016年12月在冀中能源邢台矿业集团总医院骨科治疗的慢性难愈性创面患者84例,按入院时间分为对照组和观察组,每组42例,对照组患者给予NPWT,观察组患者在对照组治疗基础上加用PRP治疗,比较2组患者治疗前后创面渗液酸碱度(p H)值、创面温度、伤口压疮愈合计分(PUSH)和治疗2周后创面细菌培养结果,记录患者治疗前及治疗4周内血清促红细胞生成素(EPO)水平变化,同时统计分析2组患者适宜植皮时间、创面愈合时间及治愈率。结果治疗2周后,观察组患者细菌培养阳性率显著低于对照组(χ~2=4.850,P<0.05)。治疗2周后,观察组患者创面渗液p H值、创面PUSH评分显著低于对照组(P<0.05),创面温度显著高于对照组(P<0.05)。2组患者血清EPO水平在治疗4周内均呈上升趋势,在不同时间段的变化差异均有统计学意义(F=7.356、8.264,P<0.05)。观察组患者治疗1、2、3、4周时的血清EPO水平显著高于对照组(P<0.05)。观察组患者适宜植皮时间、创面愈合时间均短于对照组(P<0.05),创面治愈率高于对照组(χ~2=4.720,P<0.05)。结论 PRP与NPWT联合应用具有较好的抑菌效果,能够提高机体EPO水平,促进伤口愈合。Objective To investigate the effect of platelet-rich plasma（ PRP） combined with negative pressure wound therapy（ NPWT） on orthopedic refractory wound. Methods A total of 84 patients with chronic refractory wound were selected from January 2014 to December 2016 in Department of Osteology,Jizhong Energy Xingtai Mining Group General Hospital. The patients were divided into control group and observation group according to the admission time,42 cases in each group. The patients in the control group were treated with NPWT,and the patients in the observation group were treated with PRP and NPWT. The power of hydrogen（ pH） of wound exudate,wound temperature and wound pressure ulcer scale for healing（ PUSH） were compared between the two groups before and after treatment. The bacterial culture result was compared between the two groups after two weeks of treatment. The change of serum erythropoietin（ EPO） level were observed before and four weeks after treatment,and the suitable skingrafting time,wound healing time and cure rate were observed in the two groups.Results After two weeks of treatment,the positive rate of bacterial culture in the observation group was significantly lower than that in the control group（ χ^2= 4. 850,P〈 0. 05）. The p H value of wound exudate and the wound PUSH score in the observation group were significantly lower than those in the control group（ P〈 0. 05）,but the wound temperature in the observation group was higher than that in the control group after two weeks of treatment（ P〈 0. 05）. The results of intra group comparison showed that the serum EPO level showed an upward trend within four weeks of treatment,and the difference was statistically significant at different time points in the two groups（ F = 7. 356,8. 264; P〈 0. 05）. The level of serum EPO in the observation group was significantly higher than that in the control group at the treatment of 1,2,3 and 4 weeks（ P〈 0. 05）. Compared with the control group,the suitable skingrafting time was

关 键 词：富血小板血浆 负压伤口疗法 创面 

分 类 号：R473.6[医药卫生—护理学]