富血小板血浆联合自体脂肪移植修复烧伤难愈创面的临床效果研究  

Study on the Clinical Application of Platelet-rich Plasma Combined with Autologous Fat Transplantation in the Repair of Burn Wounds

作　　者：陈思思 邹同荣[2] 李兴波[2] 岑瑛[3] 吴琛[2] CHEN Sisi;ZOU Tongrong;LI Xingbo;CEN Ying;WU Chen(Department of Burn and Plastic Surgery,Wenjiang District People's Hospital,Chengdu 611130,Sichuan,China;Department of Burn and Plastic Surgery,Yibin First People's Hospital,Yibin 644000,Sichuan,China;Department of Plastic Surgery/Burn Surgery,West China Hospital,Sichuan University,Chengdu 610000,Sichuan,China)

机构地区：[1]成都市温江区人民医院烧伤整形科,四川成都611130 [2]宜宾市第一人民医院整形烧伤科,四川宜宾644000 [3]四川大学华西医院整形美容/烧伤外科,四川成都610000

出　　处：《中国美容医学》2022年第4期59-62,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨富血小板血浆联合自体脂肪移植在烧伤难愈创面修复中的临床应用效果。方法:选择2018年5月-2020年1月168例修复烧伤难愈创面的患者作为对象,随机数字表法分为两组(n=84),对照组采用自体脂肪移植修复,观察组在对照组基础上联合富血小板血浆修复。比较两组围术期指标、视觉模拟疼痛(VAS)评分、温哥华瘢痕量表(VSS)、创面愈合率、炎症因子水平及并发症发生率。结果:观察组渗湿纱布(层)、换药次数、愈合时间、内层纱布更换次数均少(短于)对照组,差异有统计学意义(P<0.05)。两组治疗21 d后VAS、VSS评分均低于治疗前,且观察组低于对照组(P<0.05)。观察组治疗7 d、14 d、21 d后创面愈合率均高于对照组(P<0.05)。治疗21 d后,两组炎症因子TNF-α、INF-γ、IL-1β水平均低于修复前,且观察组低于对照组(P<0.05)。两组治疗过程中皮肤过敏、局部疼痛、炎性反应、胃肠道反应及红疹红肿发生率对比,差异无统计学意义(P>0.05)。结论:富血小板血浆联合自体脂肪移植用于烧伤难愈创面修复中能缩短创面愈合时间,减少换药次数,有助于减轻患者疼痛,降低炎症因子水平,未增加术后并发症发生率,值得推广应用。Objective To investigate the clinical effect of platelet rich plasma combined with autologous fat transplantation in the repair of refractory burn wounds. Methods 168 patients with refractory burn wounds from May 2018 to January 2020were selected and randomly divided into two groups, 84 cases in each group. The control group was repaired by autologous fat transplantation, while the observation group was repaired with platelet rich plasma on the basis of the control group. The repair effect of the patients was evaluated 21 days after treatment. The two groups were followed up for 2 months after repair,VAS, VSS, wound healing rate, inflammatory factor level and incidence of complications. Results The number of wet gauze(layer), dressing change times, healing time and inner layer gauze change times in the observation group were less(shorter than) those in the control group(P<0.05), the observation group was 21 days after repair the VAS and VSS scores of the observation group were lower than those of the control group(P<0.05), the wound healing rate of the observation group was higher than that of the control group at 7 d, 14 d and 21 d(P<0.05), the inflammatory factors of the two groups at 21d after repair were lower than those before repair(P<0.05), tumor necrosis factor-α(TNF-α), Interferon-γ(INF-γ)and Interleukin-1β(IL-1β) in the observation group were lower than those in the control group on the 21st day after repair(P <0.05).There was no significant difference between the two groups(P<0.05). Conclusion Platelet rich plasma combined with autologous fat transplantation in the repair of refractory burn wounds can shorten the wound healing time, reduce the frequency of dressing change, help to reduce the pain of patients, reduce the level of inflammatory factors, and do not increase the incidence of postoperative complications, which is worthy of promotion and application.

关 键 词：富血小板血浆 自体脂肪移植 烧伤创面 修复 应用效果 视觉模拟疼痛 温哥华瘢痕量表 

分 类 号：R622.9[医药卫生—整形外科]