自体富血小板血浆联合湿性愈合敷料治疗老年深Ⅱ度烧伤难愈合创面的临床观察  

Clinical observation of autologous platelet-rich plasma combined with wet healing dressing in the treatment of refractory deep second degree burn wounds in elderly patients

作　　者：王娇[1] 蒋红英[1] 余曦[1] 吴姁怿[1] Wang Jiao;Jiang Hongying;Yu Xi;Wu Shuyi(Rehabilitation Medicine Center,West China Hospital Affiliated to Sichuan University,Chengdu,Sichuan,611100,P.R.China)

机构地区：[1]四川大学华西医院康复医学中心,四川成都611100

出　　处：《老年医学与保健》2022年第3期659-663,共5页Geriatrics & Health Care

基　　金：四川省卫生健康委员会科研课题(19PJ245)。

摘　　要：目的分析自体富血小板血浆联合湿性愈合敷料治疗老年深Ⅱ度烧伤难愈合创面的疗效,为治疗该病症提供方法。方法选择2016年2月—2021年2月于四川大学华西医院收治的深Ⅱ度烧伤难愈合创面老年患者87例,使用抽签法将其分为对照组(n=43)与观察组(n=44),对照组在常规治疗基础上,使用湿性愈合敷料,观察组在对照组的基础上,使用自体富血小板血浆治疗。治疗后14d,比较2组患者的临床疗效;比较2组控制感染时间、适宜植皮时间及创面愈合时间;在治疗前、治疗7d及14d后,比较2组Bates-Jensen伤口评估与效果评价量表、视觉模拟评分法(VAS)及温哥华瘢痕量表(VSS)评分;在治疗前及治疗14d后,比较2组的血清C反应蛋白(CRP)、白细胞介素-1β(IL-1β)及血液白细胞计数(WBC)水平。结果观察组的治疗总有效率为91.30%,高于对照组的70.73%(P<0.05);治疗后,观察组控制感染、适宜植皮及创面愈合时间均短于对照组(P<0.05);治疗7d及治疗14d后,观察组Bates-Jensen评分均小于对照组(P<0.05);治疗7d及治疗14d后,观察组VAS评分均小于对照组(P<0.05);随访6个月及随访1年后,观察组VSS评分均小于对照组(P<0.05);治疗14d后,观察组CRP、IL-1β及WBC水平均小于对照组(P<0.05)。结论自体富血小板血浆联合湿性愈合敷料治疗老年患者深Ⅱ度烧伤难愈合创面的临床效果非常显著,其可促进创面愈合,减轻疼痛,降低炎症反应,并且创面在愈合后无明显瘢痕,具有一定的临床应用价值。Objective To analyze the efficacy of autologous platelet-rich plasma combined with wet healing dressing in the treatment of refractory deep second degree burn wounds in the elderly,and provide a method for the treatment of this disease.Methods 87elderly patients with refractory deep second degree burn wounds treated in West China Hospital of Sichuan University from February2016to February2021were selected and divided into control group(n=43)and observation group(n=44)by lottery method.The control group was treated with wet healing dressing on the basis of conventional treatment,and the observation group was treated with autologous platelet-rich plasma on the basis of the control group.The clinical efficacy at14d after treatment,infection control time,suitable skin grafting time and wound healing time were compared between the two groups.Before treatment,7days and14days after treatment,the Bates-Jensen Wound Assessment and Effect Evaluation Scale,Visual Analogue Scale(VAS)and Vancouver Scar Scale(VSS)scores were compared between the two groups;before treatment and after14days of treatment,the levels of serum C-reactive protein(CRP),interleukin-1β(IL-1β)and blood white blood cell count(WBC)were compared between the two groups.Results The total effective rate of the observation group was91.30%,which was higher than70.73%of the control group(P<0.05).After treatment,the infection control time,suitable skin grafting time and wound healing time of the observation group were shorter than those of the control group(P<0.05).After7days and14days of treatment,the Bates-Jensen score and VAS score of the observation group were lower than those of the control group(P<0.05).After6months and1year of follow-up,the VSS score of the observation group was lower than that of the control group(P<0.05).After 14 days of treatment,the levels of CRP,IL-1βand WBC of the observation group were lower than those of the control group(P<0.05).Conclusion The clinical effect of autologous platelet-rich plasma combined with wet healing dressing

关 键 词：老年 难愈合创面 深Ⅱ度烧伤 自体富血小板血浆 湿性愈合敷料 

分 类 号：R644[医药卫生—外科学]