自体富血小板血浆在不同慢性难治性创面治疗中的应用价值  

Application value of autologous PRP in the treatment of different chronic refractory wounds

作　　者：侯雅 温小云[2] 邱芳[3] 温燕华 杨涛[4] 方先松[3] HOU Ya;WEN Xiao-yun;QIU Fang;WEN Yan-hua;YANG Tao;FANG Xian-song(Gannan Medical University;Department of Clinical Laboratory,The First Affiliated Hospital of Gannan Medical University;Department of Blood Transfusion,The First Affiliated Hospital of Gannan Medical University;Department of Dermatology,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医学院 [2]赣南医学院第一附属医院检验科 [3]赣南医学院第一附属医院输血科 [4]赣南医学院第一附属医院皮肤科,江西赣州341000

出　　处：《赣南医学院学报》2022年第12期1247-1251,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣州市科技局课题(GZ2020ZSF011)。

摘　　要：目的:观察与评价自体富血小板血浆(Platelet rich plasma,PRP)用于治疗不同慢性难治性创面的疗效和特点。方法:对赣南医学院第一附属医院80例难治性创面患者进行局部PRP治疗,根据创面形成原因分为糖尿病性溃疡、创伤性溃疡、压迫性溃疡、血管性溃疡。创面形成时间为1~6个月,治疗前都有长期换药或治疗不愈,抽取患者静脉血10~100 mL,经2次离心分离PRP,使用凝血酶激活制成凝胶填塞或覆盖于清创后的创面。观察第1周、第2周、第3周和第4周后创面的愈合情况,面积大小。结果:4组创面完全愈合平均天数为(28.46±8.65)天,血管性溃疡组愈合时间比其他3组愈合时间更长(P<0.05)。不同组愈合率存在组间差别(F=11.752,P<0.001),患者的愈合率不同周次的趋势不同(F=3 297.5,P<0.001)。各组愈合率LSD两两比较结果,各时间点总体看血管性溃疡组均低于其他组愈合率(P<0.001),而其他3组愈合率差异无统计学意义(P>0.05)。各组各时间点愈合率LSD两两比较P均<0.001,认为随着周数增加,愈合率增加。结论:PRP治疗不同原因引起的难治性创面均有良好的效果,能促进创面的愈合,缩短治疗周期。其中血管性溃疡组治疗效果略差于其他3组。Objective : To observe and evaluate the efficacy and characteristics of autologous platelet rich plasma(PRP) in the treatment of different chronic refractory wounds. Methods : Eighty patients with refractory wounds were treated with local PRP in the First Affiliated Hospital of Gannan Medical University. According to the causes of wound formation, they were divided into diabetic ulcer, traumatic ulcer, compression ulcer and vascular ulcer. The formation time of the wound was 1-6 months, and there was a long-term dressing change or non-healing effect before treatment. About 10-100 mL of venous blood was extracted from the patient, and PRP was separated by centrifugation twice. Then, thrombin was activated to make gel filling or covering the wound after debridement. The wound healing and size were observed after the first week, the second week, the third week and the fourth week. Results : The average healing days of the four groups were 28. 46±8. 65 days, and the healing time of the vascular ulcer group was longer than those of the other three groups(P<0. 05). There were differences in healing rate among different groups(F=11. 752, P<0. 001), and the trend of healing rates were not the same in different weeks(F=3 297. 5, P<0. 001). LSD pairwise comparison results showed that the healing rate of vascular ulcer group at each time point was lower than those of other groups(P<0. 001), while there was no statistical difference among the other three groups(P>0. 05). Pairwise comparison of LSD at each time point in each group showed P<0. 001, suggesting that healing rate increased with the number of weeks. Conclusion :PRP has good effect on the treatment of refractory wounds caused by different reasons, can promote the healing of wounds and shorten the treatment period. Among them, the treatment effect of vascular ulcer group is slightly worse than the other three groups.

关 键 词：富血小板血浆 难治性创面 糖尿病性溃疡 创伤性溃疡 压迫性溃疡 血管性溃疡 

分 类 号：R459.9[医药卫生—治疗学]