同种异体富血小板血浆用于慢性难愈性创面的临床研究  

Efficacy of Allogeneic Platelet Rich Plasma for Chronic Refractory Wounds

作　　者：巩蜜蜜 汪海宁 吴磊[1] 邵小宝 周琳 杨圆 王华[1] 高凤威 戴宇东[2] 朱培元 GONG Mimi;WANG Haining;WU lei(Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210022)

机构地区：[1]南京中医药大学附属南京中医院,210022 [2]南京红十字血液中心

出　　处：《临床输血与检验》2023年第3期368-374,共7页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：江苏省输血协会英科新创科研基金资金项目(No.JS2022006);南京市卫生科技发展专项资金项目(No.YKK21195)资助。

摘　　要：目的探讨同种异体富血小板血浆(PRP)治疗慢性难愈性创面(CRW)患者的临床疗效。方法选取2021年5月—2022年10月收治的无法采用自体PRP治疗的CRW患者40例,采用随机数字表法将患者随机分为治疗组和对照组各20例。两组患者均在入院或门诊就诊后进行彻底清创,在此基础上治疗组采用异体PRP进行创面外敷治疗,对照组采用常规创面换药治疗并定期换药,测定创面长度和宽度以判断疗效,采用视觉模拟评分法(VAS)对治疗第10 d、20 d的疼痛程度进行评价。结果异体PRP治疗10 d后创面见肉芽生长,后期肉芽组织较快生长、创缘上皮爬行,未见明显炎症反应;治疗30 d,治疗组创面愈合率达到95.90%,显著高于对照组的47.55%(t=–16.74,P<0.05);治疗30 d后,治疗组创面肉芽组织生长较快,治疗后创面大小明显缩减甚至愈合(Z=-4.32,P<0.05);治疗组创面中位愈合时间为34.50 d(31.25 d,36.00 d),明显短于对照组的50.00 d(45.25 d,64.50 d)(Z=–5.42,P<0.05)。治疗组创面痊愈4例,显效16例,较对照组治疗效果明显(χ^(2)=40.00,P<0.05)。疼痛评分显示在治疗第10、20天后,治疗组患者的疼痛明显减轻,差异具有统计学意义(Z=–5.52,P<0.05)。结论对于因年龄、基础疾病引起血小板减少或者血小板功能障碍等限制因素而无法采集自体PRP的患者,采用异体PRP作为辅助治疗方法,可明显加速慢性创面的愈合过程,临床疗效较好。Objective To investigate the clinical efficacy of allogeneic platelet rich plasma(PRP)for the treatment of chronic refractory wounds(CRW).Methods A total of 40 patients with CRW who could not be treated with autologous PRP from May 2021 to October 2022 were included.The patients were randomly divided into the treatment group and the control group with 20 cases in each group by using random number table.Patients in both groups underwent debridement after inpatient or outpatient visit.On this basis,patients in the treatment group were treated with allogeneic PRP external application,while patients in the control group were treated with regular wound dressing.The length and width of the wound were measured determine the curative effect.The visual analog scale(VAS)was used to evaluate the pain at the 10th and 20 th days after treatment.Results After 10 days of PRP treatment,granulation growth was observed on the wound surface.Granulation tissue grew rapidly in the later stage and the epithelium of the wound margin crawled without obvious inflammatory reaction.After 30 days of treatment,the wound healing rate in the treatment group was 95.9%,which was higher than that in the control group(47.55%)(t=–16.74,P<0.05).The granulation tissue of the wound in the treatment group grew rapidly.The size of the wound was significantly reduced and even healed after treatment(Z=–4.32,P<0.05).The median wound healing time in the treatment group was 34.50 days(31.25,36.00),which was shorter than that in the control group(50.00 days(45.25,64.50))(Z=–5.42,P<0.05).Four cases of wound healing and 16 cases of significant effect were observed in the treatment group,which was significantly better than that in the control group(χ^(2)=40.00,P<0.05).After 10 and 20 days of treatment,the pain of patients in the treatment group was significantly reduced with a statistically significant difference(Z=–5.52,P<0.05).Conclusion For patients affected by restrictive factors such as thrombocytopenia or platelet dysfunction due to age and basic

关 键 词：难愈性创面 富血小板血浆 同种异体 

分 类 号：R457[医药卫生—治疗学]