自体富血小板血浆治疗深二度烧伤合并感染创面的探讨——附1例报道  

Autologous platelet-rich plasma treatment for infected deep second-degree burn wounds:a case report

作　　者：黄皓 黄峻 梁群 刘建 李婷 赵阳 HUANG Hao;HUANG Jun;LIANG Qun;LIU Jian;LI Ting;ZHAO Yang(Department of Blood Transfusion,Guangzhou Red Cross Hospital,Guangzhou 510220,China;Department of Burn and Plastic Surgery,Guangzhou Red Cross Hospital,Guangzhou 510220,China)

机构地区：[1]广州市红十字会医院输血科,广州广东510220 [2]广州市红十字会医院烧伤整形科,广州广东510220

出　　处：《中国输血杂志》2024年第1期95-100,共6页Chinese Journal of Blood Transfusion

基　　金：广州市卫生健康科技项目(20221AO11016)。

摘　　要：目的探讨自体富血小板血浆(platelet-rich plasma,PRP)治疗深二度烧伤合并感染创面的可行性。方法回顾性分析1例深二度烧伤合并创面细菌感染患者,结合临床治疗要点与门诊随访情况,探讨自体PRP在烧伤创面合并感染的患者治疗中的可行性及临床效果。结果患者左下肢深二度烧伤创面合并凝固酶阴性葡萄球菌感染,经一般换药治疗及抗感染治疗1周,体温降至正常,但创面愈合缓慢且仍有黄色分泌物;后烧伤创面经联合外用自体PRP治疗,创面疼痛评分由8分逐渐下降至1分,2周后创面分泌物细菌培养阴性,18 d后创面完全愈合;PRP治疗后1、3、6个月创面瘢痕评分由5分降至2分,未见明显瘢痕形成;PRP疗程中亦未出现创面炎症反应加重、血常规、肝肾功能化验结果异常等不良反应。结论在深二度烧伤患者合并局部创面细菌感染,拒绝手术或不适合手术的情况下,自体PRP是1种较安全的替代方案,能够有效促进组织再生和创面愈合,本例患者在短期内达到治愈效果。Objective To explore the feasibility of using autologous platelet-rich plasma(PRP)in the treatment of deep second-degree burns complicated with wound infection.Methods A retrospective analysis was conducted on the treatment process of a patient with deep second-degree burns and bacterial infection on the wound using autologous PRP.Clinical treatment highlights and outpatient follow-up were combined to discuss the feasibility and clinical effects of using autologous PRP in the treatment of burn wounds complicated with infection.Results The patient had a deep second-degree burn with a coagulase-negative Staphylococcus infection on the left lower limb.After one week of conventional wound dressing and antibiotic treatment,the patient's body temperature returned to normal.However,wound healing was slow and yellow secretion persisted.Subsequently,the burn wound was treated combined with topical autologous PRP.The wound pain score gradually decreased from 8 to 1.After 2 weeks,the bacterial culture of the wound secretion was negative,and the wound healed completely after 18 days.The wound scar score decreased from 5 to 2 at 1,3 and 6 months after PRP treatment,and no obvious scar formation was observed.In the course of PRP treatment,there were no adverse reactions such as increased wound inflammation,abnormal blood routine and liver and kidney function test results.Conclusion For deep second-degree burn patients with localized wound bacterial infections who either refuse surgery or are not suitable for surgery,autologous PRP is a safer alternative that can effectively promote tissue regeneration and wound healing.The patient in this case achieved a curative effect in a short period of time.

关 键 词：富血小板血浆 烧伤 创面修复 创面感染 

分 类 号：R457.14[医药卫生—治疗学] R632[医药卫生—临床医学] R644