人工真皮联合自体富血小板血浆凝胶修复骨/肌腱外露创面的早期临床疗效  

Early clinical efficacy of artificial dermis combined with autologous platelet-rich plasma gel in repairing exposed bone/tendon wounds after trauma

作　　者：彭祥 高玥 姜文华 李浩[1] 章晓玲 张颖 何智灵 单记春 双峰[1] 杨迪 万得恩 PENG Xiang;GAO Yue;JIANG Wenhua;LI Hao;ZHANG Xiaoling;ZHANG Ying;HE Zhiling;SHAN Jichun;SHUANG Feng;YANG Di;WAN Deen(Department of Orthopaedics,908th Hospital of PLA Joint Logistics Support Force,Nanchang 330002,China;Department of Orthopaedics,920th Hospital of PLA Joint Logistics Support Force,Kunming 650032,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院骨科,南昌330002 [2]中国人民解放军联勤保障部队第九二〇医院骨科,昆明650032

出　　处：《中华骨与关节外科杂志》2024年第6期552-557,共6页Chinese Journal of Bone and Joint Surgery

基　　金：江西省卫生健康委科技计划(202211380,202211373,202211379);联勤保障部队第九〇八医院苗子基金课题(2022YNKT030,2022YNKT003)。

摘　　要：目的:探究人工真皮联合自体富血小板血浆(PRP)凝胶修复创伤后骨/肌腱外露创面的早期临床疗效。方法:回顾性分析2022年1月至2023年6月行骨/肌腱外露创面修复的36例患者的临床资料。男22例,女14例;年龄21~65岁,平均(40.9±11.8)岁。2022年1—10月收治的20例患者采用人工真皮治疗,作为真皮治疗组;2022年10月至2023年6月收治的16例采用人工真皮联合PRP凝胶治疗,作为联合治疗组。记录两组患者植皮成活情况及植皮区愈合时间,比较两组患者治疗后植皮区瘢痕增生情况。结果:两组均获得植皮愈合后3个月以上随访,平均随访时间(4.5±1.3)个月。联合治疗组植皮成活情况明显优于真皮治疗组,差异有统计学意义(P<0.05)。联合治疗组植皮区术后愈合时间(24.4±3.5)d较真皮治疗组(29.7±2.3)d明显缩短,差异有统计学意义(P<0.05)。术后1、3个月联合治疗组植皮区温哥华瘢痕量表(VSS)评分均明显低于真皮治疗组,差异有统计学意义(P<0.05)。结论:人工真皮联合PRP凝胶修复创伤后骨/肌腱外露创面的早期临床疗效显著,植皮成活率高,可缩短植皮区愈合时间,降低患者植皮区瘢痕增生程度,具有良好的临床应用价值。Objective:To explore the early clinical efficacy of artificial dermis combined with autologous platelet-rich plasma gel(PRP) in repairing exposed bone/tendon wounds after trauma.Methods:A retrospective analysis was conducted on the clinical data of 36 patients who underwent repair of exposed bone/tendon wounds after trauma from January 2022 to June 2023.The study included 22 males and 14 females with an age range of 21 to 65 years(mean age 40.9±11.8 years).Twenty patients admitted from January to October 2022 were treated with artificial dermis and were designated the dermal treatment group,sixteen patients admitted from October 2022 to June 2023 were treated with artificial dermis combined with PRP gel and were designated the combined treatment group.The survival and healing time of the skin grafts were recorded in the two groups,and the scar hyperplasia in the grafted areas after treatment was compared between the two groups.Results:Both groups were followed up for more than 3 months after skin graft healing,with an average follow-up time of(4.5±1.3) months.The survival of the skin graft in the combined treatment group was significantly better than that in the dermal treatment group(P<0.05).The postoperative healing time of the skin graft in the combined treatment group was significantly shorter(24.37±3.48) d compared to the dermal treatment group(29.56±2.37) d(P<0.05).At 1 and 3 months after surgery,the Vancouver scar scale scores in the combined treatment group were significantly lower than those in the dermal treatment group(P<0.05).Conclusions:Repairing exposed bone/tendon wounds after trauma with a combination of artificial dermis and PRP gel achieved significant early clinical benifit,enhanced the survival rate of skin grafts,shortened the healing time of the skin graft areas,and reduced the severity of scar hyperplasia in the skin graft area,demonstrating its potential for clinical application.

关 键 词：人工真皮 富血小板血浆 凝胶 难愈性创面 修复 

分 类 号：R683[医药卫生—骨科学]