机采富血小板血浆治疗多种难愈性创面  

The treatment of refractory wounds with apheresis platelet-rich plasma

作　　者：罗瑞献 石泽锋[2] 梁慧妍 李艳萍 单桂秋 莫柱宁[1] LUO Ruixian;SHI Zefeng;LIANG Huiyan;LI Yanping;SHAN Guiqiu;MO Zhuning(Department of Blood Transfusion,The People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China;Department of Joint Surgery and Sports Medicine,The People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China;Department of Blood Transfusion,General Hospital of the Chinese People′s Liberation Army Southern Theater Command)

机构地区：[1]广西壮族自治区人民医院输血科,广西南宁530021 [2]广西壮族自治区人民医院关节∙运动医学外科,广西南宁530021 [3]解放军南部战区总医院输血科

出　　处：《中国输血杂志》2024年第9期991-997,共7页Chinese Journal of Blood Transfusion

基　　金：广西卫生健康委科研课题(Z20190486);广西医疗卫生适宜技术开发与推广应用项目(S2020079)。

摘　　要：目的探索机采富血小板血浆(PRP)治疗难愈性创面模式,评价其疗效和安全性。方法选取2020年6月—2023年12月在本院住院的34例难愈性创面患者,使用全自动血液成分分离机采集患者PRP,根据不同类型创面,选用PRP沿创面边缘点状注射和/或直接涂抹、血小板凝胶(PG)敷盖创面或填充窦道等方式进行治疗。治疗频次为每周1~2次,每疗程4~5次。观察记录疗效,并对其安全性进行评价。结果患者采集PRP前基础血小板、白细胞、红细胞计数分别为(321.85±114.64)×10^(9)/L、(9.52±3.21)×10^(9)/L、(4.34±0.62)×10^(12)/L,机采PRP制品中血小板、白细胞、红细胞计数分别为(1438.53±376.89)×10^(9)/L、(1.38±1.03)×10^(9)/L、(0.03±0.01)×10^(12)/L,PRP制品中血小板浓度平均提升4.47倍,抽样细菌培养均阴性。34例患者经PRP治疗后,33例患者症状改善,1例患者因疾病加重长期卧床、依从性差而效果不佳。有4例患者在PRP采集或治疗过程中出现轻度不良反应,经规范处理后均能完成PRP采集或治疗。结论机采PRP制品具有质量稳定、安全可靠、可溯源等优点,能有效促进多种难愈性创面的愈合,其治疗过程安全有效,值得推广应用。Objective To explore the model of treatment of refractory wounds by apheresis platelet-rich plasma(PRP),and evaluate its efficacy and safety.Methods PRP treatment was carried out for 34 patients with refractory wounds who were hospitalized in our hospital from June 2020 to December 2023.The patient′s autologous PRP was collected by the blood composition separator.PRP point-like injection and/or direct application along the edge of the wound,or platelet gel(PG)to cover the wound and fill the sinus were used to treat different types of wounds.The frequency of treatment was once to twice a week,with each course of treatment consisting of 4 to 5 sessions.The efficacy was observed and recorded,and the safety was evaluated.Results Before PRP collection,the basal platelet,white blood cell and red blood cell counts were(321.85±114.64)×10^(9)/L,(9.52±3.21)×10^(9)/L and(4.34±0.62)×10^(12)/L,respectively.The counts of platelets,white blood cells and red blood cells in PRP products were(1438.53±376.89)×10^(9)/L,(1.38±1.03)×10^(9)/L and(0.03±0.01)×10^(12)/L,respectively.The platelet concentration of PRP products increased by 4.47 times on average,and the sampled bacterial culture was negative.Out of 34 patients treated with PRP,33 showed improvement in symptoms,while 1 did not respond well due to long-term bedridden and poor compliance.Four patients had mild adverse reactions during PRP collection or treatment,but all were able to complete PRP collection or treatment after standardized treatment.Conclusion Apheresis PRP products have the advantages of stable quality,safety,reliability and traceability,and can effectively promote the healing of a variety of refractory wounds.Its treatment process is safe and effective,and is worthy of popularization and application.

关 键 词：机采 富血小板血浆 难愈性创面 

分 类 号：R457.1[医药卫生—治疗学]