富血小板纤维蛋白联合磺胺嘧啶银敷料对慢性难愈性创面愈合时间和疗效的影响  

Effect of platelet-rich fibrin combined with sulfadiazine silver dressing on healing time and curative effect of chronic refractory wounds

作　　者：黄家彬 李承宁 游蕴腾 陈闽希 林久饶 Huang Jiabin;Li Chengning;You Yunteng;Chen Minxi;Lin Jiurao(Department of Emergency,Ningde City Hospital,Ningde Normal University,Ningde 352100,China)

机构地区：[1]宁德师范学院附属宁德市医院急诊科,福建宁德352100

出　　处：《海军医学杂志》2025年第2期174-178,共5页Journal of Navy Medicine

基　　金：福建省科技计划项目(20221002)。

摘　　要：目的探究富血小板纤维蛋白(PRF)联合磺胺嘧啶银敷料对慢性难愈性创面愈合时间和疗效的影响。方法本研究选取2022年12月1日至2023年12月1日宁德市医院接收并治疗的126例慢性难愈性创面患者作为研究对象。随机编号1~126号,将奇数号63例患者及偶数号63例患者分别纳入对照组和试验组。对照组给予磺胺嘧啶银敷料治疗,试验组给予富血小板纤维蛋白联合磺胺嘧啶银敷料治疗。比较2组患者疗效、创面恢复情况、炎症因子水平及并发症发生情况。结果试验组总有效率(96.83%,61/63)高于对照组(77.78%,49/63),差异有统计学意义(χ^(2)=10.309,P<0.05)。试验组换药次数[(4.44±1.53)次]、创面溶痂时间[(15.35±2.29)d]均低于对照组[(9.16±2.23)次、(20.25±3.24)d],差异有统计学意义(P<0.05)。试验组创面面积减少量[(14.95±2.80)cm^(2)]高于对照组[(11.21±2.35)cm^(2)],差异有统计学意义(P<0.05)。治疗前,2组患者炎症因子水平差异无统计学意义(P>0.05)。治疗14 d后,2组患者C-反应蛋白(CRP)、降钙原素(PCT)、白细胞介素-6(IL-6)水平均降低,且试验组CRP[(1.14±0.86)mg/L]、PCT[(4.07±0.56)μg/L]、IL-6[(61.54±25.33)ng/L]水平低于对照组[(2.11±0.75)mg/L、(4.96±0.71)μg/L、(84.48±24.76)ng/L],差异有统计学意义(P<0.05)。试验组患者并发症总发生率(9.52%,6/63)低于对照组(25.40%,16/63),差异有统计学意义(P<0.05)。结论富血小板纤维蛋白PRF联合磺胺嘧啶银敷料治疗慢性难愈性创面,能够提高疗效、加快创面恢复、改善血清炎症指标水平及减少并发症发生。Objective To explore the effect of platelet-rich fibrin(PRF)combined with sulfadiazine silver dressing on healing time and curative effect of chronic refractory wounds.Methods A total of 126 patients with chronic refractory wounds who were treated in Ningde City Hospital from December 1,2022 to December 1,2023 were selected as research objects.They were randomly divided into control group and experimental group according to odd-even number,with 63 cases in each group.The control group was treated with sulfadiazine silver dressing,and the experimental group was treated with PRF and sulfadiazine silver dressing.The curative effect,wound recovery,serum inflammatory cytokine levels and complications were compared between the two groups.Results The total effective rate of the experimental group was significantly higher than that of the control group([96.83%,61/63]vs[77.78%,49/63],χ^(2)=10.309,P<0.05).The frequency of dressing changes and wound healing time in the experimental group were significantly less than those in the control group([4.44±1.53]times vs[9.16±2.23]times,[15.35±2.29]d vs[20.25±3.24]d,P<0.05).The reduction of wound area in the experimental group was significantly higher than that in the control group([14.95±2.80]cm^(2) vs[11.21±2.35]cm2,P<0.05).There was no significant difference in serum inflammatory cytokine levels between the two groups before treatment(t=0.209,0.295,0.088,P>0.05).After 14 of treatment,the levels of CRP,PCT,and IL-6 were decreased in both groups,and the levels of CRP,PCT,and IL-6 in the experimental group were significantly lower than those in the control group([1.14±0.86]mg/L vs[2.11±0.75]mg/L,[4.07±0.56]μg/L vs[4.96±0.71]μg/L,[61.54±25.33]ng/L vs[84.48±24.76]ng/L,t=6.748,7.809,5.140,P<0.05).The total incidence of complications in the experimental group was significantly lower than that in the control group(9.52%vs 25.40%,χ^(2)=5.507,P<0.05).Conclusion PRF combined with sulfadiazine silver dressing can increase curative effects,accelerate wound healing,improve seru

关 键 词：富血小板纤维蛋白 磺胺嘧啶银敷料 慢性难愈性创面 疗效 

分 类 号：R641[医药卫生—外科学]