富血小板血浆注射联合负压封闭引流、外用重组人酸性成纤维细胞生长因子灌洗治疗慢性难愈性创面的临床观察  

Clinical observation of platelet rich plasma injection combined with negative pressure closed drainage and external application of recombinant human acidic fibroblast growth factor lavage for the treatment of chronic difficult to heal wounds

作　　者：陈思思 李兴波 赵霖 唐思瑶 CHEN Sisi;LI Xingbo;ZHAO Lin;TANG Siyao(Department of Burn and Plastic Surgery,Wenjiang Hospital,Sichuan Provincial People's Hospital,Chengdu 611100,China)

机构地区：[1]四川省人民医院温江医院烧伤整形外科,四川成都611100 [2]四川省人民医院温江医院骨科,四川成都611100

出　　处：《中国美容整形外科杂志》2025年第3期180-183,192,共5页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：四川省医学会伤口疾病(泰阁)专项科研课题(2022TG25)。

摘　　要：目的 探讨慢性难愈性创面采用富血小板血浆(platelet-rich plasma, PRP)注射联合负压封闭引流(vacuum sealing drainage, VSD)、外用重组人酸性成纤维细胞生长因子(recombinant human acidic fibroblast growth factor, rh-aFGF)灌洗治疗的效果。方法 自2024年7-12月,四川省人民医院温江医院烧伤整形外科收治慢性难愈性创面患者50例,按随机数表法分为观察组、对照组,25例/组。对照组采用VSD+rh-aFGF治疗,观察组采用VSD+rh-aFGF+PRP注射治疗。比较两组临床疗效及临床相关指标,同时检测其创面细菌培养转阴率,另外评估并比较两组疼痛数字评分法(numeric rating scale,NRS)评分,最后检测其血清炎症因子指标[C反应蛋白(C-reactive protein,CRP)、白细胞计数(white blood cell count,WBC)、红细胞沉降率(erythrocyte sedimentation rate, ESR)]水平。结果 无失访患者。观察组整体效果96.00%较对照组68.00%优(P<0.05);观察组临床相关指标改善情况较对照组优(P<0.05);观察组治疗后7、14 d的创面细菌培养转阴率61.90%、95.24%较对照组25.00%、55.00%均高(P<0.05);两组患者治疗后7、14 d的NRS评分较治疗前均降低,且观察组较对照组低(P<0.05);两组患者治疗后14 d的炎症因子各指标较治疗前均降低,且观察组较对照组更低(P<0.05)。结论 PRP注射联合VSD、rh-aFGF灌洗治疗慢性难愈性创面临床效果显著,不仅可缩短创面愈合时间、二期修复准备时间、住院时间,提高创面细菌培养转阴率,还可改善其疼痛症状,减轻炎症反应。Objective To explore the use of platelet-rich plasma(PRP) injection combined with vacuum sealing drainage for chronic refractory wounds vacuum sealing drainage(VSD) and recombinant human acidic fibroblast growth factor(rh-aFGF) lavage therapy.Methods From July to December 2024, 50 patients with chronic refractory wounds were admitted to the Department of Burn and Plastic Surgery in Wenjiang Hospital of Sichuan Provincial People's Hospital, and were divided into observation group and control group according to random number table method, each group with 25 cases. The control group was treated with VSD+rh-aFGF, and the observation group was treated with VSD+rh-aFGF+PRP injection. The clinical efficacy and relevant clinical indicators of the two groups were compared, and the rate of wound bacterial culture turning negative was detected. In addition, the numeric rating scale(NRS) score of the two groups was evaluated and compared, and the serum inflammatory factor index [C-reactive protein(CRP), white blood cell count(WBC), erythrocyte sedimentation rate(ESR)]. Results No patients were lost to follow-up. The overall effect of observation group was 96.00% better than that of control group 68.00%(P<0.05). The improvement of clinical indexes in the observation group was better than that in the control group(P<0.05). On 7 and 14 days after treatment, the wound turning negative rate of 61.90% and 95.24% in the observation group were higher than 25.00% and 55.00% in the control group(P<0.05). The NRS scores of both groups at 7 and 14 days after treatment were lower than those before treatment, and the observation group was lower than the control group(P<0.05). The indexes of inflammatory factors in both groups at 14 days after treatment were lower than before treatment, and the observation group was lower than the control group(P<0.05).Conclusion PRP injection combined with VSD and rh-aFGF lavage has significant clinical effect in the treatment of chronic refractory wounds, which can not only shorten the wound healing time

关 键 词：富血小板血浆注射 负压封闭引流 外用重组人酸性成纤维细胞生长因子 慢性难愈性创面 糖尿病慢性创面 

分 类 号：R641[医药卫生—外科学]