富血小板血浆对急性创伤愈合疗效的荟萃分析

Platelet-rich plasma for treating acute wounds： a meta-analysis

目的 评价富血小板血浆（PRP）对急性创伤的疗效.方法 计算机检索PubMed数据库（1950年1月至2014年2月）、Cochrane图书馆的临床对照试验数据库（CENTRAL,2014年第4期）、中国期刊全文数据库（CNKI,1979年1月至2014年2月）、中国生物医学文献数据库（CBM,1978年1月至2014年2月）、万方数据库（1990年1月至2014年2月）;对纳入文献的参考文献进一步扩大检索.纳入的随机对照试验依据Cochrane风险偏倚评价工具进行质量评价.采用RevMan5.1软件进行统计分析,评价PRP对急性创伤的疗效.结果 共纳入13篇英文文献,纳入急性创伤患者982例.系统评价及分析结果显示：与对照组比较,PRP组伤口愈合时间短,住院时间短[均数差（MD）=-1.45,95％CI：-2.07～-0.83;P＜0.01],创面愈合障碍事件发生率低[相对危险度（RR）=0.11,95％ CI：0.01～0.83;P ＜0.05],输血量减少,患者疼痛水平降低（MD=-1.26,95％ CI：-1.71～-0.82;P＜0.01）.结论 PRP能够缩短急性创伤愈合时间及住院时间,减少创面愈合障碍事件发生及输血量,减轻患者疼痛,对减少伤口感染也有一定疗效.

Objective To evaluate the efficacy of platelet-rich plasma （PRP） in the treatment of acute wounds.Methods Randomized controlled trials （RCT） were identified from PubMed （1950.1-2014.2）,Cochrane Central Register of Controlled Trials （CENTRAL,issue 4,2014） of Cochrane Library,China National Knowledge Infrastructure （CNKI,1979.1-2014.2）,China Biology Medicine （CBM,1978.1-2014.2） WANFANG database （1990.1-2014.2）.References of retrieved articles were also identified.The quality of each RCT was evaluated by the Cochrane collaboration＇s tool for assessing the risk of bias.Data analysis was performed with Review Manager 5.1 to evaluate the efficacy of PRP in the treatment of acute wounds.Results A total of 13 articles involving 982 patients were included.The results of systematic review and analysis showed that wound healing time of PRP treatment group was shorter than that of control group,so did length of hospital stay （mean difference （MD）：-1.45,95％ CI：-2.07 to -0.83 ; P ＜0.01）,the incidence of wound healing disturbance in PRP treatment group was less than that of control group （relative risk （RR）：0.11,95％ CI：0.01 to 0.83; P ＜ 0.05）,so did blood product transfusion.Moreover,post-traumatic pain level of PRP treatment group was lower than that of control group （MD：-1.26,95％CI：-1.71 to-0.82; P＜0.01）.Conclusion Use of PRP can shorten acute wound healing time and length of hospital stay,reduce the incidence of disturbed wound healing and blood products transfusion and alleviate post-traumatic pain.Moreover,it has some effect on the control of wound infections.