富含血小板血浆外敷在深Ⅱ度烧伤创面修复中的临床应用

Clinical Application of Platelet-Rich Plasma in Treatment of Deep Grade Ⅱ Burn Wounds

目的研究富含血小板血浆（PRP）创面外敷在深Ⅱ度烧伤创面治疗中的作用。方法收集躯干及四肢Ⅱ度烧伤患者68例,年龄1~65岁,烧伤面积5%~62%总身体表面积（TBSA）,将每例患者的其中一处深Ⅱ度创面平均划分为A、B 2个部分（治疗组和对照组）,确保其创面深度一致。取患者外周静脉血制成富含血小板血浆凝胶。治疗组用富含血小板血浆凝胶敷于创面,对照组用磺胺嘧啶银霜治疗。比较2组创面的愈合时间、创面愈合率、更换最内层药用纱布的次数、换药次数、创面分泌物细菌培养,同时监测患者在研究期间实验室检测指标及不良反应情况。结果治疗组创面平均愈合时间较对照组缩短[（16.5±3.1）d vs（19.5±3.8）d],第14、17天治疗组愈合率较对照组高（P〈0.05）。治疗组2周内外敷料渗湿纱布层数[（20.6±1.7）层vs（23.3±5.9）层]、炎性反应发生率（7.4%vs19.1%）、平均换药次数[（7.2±1.1）次vs（9.2±1.4）次]、内层纱布更换次数[（2.3±0.6）次vs（5.3±1.3）次]均低于对照组。2组创面细菌培养阳性率、实验室检查指标及不良反应发生率等与对照组比较差异无统计学意义。结论深Ⅱ度烧伤创面治疗中应用PRP创面外敷,能明显缩短创面愈合时间,提高创面愈合率,减少换药次数,促进创面愈合。采用PRP可安全可靠地治疗深Ⅱ度烧伤。

Objective To evaluate the clinical effects of platelet-rich plasma in treatment of Deep Ⅱ burn wounds.Methods Sixty eight cases of inpatients with Deep Ⅱ burns were selected, whose age were from 1 to 65 years and theirburn areas were between 5%~62% of total body surface area（TBSA）. Deep gradeⅡ burn of each sample was divided intotwo parts. Part A was the treatment group and part B was the control group.The burn wounds in the treatment group weretreated with platelet-rich plasma and the counterpart in the control group were treated with SD-Ag. Healing time,recoveringrate and the frequency of dressing changes,frequency of changing the most innerlayer gauze and the rate of wound infectionwere also analyzed. Finally the laboratory abnormalities and adverse effect were monitored regularly. Results The healingtime of the treatment group（16.5±3.1） d was shorter than that of the control group（19.5±3.8） d. The recovering rate of thetreatment group was higher than that of the control group on the 14 thand 17thday after treatment. There were statistically sig-nificant differences between these two groups（P〈0.05）. After two weeks＇ treatment, the internal and external dressing per-meability into wet gauze layers were 20.6±1.7, which were significantly decreased than that in the control group 23.3±5.9.The frequency of dressing changes was（7.2±1.1）times in treatment group versus（9.2±1.4）times in control group and thefrequency of changing the inner most layer gauze was（2.3±0.6）times in the treatment group versus（5.3±1.3）times in con-trol group. There were 5 inflammation reaction cases in the treatment group, but 13 cases in the control group. However,there was no statistic significance between the two group in the outcomes of bacterial culture, the laboratory abnormalitiesand the adverse effect. Conclusion Platelet-rich plasma can remarkably shorten the healing time,improve healing rate,re-duce frequency of dressing change and promote wound healing for deep Ⅱ burn wound. PRP is a potential safety reagent intreating deep Ⅱ burn wound.