蝎肽凝胶联合富血小板血浆在修复溃疡创面中的应用

The application of scorpion peptide gel combined with platelet-rich plasma in repairing ulcer wounds

目的探讨蝎肽凝胶联合富血小板血浆应用于清创术后的溃疡创面对溃疡创面的修复作用。方法慢性难愈性溃疡创面60例,序贯随机分为自体富血小板血浆凝胶组(plateletrich plasma gel,PRP组)和蝎肽凝胶联合富血小板血浆凝胶组(scorpion peptide gel,SP组),两组病人清创处理后,采用多层次深浅注射和表面均匀涂抹PRP凝胶,随后PRP组用无菌敷料包扎,SP组用已涂抹蝎肽凝胶的无菌敷料包扎,隔日更换各组无菌敷料,每7天换PRP凝胶,3次为1疗程。观察两组病人创口细菌培养转阴率、创面愈合率、创面愈合时间、瘢痕增生、不良反应发生率以及创口疼痛等情况。结果两组病人治疗3天后,SP组病人细菌培养转阴率(84.6%)显著高于PRP组(40.0%),差异有统计学意义(P<0.05)。治疗后,两组病人疼痛程度明显较本组前一个时间点显著减轻,治疗后第3天时SP组病人疼痛程度也明显较PRP组病人轻,差异均有统计学意义(P<0.05),但两组患不良反应发生率均较少,差异无统计学意义(P>0.05)。SP组治疗后1周、2周、3周时病人创面愈合率分别为(53.6±13.7)%、(68.4±13.1)%和(85.7±12.1)%,PRP组分别为(45.7±12.8)%、(60.3±11.6)%和(78.8±13.5)%,两组比较差异有统计学意义(P<0.05),SP组病人完全愈合时间为(28.3±7.4)天,PRP组(33.7±6.7)天,差异有统计学意义(P<0.05)。瘢痕愈合VAA评分随时间延长而评分增加,但差异无统计学意义(P>0.05)。结论 SP联合PRP能增加创面血运,加速愈合,适合于溃疡创面修复治疗。

Objective To investigate whether scorpion peptide gel combined with platelet-rich plasma can be used to repair ulcer wounds after debridement. Methods 60 cases with chronic ulcers were sequentially randomly divided into the platelet-rich plasma gel group（ PRP group） and the scorpion peptide gel combined with platelet-rich plasma gel group（ SP group）. After debridement,the two groups were treated with multi-level deep-injection PRP gel and evenly daubed PRP gel on the surface,then the PRP group was dressed with a sterile dressing and the SP group was dressed with a sterile dressing coated with scorpion peptide gel. The sterile dressings were replaced every 2 days and the PRP gel was replaced every 7 days,so 3 times were as a course of treatment. The negative rate of bacterial culture,wound healing rate,wound healing time,scar hyperplasia,incidence of adverse reactions and wound pain were observed in the two groups. Results After 3 days of treatment in the two groups,the negative rate of bacterial culture in group SP（ 84. 6%） was significantly higher than that in group PRP（ 40. 0%）,and the difference was statistically significant（ P〈0. 05）. The wound healing rate of 1 week,2 week,3 week of SP group were（ 53. 6 ± 13. 7） %,（ 68. 4 ± 13. 1） % and（ 85. 7 ± 12. 1） %,respectively. While in PRP group were（ 45. 7 ± 12. 8） % 、（ 60. 3 ± 11. 6） % and（ 78. 8 ± 13. 5） %,respectively,and the difference was statistically significant（ P〈0. 05）. The wound healing time of SP group and PRP group were（ 28. 3 ± 7. 4） d and（ 33. 7 ± 6. 7） d（ P〈0. 05）. The VAA score of scar healing also increased over time,but the difference between the two groups was not statistically significant（ P〉0. 05）. Conclusion The combination of scorpion peptide gel and platelet-rich plasma can increase the blood flow of the wound and accelerate the healing,which is suitable for the healing of ulcer wounds.