输血科开展富血小板血浆治疗的可行性探讨——附176例PRP应用的疗效分析

Feasibility analysis of platelet-rich plasma treatment by blood transfusion departments with efficacy analysis for 176 PRP cases

目的探讨输血科在当前输血医学的发展新形势下开展富血小板血浆（PRP）治疗的可行性。方法总结分析2014年1月—2017年1月本科独立完成或与临床科室配合完成的来自门诊或住院的176名接受PRP治疗患者的情况,以证明PRP治疗的有效性和安全性,结合实践重点阐释输血科开展PRP治疗的可行性、必要性和紧迫性。176例自愿接受PRP治疗的病案资料包括糖尿病慢性难愈合皮肤溃疡创面67例、整形美容配合治疗100例、膝关节损伤16例。血液采集、PRP、血小板凝胶（PG）或PG上清液的制备和质量控制均由输血科完成,糖尿病慢性难愈合皮肤溃疡创面和膝关节损伤的PRP治疗由输血科医师独立完成,整形美容配点阵激光/水光针联合PRP/PG上清治疗由输血科医师配合整形美容科医师完成。结果糖尿病慢性难愈合皮肤溃疡患者接受异体PRP治疗12周后的痊愈率36%（24/60）、显效率18%（12/60）、好转率26.67%（16/60）、无效率13.33%（8/60）;美容整形科接受自体点阵激光/水光针联合PRP/PG上清液治疗后,总痊愈率99%（99/100）中痊愈60例、显效30例、有效9例、无效1例;运动损伤患者在接受自体PRP治疗后,痊愈率0、显效率25%（4/16）、有效率75%（12/16）、无效率0,总有效率100%。结论输血科有能力独立完成或配合临床科室开展PRP治疗。

Objective To explore the feasibility of the implementation of platelet-rich plasma（ PRP） treatment in Blood Transfusion Departments. Method Summaries and analysis of 176 outpatients or inpatients cases,recorded from January 2014 to January 2017,with PRP treatment were completed individually by our department or co-completed with the clinical department. Apart from discussing the effectiveness and safety of PRP treatment,we mainly focused on the illustration of its feasibility,necessity and urgency in transfusion from a blood transfusion medicine and development practice perspective.The 176 PRP cases included 67 cases of diabetic chronic-nonhealing skin ulcers,100 cases of fractional Laserr/Water needle combined with PRP/PG supernatant treatment,16 cases of injury of knee joint. Blood sampling,preparation and quality-control of PRP or PG or PG supernatants were performed by the transfusion department. PRP treatment for diabetic chronic-nonhealing skin ulcers is completed independently by the physician in the department of blood transfusion,fractional Laser/Water needle combined with PRP/PG supernatant treatment is completed by the physicians in the blood transfusion department with assistance of the physicians in plastic and cosmetic department. Results Patients with diabetic chronic-nonhealing skin ulcers after 12 weeks of treatment with allogeneic PRP showed a cure rate of 36%（ 24/67）,a significant rate of 18%（ 12/67）,an improvement rate of 24%（ 16/67）,and a inefficiency rate of 12%.（ 8/67）. The loss rate of follow-up was 10%（ 7/67）. Patients after receiving treatment of autologous-dot fractional Laser/Water needle combined with PRP/PG supernatant treatment in plastic and cosmetic department showed a total cure rate of 99%（ 99/100）,of which 60 cases were cured,30 cases were considered effectively treated,9 cases were effective,and 1 case failed to treat the patient. After receiving autologous PRP treatment,patients with athletic injury showed a cure rate of 0,a significant efficiency of 25%（ 4/16）,an effective rate of 75%（ 12/16）,an ineffective rate of 0,and a total effective rate of 100%. Conclusion The Blood Transfusion Department has the ability to perform PRP treatment independently or in conjunction with clinical departments.