富血小板血浆预防大白兔海水浸泡伤口感染与促进伤口愈合的实验研究

Experimental research on the effects of platelet rich plasma on the prevention of seawater immersion wound infection and promotion of wound healing

目的探讨富血小板血浆(platelet rich plasma,PRP)预防海水浸泡伤口感染及促进伤口愈合的临床价值。方法用新西兰大白兔建立海水浸泡伤的动物模型,将动物模型分为3组,分别为生理盐水浸泡伤口组、海水浸泡伤口组及海水浸泡伤口后PRP填充伤口组。术后3、7、14、21、28、35及42 d记录术后大白兔的一般情况,观察伤口的外观及愈合情况。42 d后取手术部位的部分组织进行病理学检测,部分组织磨碎用于细菌学检测。结果海水浸泡伤口后PRP填充组的体温、体质量及白细胞水平明显优于海水浸泡伤口组(P<0.05)。海水浸泡伤口组术后伤口明显红肿,产生大量的脓性分泌物,伤口后期可愈合,但愈合后的伤口明显肿胀,海水浸泡伤口后填充PRP组术后无明显感染,伤口愈合良好。组织病理学结果显示海水浸泡伤口后PRP填充组的肌肉纤维结构完整,无明显炎症细胞浸润,海水浸泡伤口组的肌肉纤维断裂、溶解、结构紊乱,炎症细胞浸润。微生物学研究结果显示,感染的细菌菌属为球菌属,海水浸泡伤口后PRP填充组培养形成的细菌集落数明显少于海水浸泡伤口组(P<0.05)。结论 PRP能预防海水浸泡伤的感染,促进伤口的愈合,对海水浸泡伤有潜在的应用价值。

Objective To investigate whether platelet rich plasma (PRP) could prevent seawater immersion wound infection and promote wound healing. Methods New Zealand white rabbits were used to establish the seawater immersion injury model and were randomly divided into 3 groups: the saline immersion group, the seawater immersion group and the seawater immersion wound treated with platelet rich plasma (PRP) group (or simply the PRP treatment group). General medical data, wound outward appearance and healing of the rabbits after surgery were closely recorded at 3, 7, 14, 21, 28, 35, 42 days. Forty-two days after treatment, some tissues taken from the surgical sites were collected to perform histopathological detection by HE, and other tissues were ground to have bacteriological examination. Results Body temperature, body weight, and white blood cell level of the PRP treatment group were significantly superior to those of the seawater immersion group(P<0.05). After surgery, the wound in the seawater immersion group was obviously swollen, and there was a lot of purulent secretion. Though the wound could be healed at late stage, the healed wound was clearly swollen. On the other hand, there was no significant infection for the PRP treatment group after surgery, with good wound healing. Histopathological detection results showed that the structure of muscle fibers for the PRP treatment group remained intact, without obvious inflammatory cell infiltration. However, the structure of muscle fibers for the seawater immersed group was disrupted, dissolved and was in a state of disorder, with obvious inflammatory cell infiltration. Microbiological study indicated that the infecting bacterium genus was Coccus. The number of cultured bacterial colonies in the PRP treatment group was significantly smaller than that in the seawater immersion group(P<0.05). Conclusion PRP could prevent seawater immersion wound infection, promote wound healing, and had the potential for infection prevention and treatment of seawater immersion wound.