不同浓度富血小板血浆在慢性难愈合创面的临床疗效分析

Clinical Effect Analysis of Different Concentrations of Platelet Rich Plasma on Chronic Infectious Wound

目的:比较不同浓度的自体富血小板血浆(Platelet-rich plasma,PRP)治疗慢性难愈性创面的临床效果,尽可能确定最佳血小板浓度.方法:2015年12月-2017年12月,选取我院骨科及烧伤创面修复科患有伤口不愈合的病人59人纳入研究(最终获得52人病例完整资料),经随机分为A、B、C、D 4组,分别给与不同浓度的自体富血小板血浆,记录病人的年龄、性别、伤口术前体积、术后不同时间点的体积及覆盖率等指标,比较各组术后指标的差异性.采用SPSS25.0统计学软件,各组间的比较采用单因素方差分析,组间性别比较采用卡方检验.结果:本研究未发生菌血症、排异反应、创面感染加重、局部异常组织增生等不良反应.各组间年龄、性别、治疗前创面体积无明显差异,治疗后第1、2、3、4周随访时,各组间创面体积、伤口表面覆盖率差异有统计学意义(P<0.05),并且每个时间点C组的伤口体积平均值最小,创面平均覆盖率最高.说明C组比其它3组促进伤口愈合能力强.结论:适当浓度的PRP能够促进伤口愈合,浓度超过一定范围,可能会抑制伤口的愈合,这个范围可能是(1500-1800)×10^9/L.

Objective: To compare the clinical effects of different concentrations of Platelet - rich plasma ( PRP) in the treatment of chronic refractory wounds and determine the optimal platelet concentration as far as possible. Methods: From December 2015 to December 2017, 59 patients with nonunion in the department of orthopedics and department of bum wound repair in our hospital were selected for the study (complete data of 52 cases were obtained finally). All patients were randomly divided into four groups: A, B, C and D. Different concentrations of autologous platelet - rich plasma were given respectively. Patients'age, gender, preoperative wound volume, and postoperative volume and coverage at different time points were recorded, and the differences of postoperative indicators in each group were compared. SPSS25. 0 was used, one - way analysis of variance was used for the comparison between the four groups, and chi - square test was used for the sex comparison between groups. Results: In this study, there were no adverse reactions such as bacteremia, rejection reaction ,aggravation of wound infection and local abnormal tissue hyperplasia. There was no significant difference in age, gender and wound volume before treatment between the groups. At week 1,2,3 and 4 after treatment, there were statistically significant differences in wound volume and wound surface coverage between the groups ( P <0. 05 ). At each time point, group C had the lowest average wound volume and the highest average wound coverage. This result indicates that group C has a stronger ability to promote wound healing than the other three groups. Conclusion: Appropriate concentration of PRP can promote wound healing, and the concentration exceeding a certain range may inhibit wound healing, which may be ( 1500 - 1800)× 10^9 / L.