富血小板血浆治疗Ⅳ期压疮的临床疗效

Clinical efficacy of platelet-rich plasma for the treatment ofⅣperiod bedsore

目的探讨富血小板血浆对Ⅳ期压疮的临床疗效。方法选取2019年1月~2020年5月佛山健翔医院外科与康复科、佛山市中医院外一科符合选择标准的IV压疮患者52例,采用随机数字表法分为PRP组27例,对照组25例,分别进行外科清创、创面注射富血小板血浆凝胶与外科清创、常规换药处理。在第0、7、14、21天测量两组的创面体积、进行创面炎症反应症状评分以及观察总有效率。结果PRP组治疗后创面平均体积为(16.7±4.4)cm3与治疗前的(49.4±18.6)cm3比较,差异有高度统计学意义(P<0.01)。PRP组在第7、14、21天的创面平均体积与对照组同期比较,差异有高度统计学意义(P<0.01);且三个时期PRP组炎症反应症状评分均比对照组低,差异有高度统计学意义(P<0.01)。PRP组治疗总有效率为85.2%,与对照组的32.0%比较,差异有高度统计学意义(P<0.01)。结论富血小板血浆用于外科清创治疗后的Ⅳ期压疮创面能有效促进肉芽组织生长,且对创面有抑制炎症反应的作用。

Objective To explore the clinical efficacy of platelet-rich plasma for the treatment of Ⅳ period bedsore.Methods A total of 52 patients who met the inclusion criteria in the department of surgery and rehabilitation of Foshan Jianxiang Hospital and the departmentⅠof surgery of Foshan Hospital of TCM from January 2019 to May 2020 were selected and divided into the platelet-rich plasma(PRP)group(n=27)and the control group(n=25)according to the number table method.The control group was treated by surgical debridement and routine dressing change,while the PRP group was treated by surgical debridement and injection of PRP gel into the wound.On day 0,day 7,day 14 and day 21,the wound volume of the two groups was measured,the wound inflammation symptom scoring was performed,and the effective ratio was observed.Results The mean wound volume was(16.7±4.4)cm2 in the PRP group after treatment was significantly different from that before treatment was(49.4±18.6)cm2(P<0.01).The mean wound volume of the PRP group on day 0,day 7,day 14 and day 21 was compared with that in the control group in the same period,and the difference was statistically significant(P<0.01).In addition,inflammation symptom scores of PRP group were lower than those of the control group at three periods,and the differences were statistically significant(P<0.01).The effective rate of PRP group was 85.2%,which was significantly different from 32.0%of the control group(P<0.01).Conclusion PRP can effectively promote the growth of granulation tissue on the wounds ofⅣperiod bedsore after surgical debridement treatment,and it can inhibit the inflammation of the wounds.