自体富血小板凝胶治疗难愈性糖尿病足溃疡的临床疗效观察

Clinical observation of autogenous platelet-rich gel in the treatment of refractory diabetic foot ulcer

目的:观察自体富血小板凝胶(APG)治疗难愈性糖尿病足溃疡(DFU)的临床疗效。方法:住院的50例难愈性DFU病人随机分为观察组(25例)和对照组(25例),观察组治疗采用APG,对照组采用常规外科换药,对2组治疗后的溃疡愈合率、溃疡面缩小速率及愈合时间进行比较,并对观察组病例APG治疗前后的溃疡面组织进行病理切片。结果:观察组愈合率为80.00%,溃疡面缩小速率为(0.48±0.56)cm^2/w,愈合时间为(26.7±3.0)d;对照组愈合率为24.00%,溃疡面缩小速率为(0.29±0.09)cm^2/w,愈合时间为(50.3±3.7)d。观察组的愈合率与愈合时间均优于对照组(P<0.01),溃疡面缩小速率与对照组差异无统计学意义(P>0.05)。观察组在应用APG之后溃疡面的病理切片结果显示,新生血管和肉芽组织有少量的生成。结论:与传统方法相比,APG对难愈性DFU的愈合具有较好的疗效,能够提高愈合率和缩短溃疡面的愈合时间。

Objective:To observe the clinical efficacy of autologous platelet-rich gel(APG)in the treatment of refractory diabetic foot ulcers(DFU).Methods:Forty-five patients with refractory DFU were randomly divided into the observation group(25 cases)and control group(20 cases).The observation group were treated with,and the control group were treated with traditional surgical dressing change.The ulcer healing rate,ulcer surface reduction rate and healing time between two groups were compared after treatment,and the pathological sections of ulcer tissue in observation group before and after APG were made.Results:The healing rate,reduction rate of ulcer surface and healing time in observation group were 80.00%,(0.48±0.56)cm^2/w and(26.7±3.0)d,respectively.The healing rate,reduction rate of ulcer surface and healing time in control group were 24.00%,(0.29±0.09)cm^2/w and(50.3±3.7)d,respectively.The healing rate and time in observation group were better than those in control group(P<0.01),and the difference of reduction rate of ulcer surface between two groups was not statistically significant(P>0.05).After APG was applied in the observation group,the results of pathological section of ulcer surface showed that a small amount of neovascularization and granulation tissue generated.Conclusions:Compared with traditional surgical dressing change,APG has a good effects on the healing of refractory DFU,which can significantly improve the healing rate,and shorten the healing time of ulcer surface.