自体富血小板血浆凝胶联合皮瓣移植对股骨内侧难愈合性创面的修复效果

Repair Effect of Autologous Platelet Rich Plasma Gel Combined with Flap Transplantation on Refractory Medial Femoral Wound

目的:探讨自体富血小板血浆凝胶联合皮瓣移植对股骨内侧难愈合性创面的修复效果。方法:选取2019年7月-2020年12月收治的股骨内侧难愈合性创面患者76例进行研究,随机数字表法分为对照组、观察组,各38例。对照组给予皮瓣移植,观察组在对照组基础上加用自体富血小板血浆凝胶,对两组治疗后创面的修复效果、上皮细胞细胞改善情况、住院时间及VAS、VSS评分进行比较。结果:观察组创面愈合优良率为91.67%,较对照组的72.22%高(P<0.05);术后14、21 d时,观察组VAS、VSS评分与对照组比较差异有统计学意义(P<0.05);观察组术后创面/皮片血液灌流值较对照组高,上皮组织完全覆盖创面时间、住院时间均较对照组短(P<0.05);观察组术后21 d创面感染、瘢痕增生挛缩、创面出血、积液等并发症发生率较对照组低,差异有统计学意义(P<0.05)。结论:自体富血小板血浆凝胶联合皮瓣移植用于股骨内侧难愈合性创面患者治疗中,不仅可提高创面愈合率,促进皮细胞的扩增,还可以降低术后并发症发生率,值得推广。

Objective:To investigate the effect of autologous platelet rich plasma gel combined with skin flap transplantation on the repair of refractory medial femoral wound.Method:A total of 76 patients with refractory medial femoral wound from July 2019 to December 2020 were divided into the control group and the observation group by table of random numbers,with 38 cases in each group.The control group was treated with skin flap transplantation.The observation group was treated with autologous platelet rich plasma gel on the basis of the control group.The healing effect,the improvement of epithelial cells,length of hospital stay,VAS and VSS scores of the two groups after treatment were compared.Result:The excellent and good rate of wound healing in the observation group was 91.67%,which was higher than 72.22% in the control group (P<0.05);there were significant differences in VAS and VSS scores between the observation group and the control group at 14 and 21 days after operation (P<0.05);the blood perfusion value of wound/skin graft in the observation group was higher than that of the control group,the time of epithelial tissue completely covering the wound,length of hospital stay and were shorter than those of the control group (P<0.05);the incidence of wound infection,scar hyperplasia contracture,wound bleeding,effusion and other complications in the observation group 21 days after operation were lower than those in the control group,the difference was statistically significant (P<0.05).Conclusion:Autologous platelet rich plasma gel combined with skin flap transplantation can not only improve wound healing rate,promote the expansion of skin cells,reduce the incidence of postoperative complications,but also be worthy of promotion.