自体富血小板血浆联合胫骨横向骨搬运在难愈性糖尿病足创面的应用

Application of autologous platelet-rich plasma combined with transverse tibia lateral bone transport in refractory diabetic foot wounds

目的探究自体富血小板血浆(PRP)联合胫骨横向骨搬运在难愈性糖尿病足(DF)创面的应用。方法选取2020年1—12月赣南医学院第一附属医院收治的45例DF患者,依照随机数字表法分为A、B、C组,每组各15例。A组予以PRP治疗,B组予以胫骨横向骨搬运治疗,C组予以PRP联合胫骨横向骨搬运治疗。比较三组的治疗总有效率、治疗前后血清生长因子[表皮生长因子(EGF)、血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)]水平及不良反应的发生情况。结果治疗后,三组总有效率比较,差异有统计学意义(P<0.05);C组总有效率高于A组和B组,差异有统计学意义(P<0.05)。治疗后,三组EGF、VEGF、bFGF水平高于本组治疗前,且C组EGF、VEGF、bFGF水平高于A组、B组,B组EGF、VEGF、bFGF水平高于A组,差异有统计学意义(P<0.05)。三组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论PRP联合胫骨横向骨搬运用于难愈性糖尿病足创面治疗时,可有效增加治疗有效率,增强机体组织再生修复活性,且安全性较高。

Objective To explore the application of autologous platelet-rich plasma(PRP)combined with tibia lateral bone transport in the refractory diabetic foot(DF)wound.Methods A total of 45 patients with DF admitted to the First Affiliated Hospital of Gannan Medical University from January to December 2020,and divided into group A,group B and group C according to the random number table method,with 15 cases in the each group.Group A was treated with PRP,group B was treated with tibia lateral bone transport,and group C was treated with PRP combined with tibia lateral bone transport.The total effective rate,the levels of serum growth factors(epidermal growth factor[EGF],vascular endothelial growth factor[VEGF],basic fibroblast growth factor[bFGF])before and after treatment,and the occurrence of adverse reactions were compared among the three groups.Results After the treatment,the total effective rate was compared among the three groups,with statistically significant difference(P<0.05).The total effective rate of group C was higher than that of the group A and group B,with statistically significant difference(P<0.05).After the treatment,the level of EGF,VEGF and bFGF in the three groups were higher than those before the treatment in the group,and the level of EGF,VEGF and bFGF in group C was higher than those in the group A and group B,the level of EGF,VEGF and bFGF in group B was higher than those in the group A,the differences were statistically significant(P<0.05).There was no statistically significant difference in the occurrence of adverse reactions compared among the three groups(P>0.05).Conclusion The application of PRP combined with tibia lateral bone transport in the treatment of refractory DF wounds could effectively increase response rate of treatment,enhance the activities of tissue regeneration and repair,it′s with highly safety.