富血小板血浆在糖尿病足创面修复中的作用研究

Effect of platelet-rich plasma on wound healing in diabetic foot

目的探究富血小板血浆(PRP)在糖尿病足创面修复中的作用。方法选取2019年2月至2020年1月新疆维吾尔自治区人民医院收治的糖尿病足患者120例,根据治疗方式的不同将其分为对照组和研究组,每组各60例。所有患者经抗感染、控制血糖及手术清创处理,并对创面进行照相。对照组采用常规换药治疗,研究组将PRP均匀完整覆于创面,2组均使用凡士林纱布对创面进行覆盖,按需换药/清创,直至创面完全愈合。对2组患者的创面愈合率、创面完全愈合时间及炎症反应阳性率、换药/清创次数进行统计分析;数据比较采用t检验和χ^(2)检验。结果换药后第6天、第9天、第18天,研究组的创面愈合率分别为(18.90±7.18)%、(58.49±9.80)%、(96.70±5.39)%,分别优于对照组[(14.76±6.79)%、(43.76±7.29)%、(80.51±7.40)%],差异均有统计学意义(t=2.814、8.092、11.860,P<0.05);研究组创面完全愈合时间为(21.49±3.18)d,短于对照组[(27.46±3.79)d],差异有统计学意义(t=8.094,P<0.05);研究组炎症反应阳性率为8.68%,明显低于对照组(35.12%),差异有统计学意义(χ^(2)=6.534,P<0.05);研究组的换药与清创次数分别为(7.19±1.08)、(2.28±0.59)次,均低于对照组[(9.68±1.47)、(5.37±1.29)次],差异均有统计学意义(t=4.583、7.282,P<0.05)。结论应用PRP进行糖尿病足创面的外用对糖尿病足患者创面修复疗效更佳,可缩短愈合时间,减少炎症反应阳性率、换药/清创次数,值得应用。

Objective To explore the role of platelet-rich plasma(PRP)in wound repair of diabetec foot.Methods One hundred and twenty patients with diabetic foot admitted in People′s Hospital of Xinjiang Uygur Autonomous Region from February 2019 to January 2020 were selected.The patients were randomly divided into two groups:control group and study group according to the different ways of treatment,with each group 60 cases.All patients were treated with anti-infective,blood glucose control and taking photos after surgical debridement.Control group:conventional dressing change therapy;study group:PRP was applied to the wound evenly and completely,all patients covered the wound with vaseline gauze,changed/debridement as needed,until the wound was completely healed.The wound healing rate,complete wound healing time,positive rate of inflammatory reaction and times of dressing change/debridement were statistically analyzed in the two groups,and the data were analyzed with t test and chi-square test.Results On the 6th,9th and 18th day after dressing change,the wound healing rate of the study group[(18.90±7.18)%,(58.49±9.80)%,(96.70±5.39)%]were better than those of the control group[(14.76±6.79)%,(43.76±7.29)%,(80.51±7.40)%],the differences were statistically significant(t=2.814,8.092,11.860;P<0.05),and the complete wound healing time of the study group[(21.49±3.18)d]was shorter than the control group[(27.46±3.79)d],the difference was statistically significant(t=8.094,P<0.05).The positive rate of inflammatory reaction in the Study group(8.33%)was significantly lower than that in the latter group(35.00%),the difference between the two groups was statistically significant(χ^(2)=6.534,P<0.05).The times of dressing change/debridement in the study group[(7.19±1.08),(2.28±0.59)times]were lower than those in the control group[(9.68±1.47),(5.37±1.29)times],the differences were statistically significant(t=4.583,7.282;P<0.05).Conclusion The external application of platelet-rich plasma is more effective in the repair of diabetic foot wounds,which can shorten the healing time,reduce the incidence of posetive inflammatory reaction and the Times of dressing change/debridement.