富血小板血浆联合负压引流治疗下肢静脉曲张伴溃疡的效果

Effect of Platelet-rich Plasma Combined with Negative Pressure Drainage in the Treatment of Varicose Veins of Lower Limbs with Ulcer

目的:探讨富血小板血浆联合负压引流治疗下肢静脉曲张伴溃疡的效果。方法:选取2021年4月-2022年1月粤北人民医院烧伤整形科的86例下肢静脉曲张伴溃疡患者。根据随机数字表法将其分为对照组和观察组,各43例。对照组采用负压引流联合银离子敷料治疗,观察组采用富血小板血浆联合负压引流治疗。比较两组治疗前及治疗4周后创面大小及疼痛、创面愈合时间、换药次数。比较两组治疗前及治疗4周后静脉临床严重程度评分(VCSS)及安全性。结果:治疗4周后,两组创面大小、视觉模拟疼痛评分法(VAS)评分得到明显降低,观察组创面大小小于对照组,VAS评分低于对照组(P<0.05)。观察组创面愈合时间早于对照组,换药次数少于对照组(P<0.05)。治疗4周后,两组疼痛、静脉曲张、色素沉着、水肿、硬结、活动溃疡数、溃疡时间、溃疡大小及炎症评分均得到降低,观察组疼痛、静脉曲张、色素沉着、水肿、硬结、活动溃疡数、溃疡时间、溃疡大小及炎症评分均低于对照组(P<0.05)。两组治疗期间并发症发生率比较差异无统计学意义(P>0.05)。结论:富血小板血浆联合负压引流用于下肢静脉曲张伴溃疡患者中,有助于减小创面大小,缩短愈合时间,可减轻患者疼痛,改善下肢静脉严重程度,且安全性较好,值得推广应用。

Objective:To investigate the effect of platelet-rich plasma combined with negative pressure drainage in the treatment of varicose veins of lower limbs with ulcer.Method:From April 2021 to January 2022,86 patients with varicose veins of lower limbs with ulcer were selected from the Department of Burn and Plastic Surgery of Yuebei People’s Hospital.According to the random number table method,they were divided into control group and observation group,43 cases in each group.The control group was treated with negative pressure drainage combined with silver ion dressing,and the observation group was treated with platelet-rich plasma combined with negative pressure drainage.The wound size,pain before and after 4 weeks of treatment,wound healing time and dressing change times were compared between the two groups.The venous clinical severity score (VCSS) before and after 4 weeks of treatment and safety were compared between the two groups.Result:After 4 weeks of treatment,the wound size and visual analogue pain scale (VAS) score of the two groups were significantly reduced.The wound size of the observation group was smaller than that of the control group,and VAS score was lower than that of the control group (P<0.05).The wound healing time of the observation group was earlier than that of the control group,and the dressing changes times was less than that of the control group (P<0.05).After 4 weeks of treatment,the pain,varicose veins,pigmentation,edema,induration,number of active ulcers,ulcer time,ulcer size and inflammation scores of the two groups were reduced.The pain,varicose veins,pigmentation,edema,induration,number of active ulcers,ulcer time,ulcer size and inflammation scores of the observation group were lower than those of the control group (P<0.05).There was no significant difference in the incidence of complications between the two groups (P>0.05).Conclusion:Platelet-rich plasma combined with negative pressure drainage in patients with varicose veins of lower limbs with ulcer is conducive to reduce the size of the wound,shorten the healing time,reduce the pain of the patients,improve the severity of the veins of the lower limbs,and have good safety.It is worth popularizing and applying.