负压封闭引流联合自体富血小板血浆对慢性难愈性创面疼痛程度的影响

Effect of Negative Pressure Sealing Drainage Combined with Autologous PlateLet-rich Plasma on Pain Degree in Patients with Chronic Refractory Wounds

目的探讨负压封闭引流联合自体富血小板血浆对慢性难愈性创面患者疼痛程度的影响。方法选取2020年1月至2021年1月福建医科大学附属第一医院收治的76例慢性难愈性创面患者为研究对象,按照随机数表法将患者分为对照组与试验组,每组38例。对照组采用负压封闭引流治疗,试验组在对照组基础上采用自体富血小板血浆治疗,比较两组创面愈合相关指标,治疗前及治疗1、2周后疼痛程度[采用视觉模拟评分法(VAS)评估],细菌培养阳性率,血清炎症因子水平。结果试验组创面愈合时间及住院时间均短于对照组,治疗期间换药次数少于对照组,出院时创面愈合率高于对照组,差异有统计学意义(P<0.05);治疗前,两组VAS评分比较,差异无统计学意义(P>0.05);治疗1、2周后,两组VAS评分均低于治疗前,且试验组低于对照组,差异有统计学意义(P<0.05);治疗前,两组细菌培养阳性率比较,差异无统计学意义(P>0.05);治疗1、2周后,两组细菌培养阳性率均低于治疗前,且试验组低于对照组,差异有统计学意义(P<0.05);治疗前,两组白细胞计数、血清C-反应蛋白水平比较,差异均无统计学意义(P>0.05);治疗后,两组白细胞计数及血清C-反应蛋白水平均低于治疗前,且试验组低于对照组,差异有统计学意义(P<0.05)。结论负压封闭引流联合自体富血小板血浆可有效减轻慢性难愈性创面患者的疼痛程度,降低血清炎症因子水平,促进细菌培养转阴,提高创面愈合率,缩短康复时间。

Objective To investigate the effect of vacuum sealing drainage combined with autologous platelet-rich plasma on the pain degree of patients with chronic refractory wounds.Methods In January 2020-January 2021 in our hospital 76 cases of patients with chronic wound painless sex as the research object,USES the prospective,randomized study,according to the random number table method was divided into control group and the team all the 38 cases,were given the closed negative pressure drainage treatment,and on the basis of the closed negative pressure drainage treatment given autologous platelet rich plasma treatment.The wound healing time,dressing change times during treatment,wound healing rate at discharge,length of hospital stay,pain degree and positive rate of bacterial culture before treatment,1 week after treatment and 2 weeks after treatment were compared between the two groups,and the levels of serum inflammatory factors before and after treatment were observed.Results After treatment,the wound healing time,times of dressing change during treatment,wound healing rate at discharge and length of hospital stay in the study group were better than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in pain degree between the two groups(P>0.05).After 1 week and 2 weeks of treatment,the pain degree of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the positive rate of bacterial culture between the two groups(P>0.05).After 1 week and 2 weeks of treatment,the positive rate of bacterial culture in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in white blood cell count and C-reactive protein between the two groups(P>0.05).After treatment,the white blood cell count and C-reactive protein in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Negative pressure sealing drainage combined with autologous platelet-rich plasma can effectively relieve the pain degree of patients with chronic refractory wounds,reduce the level of inflammatory factors,and promote wound healing,which is worthy of clinical application.