自体富血小板血浆治愈儿童难治性骨髓炎合并骨折1例

Autologous platelet-rich plasma cured refractory osteomyelitis complicated with fracture:a case report

目的自体富血小板血浆(platelet rich plasma,PRP)联合治疗成功治愈儿童难治性骨髓炎合并骨折的经验分享。方法经传统治疗14月余无效的儿童难治性骨髓炎合并骨折1例,采集患儿全血20 mL,应用二次离心法制备4~5倍浓度PRP共6 mL,3 mL PRP与0.3 mL激活剂混合,制备浓缩血小板凝胶(PG)2 cm×2 cm覆盖骨折端,剩余3 mL PRP与0.3 mL激活剂使用三通管喷洒到周围组织。结果患者随访1周X线片显示骨折线模糊,骨折端有明显骨痂形成;4个月X线片复查,骨折端愈合良好,骨折面愈合,骨髓炎痊愈。结论应用自体PRP联合治疗儿童难治性骨髓炎合并骨折具有一定的临床效果,可为儿童难治性骨髓炎治疗提供新思路。

Objective To share the experience of autologous platelet-rich plasma(PRP)combined therapy in successful treatment of refractory osteomyelitis with fractures in children.Methods One case of refractory osteomyelitis with fracture in children failed to respond to traditional treatment for more than 14 months.A total of 20 mL of whole blood was collected from the child,and 6 mL of PRP with 4 to 5 times concentration was prepared by secondary centrifugation.To prepare 2 cm×2 cm platelet concentrate gel(PG),3 mL of PRP was mixed with a 0.3 mL activator which was then covered with an absorbable dressing.A three-way tube sprayed the remaining 3 mL of PRP and 0.3 mL activator into the surrounding tissues.Results The X-ray film of the patient followed up for 1 week showed that the fracture line was blurred,and the fracture end had obvious callus formation.The X-ray film reexamination at 4 months showed that the fracture end healed well,the fracture surface healed,and the osteomyelitis healed.Conclusion Autologous PRP has a good effect in the treatment of refractory osteomyelitis combined with fracture in children,which can provide a new method for clinical treatment.