PRP结合VSD技术对老年慢性难愈性创面患者的创面愈合效果及其对创面微环境、愈合因子水平的影响

Effect of PRP combined with VSD on wound healing in elderly patients with chronic refractory wounds and its influence on wound microenvironment and healing factor levels

目的:研究自体富血小板血浆(Platelet Rich Plasma,PRP)凝胶干预结合封闭引流技术(Vacuum sealing drainage,VSD)对老年慢性难愈性创面患者创面微环境及愈合因子水平的影响。方法:选取本院2020年9月至2021年12月期间115例老年慢性难愈性创面患者随机分组,对照组57例给予VSD技术,观察组58例在对照组基础上加用自体PRP凝胶干预,对比两组患者创面愈合情况、创面微环境、相关愈合因子水平和不良反应。结果:观察组干预1m内创面愈合率高于对照组,创面完全愈合时间、住院时间均低于对照组(P<0.05);干预后,两组创面渗液pH值、创面细菌培养阳性率均降低,创面温度均升高(P<0.05),其中观察组更为显著(P<0.05);干预后,两组促红细胞生成素(Erythropoietin,EPO)、转化生长因子-α(Transforming growth factor-α,TGF-α)水平均升高(P<0.05),其中观察组更为显著(P<0.05);两组不良反应发生率无统计学差异。结论:自体PRP凝胶联合VSD技术干预能够加速老年慢性难愈性创面愈合,有效改善创面微环境,提高相关愈合因子水平,安全性高。

Objective:To investigate the effects of Platelet Rich Plasma(PRP)gel combined with the Vacuum Sealing Drainage(VSD)on the wound microenvironment and healing factors in the elderly patients with chronic refractory wounds.Methods:A total of 115 elderly patients with chronic refractory wounds from September 2020 to December 2021 in our hospital were randomly assigned,57 patients in the control group were received VSD technology,and 58 patients in the observation group were received PRP gel intervention on the basis of the control group.Wound healing rate,wound microenvironment,the levels of related healing factors and adverse reactions were compared between the two groups.Results:The wound healing rate in the observation group was higher than that in the control group within 1 month after intervention,and the time of complete wound healing and hospital stay in the observation group were lower than those in the control group(P<0.05).After intervention,the pH value of wound seepage and the positive rate of wound bacterial culture were decreased,and the wound temperature was increased(P<0.05),the changes in these indexes of observation group were bigger than those of control group(P<0.05).Erythropoietin(EPO)and Transforming Growth Factor-α(TGF-α)levels were increased in both groups after the intervention compared with before the intervention,and the amplitudes in observation group were bigger than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:Autologous PRP gel combined with VSD technique can accelerate the healing of chronic refractory wounds in the elderly,effectively improve the wound microenvironment,and improve the level of related healing factors,with high safety.