摘要
目的:观察同种异体富血小板血浆(PRP)治疗糖尿病慢性创面的疗效。方法:40例患者为2014年1月-2020年1月暨南大学附属第一医院整形外科收治的糖尿病慢性创面患者,采用随机数字表法分为两组:同种异体PRP治疗组(治疗组)和常规换药对照组(对照组),每组20例。PRP来源于患者的健康直系亲属的外周血,采用密度梯度离心法制备。在创面清创的基础上,治疗组在创面床及创周局部注射同种异体PRP,对照组给予常规换药治疗,两组均根据创面肉芽组织生长情况用自体皮闭合创面。观察创面大体变化,治疗前与治疗后30 d测量创面面积、计算创面愈合率,记录创面完全愈合时间。结果:PRP治疗1周后创面表现为较快的肉芽生长、创缘上皮爬行、移植皮片较快地转红和上皮扩展,未见明显炎症反应。治疗30 d,治疗组创面愈合率为100%,较对照组创面愈合率92%(48%,100%)高(Z=4.447,P <0.05)。对照组治疗30d后,创面肉芽组织生长缓慢,5例仍未达到植皮条件,特别是伴有骨或肌腱外露时几乎无肉芽生长现象。治疗组创面愈合时间为24.0(19.5,27.7)d,较对照组创面愈合时间[36.5(28.0,57.5) d]短(Z=4.225,P <0.05)。结论:同种异体PRP创面局部注射作为糖尿病慢性创面治疗的辅助方法,可明显加速创面的愈合过程,临床疗效较好。在自体PRP应用受限的情况下同种异体PRP是有效的辅助治疗手段。
Objective: To observe the efficacy of allogeneic platelet-rich plasma(PRP) in treatment of chronic diabetic wounds. Methods: A total of 40 patients with chronic diabetic wounds admitted to the Department of Plastic Surgery of the First Affiliated Hospital of Jinan University from Jan. 2014 to Jan. 2020 were selected and divided into two groups(20 each) with the random number table: allograft PRP treatment group(treatment group) and routine dressing change control group(control group). PRP was derived from the peripheral blood of the patient’s healthy direct relative, and prepared by density gradient centrifugation. Based on wound debridement, allograft PRP was injected locally in the wound bed and around the wound in the treatment group, while routine dressing change was given to the control group. Autogenous skin was used to close the wound in both groups according to the growth of the granulation tissue on the wound. The gross changes of the wound were visually observed before treatment and one month after treatment, the wound area was measured objectively, the wound healing rate was calculated, and the time of complete wound healing was recorded. Results: One week after allogeneic PRP treatment, a rapid granulation growth was observed on the wound, and crawling of the wound margin epithelium, rapid reddening and epithelial expansion without obvious inflammatory reaction. Thirty days after treatment, the wound healing rate in treatment group was 100%, higher than that in control group [92%(48%, 100%), Z=4.447, P<0.05]. The granulation tissue grew slowly in control group 30 days after treatment, and 5 cases still failed to meet the conditions of skin grafting, especially when accompanied by bone or tendon exposure, there was almost no granulation growth. The wound healing time was 24(19.5, 27.75) days in treatment group, which was shorter than that in control group [36.5(28, 57.5) days, Z=4.225, P<0.05]. Conclusions: On treatment of chronic diabetic wound, as an auxiliary therapeutic method, local injection of
作者
陈若曦
李升红
卢金强
张志丹
黄苏
肖丽玲
刘宏伟
廖选
Chen Ruoxi;Li Shenghong;Lu Jinqiang;Zhang Zhidan;Huang Su;Xiao Liling;Liu Hongwei;Liao Xuan(Department of Plastic Surgery,The First Affiliated Hospital of Jinan University,Innovative Technology Institute of Tissue Repair and Regeneration,Key Laboratory of Regenerative Medicine,Ministry of Education,Guangzhou,Guangdong 510630,China)
出处
《感染．炎症．修复》
2021年第1期10-15,F0002,共7页
Infection Inflammation Repair
基金
国家自然科学基金资助项目(81372065,81871563)
广东省医学科研基金项目(A2021165)
中央高校基本科研业务费专项资金资助(21619350)
暨南大学第一临床医学院科研培育专项基金(2017306)。
