摘要
目的观察富血小板血浆(PRP)治疗外伤性难愈性创面的临床疗效。方法 2014年1月至2016年8月,广州军区广州总医院一五七分院骨科治疗15例外伤性难愈性创面患者,纳入标准为经正规治疗1个月以上仍未愈合,有骨骼、肌腱、深筋膜或接骨板外露的外伤所致的慢性创面,排除癌性创面和非外伤性创面。经过1个月以上的清创、换药、负压封闭引流(VSD)等治疗后,仍无明显愈合趋势,创面面积平均(15.0±2.4)cm2,使用自体PRP凝胶进行治疗使创面缩小至1 cm2以内,并观察治疗前、治疗后5 d的体温、白细胞计数(WBC)、C反应蛋白(CRP)、血沉(ESR)、视觉模拟评分(VAS)疼痛评分及局部皮温,采用SPSS 16.0统计软件进行配对t检验统计分析。结果经1~3次PRP治疗后,创面均获得上皮化愈合,平均愈合时间(33±3.6)d。治疗前后体温(t=0.878,P>0.05)、WBC(t=0.734,P>0.05)、CRP(t=0.284,P>0.05)、ESR(t=0.416,P>0.05)、VAS疼痛评分(t=1.506,P>0.05)、局部皮温(t=0.576,P>0.05),差异无统计学意义。结论经清创、换药、VSD等方法治疗后仍不能愈合的合并深部组织外露的外伤性难愈性创面,PRP治疗能获得创面的上皮化愈合。
Objective To investigate the clinical effectiveness of platelet-rich plasma （ PRP） in the treatment of traumatic refractory wounds .Methods From January 2014 to August 2016,15 cases of traumatic refractory wounds with exposing deep tissues of bone ,tendon,deep fascia and plate,after having been treated with failed treatment of debridement ,dress changing and vacuum sealing drainage （ VSD ） technology more than one month,remaining average wound area （15.0 ±2.4）cm2,treated with PRP gel. The PRP therapy was reused until the wound areas smaller than 1 cm2 .The temperature ,white blood cell count（WBC）,C-reactive protein （CRP）,erythrocyte sedimentation rate （ESR）,visual analogue scale （ VAS） ,and skin temperature at base line and five days after the treatment were obtained ,and statistical analysis was performed using SPSS 16.0 for paired t-test.Results After one to three times of PRP therapy,all the wounds of 15 cases were fully covered with granulation tissue and healed with epithilialization.The average healing period was （33 ±3.6） d.The body temperature （ t =0.878,P 〉0.05）、WBC（t=0.734,P〉0.05）、CRP（t=0.284,P〉0.05）、ESR（t=0.416,P〉0.05）、VAS（t=1.506,P〉0.05）、skin temperature（t=0.576,P〉0.05）of five days after treatment had no significant difference statistically compared to base line .Conclusion Traumatic refractory wounds with exposing deep tissues,which are failed with treatment of debridement ,dress changing and VSD technology ,could be healed with epithilialization using PRP therapy .
出处
《中华关节外科杂志（电子版）》
CAS
2017年第6期666-670,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
富血小板血浆
创伤和损伤
伤口愈合
Platelet-rich plasma
Wounds and injuries
Wound healing
