PRP治疗难愈性骨或腱性组织外露创面的疗效分析-现代医学

PRP治疗难愈性骨或腱性组织外露创面的疗效分析

单位：1. 溧阳市中医院手外科, 江苏常州 213300;
2. 南京大学医学院附属南京鼓楼医院手外科, 江苏南京 210000

分类号：R685

出版年·卷·期（页码）：2017·36·第十二期（1704-1708）

摘要：

目的：探讨富血小板血浆（PRP）治疗难愈性骨或腱性组织外露创面的临床疗效。方法：选取溧阳市中医院收治的30例难愈性骨或腱性组织外露创面患者作为研究对象，所有患者在进行清创处理后，均运用自体PRP伤口内注射进行治疗，观察创面愈合情况。结果：首次PRP注射治疗10 d后创面修复情况良好，25例的外露肌肉/骨组织表面有新生肉芽组织覆盖，创面内的坏死组织及脓苔消失，创面色泽红润、血供良好，与PRP治疗前相比差异有统计学意义（P<0.05）。PRP治疗前的创面体积为（12.75±2.46） cm³，PRP治疗2次后的创面体积为（3.22±1.14） cm³，治疗前后的创面体积比较差异有统计学意义（P<0.05）。PRP治疗2次后的平均创面覆盖率显著高于治疗前（P<0.05）。PRP治疗2次后的创面愈合率为33.33%。结论：难愈性骨创面或腱性组织外露创面运用自体PRP进行治疗，能够有效促进软组织修复，加快创面愈合，缩短治疗周期，值得推广。

Objective: To evaluate the clinical efficacy of platelet rich plasma (PRP) treatment on refractory bone wound or tendon tissue exposed wounds.Methods: 30 cases of refractory bone wound or tendon tissue exposed wounds patients in Liyang Hospial of Traditional Chinese Medicine were chosen for the study. after making debridement, all patients were treated with autologous PRP injection. The wound healing situation were observed.Results: The wound was repaired well after the first PRP injection for 10 days. 25 cases of patients' exposed muscle/bone tissue surface had new granulation tissue coverage, the necrotic tissue and pus moss disappeared in the wound, the color of the wound was ruddy and the blood supply was good. There was significant difference compared with before PRP treatment (P<0.05). The wound volume before PRP treatment was (12.75±2.46)cm³, and the wound volume after PRP treatment was (3.22±1.14) cm³. There was significant difference between before and after PRP treatment (P<0.05). The mean wound coverage after PRP treatment was significantly higher than that before PRP treatment (P<0.05). The wound healing rate was 33.33% after 2 times of PRP treatment.Conclusion: The use of autologous PRP in the treatment of refractory wound or tendon tissue exposed wounds can effectively promote soft tissue repair, accelerate wound healing, shorten the treatment cycle, and be worthy of promotion.

参考文献：

[1] 陈震宇,张会增.创面封闭式引流结合富血小板血浆治疗难愈性创面短期疗效观察[J].中国骨伤,2014(3):247-249.
[2] BIELECKI T,DOHAN-EHRENFEST D M,EVERTS P A,et al.The role of Leukocytes from L-PRP/L-PRF in wound healing and immune defense:new perspectives[J].Curr Pharm Biotechno,2012,13(7):1153-1162.
[3] 廖怀伟,韩超,刘丽忠,等.富血小板血浆凝胶对脂肪干细胞修复皮肤软组织缺损创面的影响[J].重庆医学,2013(32):3859-3862.
[4] 张琳,富泽龙,冯锐,等.人脂肪干细胞复合富血小板血浆治疗裸鼠放射性皮肤损伤的实验研究[J].医学研究杂志,2015(7):57-61.
[5] 赵月强,朱占永,李爱林,等.富血小板血浆治疗慢性难愈性创面的临床研究[J].临床外科杂志,2016,24(3):175-178.
[6] 邹国友,郑闽前,贾伟涛,等.自体富含血小板血浆凝胶治疗Ⅳ期褥疮探讨[J].中华老年医学杂志,2014,33(12):1338-1340.
[7] 刘宸,章宏伟.富血小板血浆促进慢性创面愈合研究进展[J].中华烧伤杂志,2014,30(5):433-436.
[8] 郝岱峰,冯光,李涛,等.富血小板血浆联合负压伤口疗法治疗患者开胸术后胸骨骨髓炎和窦道的效果[J].中华烧伤杂志,2016,32(6):331-335.
[9] TAKIKAWA M,ISHIHARA M.Enhanced healing of mitomycin C-treated healing-impaired wounds in rats with PRP-containing fragmin/protamine microparticles (PRP&F/P MPs)[J].J Plast Surg Hand Su,2015,49(5):268-274.
[10] ROUBELAKIS M G,TROHATOU O,ROUBELAKIS A,et al.Platelet-Rich Plasma (PRP) Promotes Fetal Mesenchymal Stem/Stromal Cell Migration and Wound Healing Process[J].Stem Cell Reviews,2014,10(3):417-428.
[11] LA W G,YANG H S.Heparin-conjugated poly(lactic-co-glycolic acid) nanospheres enhance large-wound healing by delivering growth factors in platelet-rich plasma[J].Artificial Organs,2015,39(4):388-394.
[12] SERRAINO G F,DOMINIJANNI A,JIRITANO F,et al.Platelet-rich plasma inside the sternotomy wound reduces the incidence of sternal wound infections[J].Int Wound J,2015,12(3):260-264.
[13] NOTODIHARDJO P V,MORIMOTO N,KAKUDO N,et al.Gelatin hydrogel impregnated with platelet-rich plasma releasate promotes angiogenesis and wound healing in murine model[J].J ArtifOrgans,2015,18(1):64-71.
[14] 刘哲伟,苏开新,陈军,等.富含血小板血浆外敷在深Ⅱ度烧伤创面修复中的临床应用[J].天津医药,2014(12):1213-1215.
[15] YAMAGUCHI R,TERASHIMA H,YONEYAMA S,et al.Effects of platelet-rich plasma on intestinal anastomotic healing in rats:PRP concentration is a key factor[J].J SurgRes,2012,173(2):258-266.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录