摘要
目的探讨自体富血小板血浆凝胶联合皮瓣移植修复治疗难愈性创面的治疗效果。方法选取2017年5月~2018年5月解放军海军军医大学附属长征医院收治的难愈性创面患者120例,按照随机数字表法将其分为观察组和对照组,每组60例。观察组采用自体富血小板凝胶联合皮瓣移植治疗难愈性创面,对照组采用常规方法处理。比较经治疗后,两组患者1周内敷料更换情况及换药次数、创面平均愈合率、皮瓣移植后的成活率、并发症的发生率及复发率、伤口处炎性因子水平、治疗前后创面疼痛程度以及瘢痕增伤情况。结果观察组1周内渗湿纱布层数、内层纱布更换次数,以及换药次数明显低于对照组(均P<0.05);观察组经治疗后创面平均愈合率、皮瓣成活率明显高于对照组(均P<0.05);而观察组并发症发生率、复发率以及肿瘤坏死因子α、白细胞介素-1β以及γ-干扰素等炎性因子水平明显低于对照组(均P<0.05);同时观察组治疗后创面疼痛程度以及随防2个月后瘢痕增伤情况评分低于对照组(均P<0.05)。结论利用自体富血小板血浆凝胶联合皮瓣移植修复治疗难愈性创面,具有良好的治疗效果,能够显著提高伤口愈合速率,减轻患者疼痛感,提高患者生活质量,值得在临床推广使用。
Objective To investigate the effect of autologous platelet-rich blood plasma gel combined with skin flap transplantation in the treatment of refractory wound surface.Methods One hundred and twenty patients with refractory wound surface admitted to Changzheng Hospital Affiliated to The Second Military Medical University from May 2017 to May 2018 were selected and divided into the observation group and the control group according to the random number table method,with 60 patients in each group.The observation group was treated with autologous platelet-rich gel combined with skin flap transplantation in the treatment of refractory wound surface,while the control group was treated with conventional methods.After treatment,patients in the two groups were compared with dressing replacement and the number of dressing changes within one week,average wound surface healing rate,survival rate after skin flap transplantation,incidence of complications and the recurrence rate,inflammatory factor level in the wound,the degree of wound surface pain and scar injury before and after treatment.Results The number of wetted gauze layers,inner gauze replacement and dressing changes in the observation group within one week were significantly lower than those in the control group(all P<0.05).The average wound surface healing rate and skin flap survival rate in the observation group were significantly higher than those in the control group(all P<0.05).However,the incidence of complications,recurrence rate and the levels of inflammatory factor tumor necrosis factorα,interleukin-1β and γ-interferon were significantly lower in the observation group than those in the control group(all P<0.05).At the same time,the score of wound surface pain after treatment and scar injury during the 2 monthes of follow-up in the observation group was lower than those in the control group(all P<0.05).Conclusion The application of autologous platelet-rich blood plasma gel combined with skin flap transplantation in the treatment of refractory wound surface has a good therapeutic effect,which can significantly improve the wound healing rate,reduce the pain of patients,and improve the quality of life of patients.Therefore,it is worthy of clinical application.
作者
田梦
王钢仁
徐晓静
张颖川
朱晓海
TIAN Meng;WANG Gangren;XU Xiaojing;ZHANG Yingchuan;ZHU Xiaohai(Department of Plastic Surgery,Changzheng Hospital Affiliated to the Second Military Medical University,Shanghai 200003,China;Department of Orthopaedics,Armed Police Corps Hospital of Shanghai,Shanghai 201103,China;Department of Dermatology,Armed Police Corps Hospital of Shanghai,Shanghai 201103,China;Surgical Intensive Care Unit,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai 201103,China)
出处
《中国医药导报》
CAS
2019年第28期110-113,共4页
China Medical Herald
基金
上海市卫生和计划生育委员会科研课题（20164037）
上海市长宁区科学技术委员会项目（CNKW2016Y28）
关键词
富血小板血浆凝胶
皮瓣移植
难愈性创面
临床效果
Platelet-rich blood plasma gel
Skin flap transplantation
Refractory wound surface
Clinical effect
