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自体富血小板血浆联合封闭负压引流治疗胫前慢性难愈性创面的临床疗效观察
Clinical observation of autogenous platelet-rich plasma combined with vacuum sealing drainage in the treatment of chronic refractory wounds
投稿时间:2023-10-11  
DOI:10.3969/j.issn.1672-5972.2024.02.012
中文关键词:  慢性难愈性创面  胫前  富血小板血浆  封闭负压引流
英文关键词:Chronic refractory wounds  Pre-tibial  Platelet-rich plasma  Vacuum sealing drainage
基金项目:
作者单位邮编
浦飞飞 武汉市第一医院骨科湖北 武汉430022 430022
赵晓龙 武汉市第一医院骨科湖北 武汉430022 430022
杨林 武汉市第一医院骨科湖北 武汉430022 430022
刘伟 武汉市第一医院骨科湖北 武汉430022 430022
冯晶 武汉市第一医院骨科湖北 武汉430022 430022
夏平* 武汉市第一医院骨科湖北 武汉430022
武汉市第四医院骨科湖北 武汉430030 
430030
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中文摘要:
      目的 研究应用自体富血小板血浆(platelet-rich plasma, PRP)联合持续封闭负压引流(vacuum sealing drainage, VSD)治疗胫前慢性难愈性创面患者的临床治疗效果。方法 选择2018年1月至2022年12月武汉市第一医院收治的胫前慢性难愈性创面患者40例,按随机数字表法分为PRP+VSD组和VSD组,每组20例。PRP+VSD组采用PRP联合VSD治疗,VSD组采用VSD治疗。比较两组患者的住院时间、抗菌药物使用时间、创面愈合时间、医疗费用和创面愈合情况。结果 两组患者均获随访,PRP+VSD组随访时间2 ~ 12个月(平均3.72个月),VSD组随访时间3 ~ 14个月(平均4.25个月)。PRP+VSD组的住院时间、抗菌药物使用时间、创面愈合时间均低于VSD组(P<0.05)。PRP+VSD组医疗费用高于VSD组,但两组比较差异无统计学意义(P>0.05)。PRP+VSD组20例患者创面全部愈合,其中16例患者一次性愈合,4例患者经过2次PRP+VSD治疗后愈合。VSD组9例患者一次性愈合,其余11例患者均经多次清创和VSD治疗才使创面完全愈合。结论 自体PRP联合VSD治疗胫前慢性难愈性创面可缩短创面愈合时间、患者住院时间和抗菌药物使用时间,降低二次手术率。自体PRP联合VSD是治疗胫前慢性难愈性创面的有效方法,为慢性难愈性创面的修复治疗提供了临床指导。
英文摘要:
      Objective To study the clinical effect of autologous platelet-rich plasma (PRP) combined with continuous vacuum sealing drainage (VSD) in patients with chronic refractory wounds.Methods Forty patients with refractory tibial anterior wounds admitted to the Wuhan No.1 Hospital from January 2018 to December 2022 were selected and divided into PRP+VSD group and VSD group according to random number table method, with 20 patients in each group. The PRP+VSD group was treated with PRP combined with VSD, while the VSD group was treated with VSD. The length of hospital stay, the use of antibiotics, the time of wound healing and the condition of wound healing were compared between the two groups.Results Both patients of the two groups were followed up, the follow-up time of the PRP+VSD group was 2 - 12 months (mean 3.72 months), and the follow-up time of VSD group was 3 - 14 months (mean 4.25 months). The PRP+VSD group had shorter hospital stay, antibiotic use time and wound healing time than the VSD group (P<0.05). The medical cost of the PRP+VSD group was higher than that of the VSD group, but there was no statistical difference between the two groups (P>0.05). In the PRP+VSD group, all wounds healed, including 16 patients healed at one time and 4 patients healed after 2 times of PRP+VSD treatment. In the VSD group, 9 patients healed at one time, and the other 11 patients were treated with debridement and VSD until the wound healed completely.Conclusion Autologous PRP combined with VSD can effectively heal the refractory tibial anterior wound, shorten the healing time and hospital stay, reduce the use of antibiotics, and decrease the rate of second surgery. This treatment is an effective method for treating chronic refractory wounds and it provides clinical guidance for the repair and management of chronic refractory wounds.
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