同种异体富血小板血浆用于慢性难愈性创面的临床研究*

doi:10.3969/j.issn.1671-2587.2023.03.014

临床输血与检验 ›› 2023, Vol. 25 ›› Issue (3): 368-374.DOI: 10.3969/j.issn.1671-2587.2023.03.014

同种异体富血小板血浆用于慢性难愈性创面的临床研究^*

巩蜜蜜, 汪海宁, 吴磊, 邵小宝, 周琳, 杨圆, 王华, 高凤威, 戴宇东, 朱培元

210022 南京中医药大学附属南京中医院（巩蜜蜜,吴磊,邵小宝,周琳,杨圆,王华,高凤威）; 南京红十字血液中心（汪海宁,戴宇东）

收稿日期:2023-02-23 发布日期:2023-07-10
通讯作者: 朱培元,硕士研究生导师,主任技师,（E-mail）zhupy@njucm.edu.cn。共同通信作者：戴宇东,主任技师,（E-mail）yudongdai2012@sina.cn。
作者简介:巩蜜蜜,主要从事中西医结合内分泌专业,（E-mail）2436729983@qq.com。并列第一作者：汪海宁,主要从事临床输血、血液库存与供应管理专业,（E-mail）2529671663@qq.com。
基金资助:
^*本课题受江苏省输血协会英科新创科研基金资金项目（No.JS2022006）,南京市卫生科技发展专项资金项目（No.YKK21195）资助

Efficacy of Allogeneic Platelet Rich Plasma for Chronic Refractory Wounds

GONG Mimi, WANG Haining, WU lei, et al

Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210022

Received:2023-02-23 Published:2023-07-10

摘要/Abstract

摘要： 目的探讨同种异体富血小板血浆（PRP）治疗慢性难愈性创面（CRW）患者的临床疗效。方法选取2021年5月—2022年10月收治的无法采用自体PRP治疗的CRW患者40例,采用随机数字表法将患者随机分为治疗组和对照组各20例。两组患者均在入院或门诊就诊后进行彻底清创,在此基础上治疗组采用异体PRP进行创面外敷治疗,对照组采用常规创面换药治疗并定期换药,测定创面长度和宽度以判断疗效,采用视觉模拟评分法（VAS）对治疗第10 d、20 d的疼痛程度进行评价。结果异体PRP 治疗10 d后创面见肉芽生长,后期肉芽组织较快生长、创缘上皮爬行,未见明显炎症反应;治疗30 d,治疗组创面愈合率达到95.90%,显著高于对照组的47.55%（t=-16.74,P<0.05）;治疗30 d后,治疗组创面肉芽组织生长较快,治疗后创面大小明显缩减甚至愈合（Z=–4.32,P<0.05）;治疗组创面中位愈合时间为34.50 d（31.25 d,36.00 d）,明显短于对照组的 50.00 d（45.25 d, 64.50 d）（Z=-5.42,P<0.05）。治疗组创面痊愈4例,显效16例,较对照组治疗效果明显（χ²=40.00,P<0.05）。疼痛评分显示在治疗第10、20天后,治疗组患者的疼痛明显减轻,差异具有统计学意义（Z=-5.52,P<0.05）。结论对于因年龄、基础疾病引起血小板减少或者血小板功能障碍等限制因素而无法采集自体PRP的患者,采用异体 PRP作为辅助治疗方法,可明显加速慢性创面的愈合过程,临床疗效较好。

关键词: 难愈性创面, 富血小板血浆, 同种异体

Abstract: Objective To investigate the clinical efficacy of allogeneic platelet rich plasma (PRP) for the treatment of chronic refractory wounds (CRW). Methods A total of 40 patients with CRW who could not be treated with autologous PRP from May 2021 to October 2022 were included. The patients were randomly divided into the treatment group and the control group with 20 cases in each group by using random number table. Patients in both groups underwent debridement after inpatient or outpatient visit. On this basis, patients in the treatment group were treated with allogeneic PRP external application, while patients in the control group were treated with regular wound dressing. The length and width of the wound were measured determine the curative effect. The visual analog scale (VAS) was used to evaluate the pain at the 10th and 20th days after treatment. Results After 10 days of PRP treatment, granulation growth was observed on the wound surface. Granulation tissue grew rapidly in the later stage and the epithelium of the wound margin crawled without obvious inflammatory reaction. After 30 days of treatment, the wound healing rate in the treatment group was 95.9%, which was higher than that in the control group (47.55%) (t=-16.74, P<0.05). The granulation tissue of the wound in the treatment group grew rapidly. The size of the wound was significantly reduced and even healed after treatment (Z=-4.32, P<0.05). The median wound healing time in the treatment group was 34.50 days (31.25, 36.00), which was shorter than that in the control group (50.00 days (45.25, 64.50)) (Z=-5.42, P<0.05). Four cases of wound healing and 16 cases of significant effect were observed in the treatment group, which was significantly better than that in the control group (χ²=40.00, P<0.05). After 10 and 20 days of treatment, the pain of patients in the treatment group was significantly reduced with a statistically significant difference (Z=-5.52, P<0.05). Conclusion For patients affected by restrictive factors such as thrombocytopenia or platelet dysfunction due to age and basic diseases, allogeneic PRP as an auxiliary method can significantly accelerate the healing process of chronic wounds, with good clinical efficacy.

Key words: Refractory wound, Platelet rich plasma, Allogeneic

中图分类号:

R457

巩蜜蜜, 汪海宁, 吴磊, 邵小宝, 周琳, 杨圆, 王华, 高凤威, 戴宇东, 朱培元. 同种异体富血小板血浆用于慢性难愈性创面的临床研究^*[J]. 临床输血与检验, 2023, 25(3): 368-374.

GONG Mimi, WANG Haining, WU lei, et al. Efficacy of Allogeneic Platelet Rich Plasma for Chronic Refractory Wounds[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2023, 25(3): 368-374.

参考文献

[1] AKITA S.Wound repair and regeneration:mechanisms,signaling[J].Int J Mol Sci,2019,20(24):6328.
[2] WERDIN F,TENENHAUS M,RENNEKAMPFF H O.Chronic wound care[J].Lancet,2008,372(9653):1860-1862.
[3] RAMASWAMY REDDY S H,REDDY R,BABU N C,et al.Stem-cell therapy and platelet-rich plasma in regenerative medicines:a review on pros and cons of the technologies[J].J Oral Maxillofac Pathol,2018,22(3):367-374.
[4] BHANOT S,ALEX J C.Current applications of platelet gels in facial plastic surgery[J].Facial Plast Surg,2002,18(1):27-33.
[5] MOTOLESE A,VIGNATI F,ANTELMI A,et al.Effectiveness of platelet-rich plasma in healing necrobiosis lipoidica diabeticorum ulcers[J].Clin Exp Dermatol,2015,40(1):39-41.
[6] MAGHSOUDI H,NEZAMI N,MIRZAJANZADEH M.Enhancement of burn wounds healing by platelet dressing[J].Int J Burns Trauma,2013,3(2):96-101.
[7] O'CONNELL B,WRAGG N M,WILSON S L.The use of PRP injections in the management of knee osteoarthritis[J].Cell Tissue Res,2019,376(2):143-152.
[8] KAZAKOS K,LYRAS D N,VERETTAS D,et al.The use of autologous PRP gel as an aid in the management of acute trauma wounds[J].Injury,2009,40(8):801-805.
[9] YUKSEL E P,SAHIN G,AYDIN F,et al.Evaluation of effects of platelet-rich plasma on human facial skin[J].J Cosmet Laser Ther,2014,16(5):206-208.
[10] THEYS T,VAN HOYLANDT A,BROECKX C E,et al.Plasma-rich fibrin in neurosurgery:a feasibility study[J].Acta Neurochir,2018,160(8):1497-1503.
[11] SHIRVAN M K,ALAMDARI D H,GHOREIFI A.A novel method for iatrogenic vesicovaginal fistula treatment:autologous platelet rich plasma injection and platelet rich fibrin glue interposition[J].J Urol,2013,189(6):2125-2129.
[12] TROWBRIDGE C,STAMMERS A,WOODS E,et al.Use of platelet gel and its effects on infection in cardiac surgery[J].J Extra Corpor Technol, 2005,37(4):381-386.
[13] WHITMAN D H,BERRY R L,GREEN D M.Platelet gel:an autologous alternative to fibrin glue with applications in oral and maxillofacial surgery[J].J Oral Maxillofac Surg,1997,55(11):1294-1299.
[14] MARX R E,CARLSON E R,EICHSTAEDT R M,et al.Platelet-rich plasma[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endodontology,1998,85(6):638-646.
[15] 刘广亚,周谋,单桂秋.输血医学科开展自体富血小板血浆治疗新技术的思考[J].中国临床新医学,2022,15(8):706-710.
[16] 单桂秋,李艳辉,张雅妮,等.同源异体血小板凝胶治疗糖尿病性难愈合创面的研究[J].中国输血杂志,2011,24(4):279-282.
[17] PICARD F,HERSANT B,BOSC R,et al.Should we use platelet-rich plasma as an adjunct therapy to treat “acute wounds,” “burns,” and “laser therapies”:a review and a proposal of a quality criteria checklist for further studies[J].Wound Repair Regen,2015,23(2):163-170.
[18] 付小兵. 如何在中国建立规范化的体表慢性难愈合创面防控培训与教育体系:我们的初步实践与体会[J].感染、炎症、修复,2019,20(1):23-26.
[19] 王泽蓉,范娅涵,张红,等.同种异体富血小板血浆对难愈合创面修复的疗效研究[J].临床血液学杂志,2018,31(12):895-897.
[20] CHICHARRO-ALCÁNTARA D,RUBIO-ZARAGOZA M,DAMIÁ-GIMÉNEZ E,et al.Platelet rich plasma:new insights for cutaneous wound healing management[J].J Funct Biomater,2018,9(1):10.
[21] 中国输血协会临床输血管理学专业委员会.自体富血小板血浆制备技术专家共识[J].中国输血杂志,2021,34(7):677-683.
[22] 陈若曦,李升红,卢金强,等.同种异体富血小板血浆治疗糖尿病慢性创面的疗效观察[J].感染、炎症、修复,2021,22(1):10-15.

同种异体富血小板血浆用于慢性难愈性创面的临床研究^*

Efficacy of Allogeneic Platelet Rich Plasma for Chronic Refractory Wounds

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