自体富血小板血浆凝胶在治疗烧伤残余创面的临床研究

发布时间：2018-08-04 19:14

【摘要】：目的探讨自体富血小板血浆凝胶(APG)局部应用治疗烧伤残余创面的临床疗效。方法选取在甘肃省人民医院2015年3月—2016年9月期间住院治疗的烧伤残余创面患者,将符合入组标准的60例患者随机分为两组,每组30人。两组患者创面经过常规处理后,治疗组使用自体富血小板血浆凝胶(APG)涂抹创面,对照组使用凝胶基质成分涂抹创面,外面均使用无菌透明膜粘贴后固定,创面隔日换药一次。分别记录两组第一次换药后6d、12d肉芽组织成熟程度、创面愈合时间,观察比较不同时间点两组创面愈合率、创面细菌阳性培养率及测定不同时间点创面组织中表皮生长因子、成纤维细胞生长因子水平。并对患者治疗前后血尿常规、肝肾功能进行检测。结果使用SPSS17.0软件进行数据处理和统计分析,其结果:治疗组在第一次换药后6d、12d肉芽组织成熟程度明显高于对照组(P0.01)。治疗组创面愈合时间(20.6±6.3)d少于对照组(28.5±7.8)d,差异具有统计学意义(P0.01)。不同时间点创面愈合率比较:第一次换药后6d创面愈合率,治疗组(16.17±5.01)%较对照组(14.16±5.5)%差异无统计学意义(P0.05);第一次换药后12d创面愈合率,治疗组(41.06±22.44)%较对照组(29.01±19.03)%差异具有统计学意义(P0.05);第一次换药后18d创面愈合率,治疗组(71.74±24.04)%较对照组(52.82±29.56)%差异具有明显统计学意义(P0.01)。第一次换药后18天,两组创面细菌感染率有统计学意义(P0.05)。第一次换药后6d、12d治疗组创面组织中表皮生长因子、成纤维细胞生长因子水平明显高于对照组(P0.05)。治疗过程中治疗组患者无局部或全身不适反应,相关实验室检查未见明显异常。结论自体富血小板血浆凝胶(APG)治疗烧伤残余创面临床疗效显著,可以增加创面局部生长因子水平,明显促进肉芽组织生长,加速创面愈合,有效缩短愈合时间,具有较好的安全性,在抑菌抗感染方面也起到一定的作用。
[Abstract]:Objective to investigate the clinical effect of autogenous platelet-rich plasma gel (APG) in treating residual burn wounds. Methods 60 patients with residual burn wounds who were hospitalized in Gansu Provincial people's Hospital from March 2015 to September 2016 were randomly divided into two groups with 30 patients in each group. After routine treatment, the patients in the treatment group were smeared with autologous platelet-rich plasma gel (APG), the control group was smeared with gel matrix component, the external surface was fixed with aseptic hyaline membrane, and the wound was changed once every other day. The granulation tissue maturation and wound healing time were recorded 6 days after the first dressing change in both groups. The wound healing rate, bacterial positive culture rate and epidermal growth factor (EGF) in wound tissue at different time points were observed and compared. Fibroblast growth factor level. The blood and urine routine, liver and kidney function were measured before and after treatment. Results SPSS17.0 software was used for data processing and statistical analysis. The results showed that the mature degree of granulation tissue in the treatment group was significantly higher than that in the control group at 6 days after the first dressing change (P0.01). The wound healing time in the treatment group (20.6 卤6.3) days was significantly lower than that in the control group (28.5 卤7.8) days (P0.01). Comparison of wound healing rate at different time points: the wound healing rate of the treatment group (16.17 卤5.01)% was not significantly different from that of the control group (14.16 卤5.5)% on the 6th day after the first dressing change (P0.05), and the wound healing rate was 12 days after the first change of dressing. (41.06 卤22.44)% in the treatment group and (29.01 卤19.03)% in the control group (P0.05), and the wound healing rate in the treatment group (71.74 卤24.04)% was significantly higher than that in the control group (52.82 卤29.56)% (P0.01). The infection rate of wound bacteria in the two groups was statistically significant 18 days after the first dressing change (P0.05). The levels of epidermal growth factor (EGF) and fibroblast growth factor (FGF) in the wound tissue of the treatment group were significantly higher than those in the control group (P0.05). In the treatment group, there was no local or systemic discomfort, and there was no obvious abnormality in laboratory examination. Conclusion Autologous platelet-rich plasma gel (APG) is effective in treating residual burn wounds. It can increase the level of local growth factor, promote the growth of granulation tissue, accelerate wound healing and shorten the healing time. It has good safety and plays a certain role in bacteriostasis and infection.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R644

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