Effect analysis of autologous platelet-rich plasma in the treatment of chronic refractory wounds

doi:10.3760/cma.j.issn.1007-1245.2024.06.027

Abstract

Abstract:

Objective　To explore the effect of autologous platelet-rich plasma in the treatment of chronic refractory wounds. Methods　From July 2022 to June 2023, 64 patients with chronic refractory wounds in the People's Hospital of Xiangxiang City were divided into two groups by drawing lots with two-color balls. The patients with red balls were selected as the control group, and the patients with green balls as the observation group. In the control group, there were 18 males and 14 females; the age was 23-77 (46.48±3.34) years old; the course of disease was 2-22 (13.45±2.12) months; the wound area was 2-35 (16.23±3.12) cm². In the observation group, there were 19 males and 13 females; the age was 23-78 (46.12±3.12) years old; the course of disease was 2-24 (14.67±2.08) months; the wound area was 2-33 (16.12±3.07) cm². The control group was treated with traditional therapy, while the observation group was treated with autologous platelet-rich plasma. The recovery conditions (wound healing time, infection control time, hospital stay, and granulation tissue growth thickness), pain scores [Visual Analogue Scale (VAS) score], scar hyperplasia scores [Vancouver Scar Scale (VSS) score], wound recovery scores [Bates-Jensen Wound Assessment Tool (BWAT) score], wound healing levels [Pressure Ulcer Scale for Healing (PUSH) score], levels of inflammatory factors [C-reactive protein (CRP), interleukin-1β (IL-1β), and procalcitonin (PCT)], and qualities of life [36-item Short Form (SF-36) score] of the two groups were compared. Independent sample t test and χ² test were used. Results　The wound healing time, infection control time, hospital stay, and granulation tissue growth thickness in the observation group were (29.25±2.68) d, (10.12±2.48) d, (30.24±2.48) d, and (3.48±0.78) mm, respectively, which were superior to those in the control group [(35.26±2.74) d, (12.15±2.78) d, (36.59±3.12) d, and (1.57±0.45) mm] (t=8.870, 11.998, 3.082, and 9.013, all P<0.05). After treatment, the VAS and VSS scores of the observation group were (3.12±0.56) points and (2.41±0.63) points, which were lower than those of the control group [(4.45±0.78) points and (4.15±1.05) points] (t=7.835 and 8.038, both P<0.05). After treatment, the BWAT and PUSH scores of the observation group were (21.12±0.56) points and (8.35±2.04) points, which were lower than those of the control group [(27.45±0.78) points and (10.29±2.08) points] (t=37.292 and 3.763, both P<0.05). After treatment, the levels of CRP [(15.65±6.21) mg/L], IL-1β [(26.58±7.89) μg/L], and PCT [(1.89±0.48) ng/L] in the observation group were lower than those in the control group [(23.26±6.78) mg/L, (33.48±8.14) μg/L, and (3.15±0.78) μg/L] (t=4.682, 3.443, and 7.782, all P<0.05). After treatment, the general health status of life quality in the observation group was better than that in the control group [(79.46±8.45) points vs. (72.78±8.26) points] (t=3.198, P<0.05). Conclusion　Autologous platelet-rich plasma is effective in the treatment of chronic refractory wounds, which is helpful for wound healing, can effectively relieve the patients' pain, reduce the inflammatory reaction, promote the appearance improvement, and comprehensively improve their quality of life, with significant clinical value.

Key words:

Chronic refractory wounds, Autologous platelet-rich plasma, Recovery status, Pain, Scar hyperplasia, Wound recovery, Wound healing, Inflammatory factors, Quality of life

摘要：

目的　对自体富血小板血浆在慢性难愈合创面治疗中的效果进行探讨。方法　选取2022年7月至2023年6月湘乡市人民医院收治的64例慢性难愈合创面患者进行试验研究，通过双色球抽签的方式进行分组，抽取红球的患者为对照组，绿球的患者为观察组。对照组32例，男18例，女14例；年龄23～77（46.48±3.34）岁；病程2～22（13.45±2.12）个月；创口面积2～35（16.23±3.12）cm²。观察组32例，男19例，女13例；年龄23～78（46.12±3.12）岁；病程2～24（14.67±2.08）个月；创口面积2～33（16.12±3.07）cm²。对照组采用常规治疗，观察组采用自体富血小板血浆治疗。比较两组患者的恢复情况（创面愈合时间、控制感染时间、住院时间及肉芽组织生长厚度）、疼痛评分［视觉模拟评分法（VAS）评分］、瘢痕增生程度评分［温哥华瘢痕量表（VSS）评分］、创面恢复情况［Bates-Jensen伤口评估工具（BWAT）评分］、创面愈合水平［压疮愈合评分量表（PUSH）评分］、炎症因子水平［C反应蛋白（CRP）、白细胞介素-1β（IL-1β）及降钙素原（PCT）］及生活质量［健康调查简表（SF-36）评分］。采用独立样本t检验和χ²检验。结果　观察组创面愈合时间、控制感染时间、住院时间及肉芽组织生长厚度分别为（29.25±2.68）d、（10.12±2.48）d、（30.24±2.48）d及（3.48±0.78）mm，均优于对照组（35.26±2.74）d、（12.15±2.78）d、（36.59±3.12）d及（1.57±0.45）mm（t=8.870、11.998、3.082、9.013，均P<0.05）；治疗后，观察组的VAS及VSS评分分别为（3.12±0.56）分及（2.41±0.63）分，均低于对照组（4.45±0.78）分及（4.15±1.05）分（t=7.835、8.038，均P<0.05）；治疗后，观察组BWAT及PUSH评分分别为（21.12±0.56）分及（8.35±2.04）分，均低于对照组（27.45±0.78）分及（10.29±2.08）分（t=37.292、3.763，均P<0.05）；治疗后，观察组CRP［（15.65±6.21）mg/L］、IL-1β［（26.58±7.89）μg/L］、PCT［（1.89±0.48）ng/L］水平均低于对照组［（23.26±6.78）mg/L、（33.48±8.14）μg/L、（3.15±0.78）μg/L］（t=4.682、3.443、7.782，均P<0.05）；治疗后，观察组生活质量总体健康状态优于对照组［（79.46±8.45）分比（72.78±8.26）分］（t=3.198，P<0.05）。结论　慢性难愈合创面患者采用自体富血小板血浆治疗有着显著成效，不仅有助于创面愈合，还可有效减轻患者疼痛，减轻炎症反应，促进外观改善，全面提升其生活质量，临床价值显著。

关键词:

慢性难愈合创面, 自体富血小板血浆, 恢复情况, 疼痛, 瘢痕增生, 创面恢复, 创面愈合, 炎症因子, 生活质量

Ouyang Yuexian, Wu Hairong, Peng Jiao, Zhou Lide.

Effect analysis of autologous platelet-rich plasma in the treatment of chronic refractory wounds [J]. International Medicine and Health Guidance News, 2024, 30(6): 1013-1017.

欧阳月仙吴海蓉彭姣周立德.

自体富血小板血浆在慢性难愈合创面治疗中的效果分析 [J]. 国际医药卫生导报, 2024, 30(6): 1013-1017.

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