中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (34): 6453-6456.doi: 10.3969/j.issn.1673-8225.2011.34.045

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

自体富血小板血浆凝胶修复儿童面部Ⅱ度烧伤创面

陈富禄1，黎洪棉2，韩良枢1   

  1. 1广西昭平县人民医院外科，广西壮族自治区贺州市  546800
    2中山大学附属中山医院整形美容外科，广东省中山市 528403
  • 收稿日期:2010-12-23 修回日期:2011-01-29 出版日期:2011-08-20 发布日期:2011-08-20
  • 通讯作者: 黎洪棉，博士后，副主任医师，中山大学附属中山医院整形美容外科，广东省中山市 528403 binrong2112@ 163.com
  • 作者简介:陈富禄，男， 1975年生，广西壮族自治区昭平县人，汉族，2000年广西桂林医学院毕业，主治医师，主要从事烧伤创面修复研究。

Autologous platelet-rich gel for the repair of facial burn wounds of degree Ⅱ in children

Chen Fu-lu1, Li Hong-mian2, Han Liang-shu1   

  1. 1Department of Surgery, Zhaoping  County Peoples’ Hospital, Hezhou  546800, Guangxi Zhuang Autonomous Region, China
    2Department of Plastic and Aesthetic Surgery, Zhongshan Hospital of Sun Yat-sen University, Zhongshan  528403, Guangdong Province, China
  • Received:2010-12-23 Revised:2011-01-29 Online:2011-08-20 Published:2011-08-20
  • Contact: Li Hong-mian, Doctor, Associate chief physician, Department of Plastic and Aesthetic Surgery, Zhongshan Hospital of Sun Yat-sen University, Zhongshan 528403, Guangdong Province, China binrong2112@163.com
  • About author:Chen Fu-lu, Attending physician, Department of Surgery, Zhaoping County Peoples’ Hospital, Hezhou 546800, Guangxi Zhuang Autonomous Region, China

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621

被引次数

19

摘要：

背景：富血小板血浆可用凝血酶凝固成胶冻状，不仅可以黏合组织缺损处，还可以防止血小板流失，使血小板在局部长时间分泌生长因子，避免了目前广泛应用于临床的液态重组生长因子试剂在伤口及移植区易流失易蒸发的缺点。 
目的：观察外用自体富血小板血浆在儿童面部Ⅱ度烧伤创面修复过程中的治疗作用。
方法：选择2008-01/2010-01在广西昭平县人民医院外科收治的14岁以下面部浅Ⅱ度烧伤、深Ⅱ度烧伤儿童各30例。均以左侧面部为治疗组，右侧为对照组。伤后第3天，治疗组将自体富血小板血浆凝胶直接湿敷于创面上半暴露，换药1次/d；对照组创面单用等渗盐水纱布覆盖半暴露，换药1次/d。干预7，14 d观察两组患者创面愈合率、愈合时间、疼痛与瘢痕情况及不良反应。采用目测类比评分法评估疼痛情况，改良温哥华瘢痕测量法测定深Ⅱ度创面瘢痕增生情况。
结果与结论：在浅Ⅱ度烧伤创面患者中，治疗组7 d愈合率明显高于对照组(P < 0.05)，愈合时间明显短于对照组(P  < 0.05)；在深Ⅱ度烧伤创面患者中，治疗组14 d愈合率明显高于对照组(P  < 0.05)，愈合时间显短于对照组(P < 0.05)，瘢痕指数明显低于对照组(P  < 0.05)；两组患者创面疼痛评分无明显差别。说明外用自体富血小板血浆凝胶能显著加快儿童面部Ⅱ度烧伤创面愈合速度，缩短愈合时间，提高愈合质量，减少瘢痕形成，无明显不良反应。

关键词: 富血小板血浆, 凝胶, 面部烧伤, 伤口愈合, 儿童

Abstract:

BACKGROUND: Platelet-rich plasma can be formed the gel combined with thrombin. It not only sticks together with the tissue defected area but also prevents to the platelet run off, so the platelet excrete growth factors to keep on a long time at the local tissue. So the autologous platelet-rich gel (APG) can be avoid some shortcomings of the liquid recombinant human epidermal growth factor (rhEGF) run off and easily evaporated on wounds.
OBJECTIVE: To observe the therapeutic effect of APG during the repair for the children facial burn wounds of degree Ⅱ.
METHODS: Thirty cases of children (< 14 years old) facial burn of superficial degree Ⅱ and 30 cases of facial burn patients of deep degree Ⅱ were selected, who were treated in the Department of Burn and Plastic Surgery, the Guangxi Zhaoping Pepole’s Hospital between January 2008 and January 2010. They were divided into treatment group (left face) and control group (right face). At the 3rd day after burn, the patients in the treatment group were treated with APG directly on the wounds and half exposure, the dressing change was once a day till the wounds healed and those in the control group were treated with normal saline gauzes half exposure, the dressing change was once a day till the sounds healed. The healing ratio of wounds, healing time, pain, scar and adverse reaction were observed in both groups at 7 and 14 days. The pain was assessed by the visual analog score (VAS). The wounds scar hyperplasia of deep degree Ⅱ (scar index) was detected by the modified Vancouver scar measurement.
RESULTS AND CONCLUSION: For the facial burn of superficial degree Ⅱ at 7 days, the healing ratio in the treatment group was significantly higher than that in the control group (P < 0.05), and the healing time was obviously shorter than that in the control group (P < 0.05). For the facial burn patients of deep degree Ⅱ at 14 days, the healing ratio in the treatment group was significantly higher than that in the control group (P< 0.05), the healing time was obviously shorter than that in the control group (P < 0.05), and the scar index was lower than that in the control group (P < 0.05). There were no obvious differences in the pain score of two kinds of wounds between the two groups. External APG can significantly accelerate the healing speed, shorten the healing time on the children facial burn wounds of degree Ⅱ and can promote the healing quality with less scars formation, and without obvious adverse effect.

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