富血小板血浆在开胸术后纵膈感染治疗中的应用

目的探讨富血小板血浆(PRP)在开胸术后纵膈感染治疗中的应用。 方法选取2018年1月至2019年4月解放军总医院第四医学中心收治的开胸术后纵膈感染患者32例，男19例，女13例。年龄53~84岁，平均年龄(69.5±19.4)岁，入院后积极进行外科清创并进行PRP填充，分析患者的临床资料、治疗过程，观察伤口愈合情况及愈合时间，并结合检索相关文献，对纵膈感染的PRP治疗进行系统性陈述。 结果29例患者经Ⅰ期手术愈合，愈合时间14.0~25.0 d，平均愈合时间(18.0±1.2) d；2例患者经再次手术治疗后愈合，愈合时间分别为42、45 d；1例患者因多器官功能衰竭死亡。 结论开胸术后纵膈感染治疗难度大，治疗方式多样，难以统一；PRP凝胶既能彻底填塞死腔，又具有促进组织愈合的作用及抗感染力强的特点，能使创面得到良好的修复，提高治疗效果，是一种操作简便、积极有效的手术处理方法。

Application of platelet rich plasma in the treatment of mediastinal infection after thoracotomy

ObjectiveTo investigate the effect of platelet rich plasma (PRP) on the treatment of anterior thoracic mediastinal infection after thoracotomy. MethodsFrom January 2018 to April 2019, thirty-two patients with mediastinal infection after thoracotomy were selected, including 19 males and 13 females. The average age of patients was (69.5±19.4) years old, ranging from 53 to 84 years old. After admission, they actively performed surgical debridement and PRP filling, analyzed the patient′s clinical data, treatment process, observed the wound healing and healing time, and combined with the retrieval of relevant literature, systematically stated the PRP treatment of mediastinal infection. ResultsTwenty-nine patients were healed by primary operation, the healing time was 14-25 days, the average healing time was (18.0±1.2) days; the healing time of 2 patients was 42 days and 45 days respectively after reoperation; one patient died of multiple organ failure. ConclusionsIt is difficult to treat the infection of the anterior chest and mediastinum after thoracotomy; PRP can not only completely fill the dead space, but also has the effect of promoting tissue healing and strong anti infective force. It can make the wound well repaired and improve the therapeutic effect. It is a simple, active and effective surgical treatment method.