自体富血小板凝胶在糖尿病难治性皮肤溃疡中的初步应用

目的 评价自体富血小板凝胶(autologous platelet-rich gel,APG)治疗糖尿病难治性皮肤溃疡的有效性和安全性.方法 共纳入13例患者;取患者自身外周静脉血,经离心、分离、浓缩制得富含血小板血浆(platelet-rich plasma,PRP),将其与凝血酶-钙剂按一定比例(10∶1)(V/V)混合凝固形成APG,然后用双通注射器将APG均匀喷洒至溃疡表面或注射至深部窦道内.结果 13例患者治疗12周后,溃疡愈合率为69.2%(9/13),总有效率为84.6%(11/13);APG治疗后前3周溃疡面积愈合速度最快(P＜0.05);APG对窦道治愈率为83.3%(10/12);治疗过程中无不良反应发生.结论 APG用于治疗糖尿病难治性皮肤溃疡是安全有效的.

The Preliminary Application of Autologous Platelet-rich Gel Used to Treat Refractory Diabetic Dermal Ulcer

Objective To assess the effectiveness and security of autologous platelet-rich gel(APG) in the treatment of refractory diabetic dermal ulcers.Methods Thirteen diabetic patients with refractory skin lesions were enrolled for this study,and APG was produced by platelet(PLT)-rich plasma(PRP) with thrombin and calcium gluconate.APG treatment consisted of wound dressed with APG,followed by topical washing and cleaning.The APG was then covered with Vaseline gauze and left for 48 to 72 hours,after which the wounds were treated conventionally until the next PLT-gel treatment.The clinical endpoints of the study were the healing rate.Results A total of 13 patients entered the pilot study.There were no drop-outs in the study.69.2% ulcers were cured,and especially the ulcer areas were reduced significantly in the first 3 weeks;no adverse reactions were observed.Conclusion Topical therapy with APG may be considered as an effective adjuvant method to treating refractory diabetic dermal ulcer.