發(fā)布時間：2018-07-06 14:25

  本文選題：PRF + 富血小板纖維蛋白��； 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的內(nèi)源性表皮生長因子的缺乏可導(dǎo)致創(chuàng)面不愈合,自體富血小板纖維蛋白(PRF)含有多種生長因子。本實驗觀察富血小板纖維蛋白對糖尿病潰瘍創(chuàng)面的治療作用。通過制造兔糖尿病潰瘍的動物模型,將富血小板纖維蛋白應(yīng)用到動物糖尿病潰瘍創(chuàng)面中并分析比較其療效;后期將富血小板纖維蛋白應(yīng)用于臨床難治性潰瘍創(chuàng)面的換藥修復(fù)中。從而分析探討富血小板纖維蛋白治療臨床難治性潰瘍的臨床效果與可行性。方法(1)動物實驗研究將20只大白兔隨機(jī)分為空白對照組(4只)、糖尿病模型組(4只)、重組人表皮生長因子凝膠(rh EGF)組(4只),PRF組(8只),將糖尿病模型組、rh EGF組、PRF組建立糖尿病動物創(chuàng)面模型,4組動物創(chuàng)面分別予以1%碘伏清創(chuàng)、1%碘伏清創(chuàng)、rh EGF外敷、PRF外敷。觀察各組創(chuàng)面面積及容積變化情況,標(biāo)本予以HE染色觀察創(chuàng)面組織生長情況,免疫組化標(biāo)記血管內(nèi)皮生長因子(VEGF)蛋白,計算VEGF平均光密度。(2)富血小板纖維蛋白的臨床應(yīng)用收集2015年12月至2017年1月安徽醫(yī)科大學(xué)第一附屬醫(yī)院18例難治性潰瘍創(chuàng)面住院患者,按治療方法分為PRF組和傳統(tǒng)治療組,比較兩組病例治療前的一般情況以及治療后在愈合時間、抗生素使用時間、住院日、換藥次數(shù)、治愈率以及復(fù)發(fā)率方面的差別。結(jié)果(1)動物實驗:干預(yù)后3、7 d顯示,rh EGF組、PRF組創(chuàng)面面積和容積縮小的速度高于空白對照組及糖尿病模型組(P0.05)。第2、3周末大體病理觀察rh EGF組、PRF組創(chuàng)面組織表皮覆蓋完全,真皮結(jié)構(gòu)致密,皮膚結(jié)構(gòu)基本恢復(fù)正常,有大量毛細(xì)血管存在。第2、3周末標(biāo)本VEGF平均光密度蛋白含量,rh EGF組、PRF組顯著高于空白對照組、糖尿病模型組(P0.05)。(2)PRF組與傳統(tǒng)治療組患者在潰瘍愈合時間、抗生素使用時間、住院日、換藥次數(shù)等項目上統(tǒng)計結(jié)果存在差異,均有統(tǒng)計學(xué)意義(P0.05);在潰瘍復(fù)發(fā)率方面,PRF組低于傳統(tǒng)治療組,統(tǒng)計結(jié)果有統(tǒng)計學(xué)意義(P0.05)。但在潰瘍治愈率方面,兩組數(shù)據(jù)無統(tǒng)計學(xué)意義(P0.05)。結(jié)論PRF可顯著促進(jìn)糖尿病皮膚潰瘍創(chuàng)面的愈合,相對于傳統(tǒng)換藥治療能有效縮短治療時間,取材方便、安全、經(jīng)濟(jì),為今后臨床治療難治性潰瘍提供了新思路和新方法。
[Abstract]:Objective the absence of endogenous epidermal growth factor (EGF) may lead to wound nonunion and autogenous platelet-rich fibrin (PRF) contains multiple growth factors. To observe the therapeutic effect of platelet rich fibrin on diabetic ulcer wound. The platelet-rich fibrin was applied to the wound of diabetic ulcer in rabbits and the therapeutic effect was analyzed and compared by making the animal model of diabetic ulcer in rabbits, and the platelet rich fibrin was applied in the dressing repair of the wound of refractory ulcer in the later stage. The clinical effect and feasibility of platelet-rich fibrin in the treatment of refractory ulcer were analyzed and discussed. Methods (1) Twenty rabbits were randomly divided into control group (n = 4), diabetic model group (n = 4), recombinant human epidermal growth factor gel (rh EGF) group (n = 4) and PRF group (n = 8). Rats in 4 groups were treated with 1% Iodophor debridement and 1% Iodophor debridement with Rh EGF and PRF respectively. The changes of wound area and volume in each group were observed. The growth of wound tissue was observed by HE staining. Vascular endothelial growth factor (VEGF) protein was labeled by immunohistochemistry. The mean optical density of VEGF was calculated. (2) from December 2015 to January 2017, 18 hospitalized patients with refractory ulcer wounds in the first affiliated Hospital of Anhui Medical University were collected and divided into PRF group and traditional treatment group. The general conditions before treatment and the differences in healing time, antibiotic use time, hospitalization days, times of dressing change, cure rate and recurrence rate were compared between the two groups. Results (1) Animal experiment: the reduction rate of wound area and volume in PRF group was higher than that in blank control group and diabetic model group 3 days after intervention (P0.05). At the end of the 2nd week, the histopathological observation showed that in the rh EGF group, the wound tissue was completely covered by epidermis, the dermis structure was compact, the skin structure returned to normal, and a large number of capillaries were found in the rh EGF group. At the end of the 2nd week, the average optical density protein content in the Rh EGF group was significantly higher than that in the blank control group. The healing time of ulcer, the time of antibiotic use and the days of hospitalization in the diabetic model group (P0.05). (2) and the traditional treatment group were significantly higher than those in the control group. Changes in the number of items on the statistical results were statistically significant (P0.05); in the recurrence rate of ulcer in PRF group is lower than the traditional treatment group, the statistical results were statistically significant (P0.05). But in the ulcer cure rate, the two groups data have no statistical significance (P0.05). Conclusion PRF can significantly promote the healing of diabetic skin ulcer wound. Compared with traditional dressing change treatment, PRF can effectively shorten the treatment time, obtain materials conveniently, safely and economically, and provide a new way of thinking and new method for clinical treatment of refractory ulcer in the future.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R632.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前7條

1 張磊;曹東升;謝娟;李紅紅;陳增紅;朱邦中;鮑瓊;;負(fù)壓封閉引流治療糖尿病足效果評價[J];安徽醫(yī)學(xué);2016年05期

2 龔正興;趙宇;;富血小板纖維蛋白輔助的面部自體顆粒脂肪注射治療[J];中國臨床研究;2016年04期

3 何赤東;劉麗忠;;富血小板纖維蛋白在促進(jìn)軟組織損傷愈合中的臨床研究進(jìn)展[J];南昌大學(xué)學(xué)報(醫(yī)學(xué)版);2015年02期

4 黃崇友;臧曉方;熊軍;蔡智;;負(fù)壓封閉引流技術(shù)治療糖尿病足難愈創(chuàng)面32例[J];中國醫(yī)學(xué)創(chuàng)新;2012年12期

5 孫潔;張劍明;李彥秋;;富血小板纖維蛋白超微結(jié)構(gòu)的觀察與探討[J];口腔醫(yī)學(xué)研究;2010年01期

6 孫昱;楊海山;柳林;;鏈脲佐菌素與四氧嘧啶誘導(dǎo)建立兔1型糖尿病模型的比較[J];中國實驗診斷學(xué);2008年04期

7 鄧悅;王萬春;徐棣;權(quán)鐘縉;Kwon Jongjin;;富血小板血漿對表面多孔性種植體周骨再生的作用[J];中國口腔種植學(xué)雜志;2006年02期

，

本文編號：2103079