以质量求发展，以服务铸品牌

护理学报 ›› 2019, Vol. 26 ›› Issue (13): 6-11.doi: 10.16460/j.issn1008-9969.2019.13.006

• 研究生园地 • 上一篇    下一篇

自体富血小板纤维蛋白治疗慢性伤口有效性与安全性的Meta分析

邓波1, 江波2a, 陈静文1, 李显蓉2b   

  1. 1.西南医科大学 护理学院,四川 泸州 646000;
    2.西南医科大学附属医院 a.整形烧伤科;b.胃肠外科,四川 泸州 646000
  • 收稿日期:2019-02-25 发布日期:2020-07-08
  • 通讯作者: 李显蓉（1968-）,女,四川泸州人,本科学历,主任护师,硕士研究生导师。E-mail:1204987356@qq.com
  • 作者简介:邓波（1994-）,男,四川巴中人,本科学历,硕士研究生在读。
  • 基金资助:
    泸州市科技计划项目[2017-S-40（1/18）]

Efficacy and Safety of Autologous Platelet-Rich Fibrin in Treatment of Chronic Wounds：A Meta-analysis

DENG Bo1, JIANG Bo2a, CHEN Jing-wen1, LI Xian-rong2b   

  1. 1. School of Nursing, Southwest Medical University, Luzhou 646000, China;
    2. a. Dept. of Plastic Burns Surgery; b.Dept. of Gastrointestinal Surgery,Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
  • Received:2019-02-25 Published:2020-07-08

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摘要： 目的 通过系统综述探讨富血小板纤维蛋白治疗慢性伤口的有效性及安全性。方法 计算机检索PubMed、Medline、EMbase、Cochrane Library、Web of Science、CNKI、CBM、Wan-Fang data、VIP等原始数据,并补充检索了Best Practice、世界伤口治疗协会联盟、欧洲/美国压疮咨询小组、欧洲伤口管理协会、欧洲组织修复协会、国际伤口感染研究所以及中华医学会创伤学分会组织修复学组等伤口治疗专业网站,搜集关于富血小板纤维蛋白治疗慢性伤口的随机对照与类实验研究,检索时间均从建库至2018年12月。由2名研究员独立筛选及评价纳入研究质量及偏移风险,采用RevMan 5.3进行Meta分析。结果 共5个研究,206例患者被纳入。Meta分析显示：富血小板纤维蛋白组伤口愈合时间[MD=-15.47,95%CI（-16.36, -14.59）,P<0.001];患者住院时间[MD=-12.36,95%CI（-16.34, -8.47）,P<0.001];伤口治愈人数[OR=8.74,95%CI（2.97, 25.68）,P<0.001];伤口治疗有效人数[OR=7.89,95%CI（2.63, 23.62）,P<0.001]与对照组比较差异均有统计学意义。且纳入的所有研究试验组与对照组均未发生治疗相关不良事件。结论 富血小板纤维蛋白能提高伤口愈合率,缩短患者住院时间,减少住院费用,不会增加不良事件发生风险。但受研究样本之间个体性差异影响,仍需更多高质量研究对其进行论证。

关键词: 富血小板纤维蛋白, 慢性伤口, Meta分析

Abstract: Objective To evaluate the efficacy and safety of platelet-rich fibrin (PRF) in the treatment of chronic wounds. Methods We retrieved PubMed, Medline, EMbase database, Cochrane Library, Web of Science, China Knowledge Network, China Biomedical Database, Wanfang database, and VIP by computer to collect randomized controlled trials (RCTs) and quasi-experimental studies about treatment of chronic wounds with PRF from its inception to December of 2018 and we meanwhile researched articles from some professional websites of chronic wound treatment including The Best Practice, World Wound Therapy Association, European/American Pressure Ulcer Advisory Group, European Wound Management Association, European Organizational Restoration Association, the International Wound Infection Research Institute and the Chinese Medical Association Trauma Branch, and Department of Prosthetics. Two research fellows worked independently and evaluated the quality and migration risk, and Meta integration was performed using RevMan 5.3 software. Results Five articles were included with 206 patients. Meta results show that in PRF group, wound healing time[MD=-15.47,95%CI（-16.36, -14.59）, P<0.001], length of hospital stay[MD=-12.36,95%CI（-16.34, -8.47）, P<0.001], number of patients with cured wound [OR=8.74, 95%CI（2.97, 25.68）,P<0.001] and number of patients with effective treatment [OR=7.89,95%CI（2.63, 23.62）,P<0.001] were statistically significant. No treatment-related adverse events occurred in all studies. Conclusion PRF is effective for improving wound healing rate, shortening hospitalization time and reducing hospitalization cost. However, due to the individual differences between the study samples, more high-quality studies are needed.

Key words: platelet-rich fibrin, chronic wound, Meta-analysis

中图分类号: 

  • R47
[1]杨文英. 中国糖尿病的流行特点及变化趋势[J].中国科学(生命科学),2018,48(8):812-819.DOI:10.1360/N052018-00005.
[2]Palese A, Trevisani B, Guarnier A, et al.Prevalence and Incidence Density of Unavoidable Pressure Ulcers in Elderly Patients Admitted to Medical Units[J]. J Tissue Viability, 2017,26(2):85-88. DOI:10.1016/j.jtv.2017.03.003.
[3]Jiang Y F, Huang S, Fu X B, et al.Epidemiological Study of Chronic Wounds and Their Management in China[J]. Wound Repair Regen,2011,19(2):181-188. DOI:10.1111/j.1524-475X.2010.00666.
[4]Greer N, Foman R.MacDonald, et al. Advanced Wound Care Therapies for Nonhealing Diabetic, Venous, and Arterial Ulcers: A Systematic Review[J]. Ann Intern Med,2013,159(8):532-542.DOI:10.7326/0003-4819-159-8-201310150-00006.
[5]Richmond N A, Maderal A D, Vivas A C.Evidence-based Management of Common Chronic Lower Extremity Ulcers[J]. Dermatol Ther,2013,26(3):187-196.DOI:10.1111/dth.12051.
[6]Clark D, Rajendran Y, Paydar S, et al.Advanced Platelet-rich Fibrin and Freeze-dried Bone Allograft for Ridge Preservation: A Randomized Controlled Clinical Trial[J]. J Periodontoly,2018,89(4):379-387.DOI:10.1002/JPER.17-0466.
[7]Bojanic I, Mravak S M, Pulanic D, et al.Autologous Blood as a Source of Platelet Gel for the Effective and Safe Treatment of Oral Chronic Graft-versus-host Disease[J]. Transfusion,2018,58(6):1494-1499. DOI:10.1111/trf.14594.
[8]Ding Y, Cui L, Zhao Q, et al.Platelet-rich Fibrin Accelerates Skin Wound Healing in Diabetic Mice[J]. Ann Plast Surg, 2017, 79(3):e15-e19.DOI:10.1097/SAP.0000000000001091.
[9]Pinto N R, Ubilla M, Zamora Y, et al.Leucocyte and Platelet-rich Fibrin (L-PRF) as a Regenerative Medicine Strategy for the Treatment of Refractory Leg Ulcers: A Prospective Cohort Study[J]. Platelets,2018,29(5):468-475.DOI:10.1080/09537104.2017.1327654.
[10]The Cochrane Collaboration. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1[EB/OL].(2011-03-20)[2019-05-22].https://onlinelibrary.wiley.com/doi/book/10.1002/9780470712184.
[11]周英凤,顾莺,胡雁,等.JBI循证卫生保健中心关于不同类型研究的质量评价工具——干预性研究的质量评价[J].护士进修杂志,2018,33(2):112-113. DOI:10.16821/j.cnki.hsjx.2018.02.006.
[12]董希杰. 应用富血小板纤维蛋白治疗慢性伤口的临床研究[D].武汉:华中科技大学, 2017.
[13]汪新伟. 富血小板纤维蛋白在治疗难治性溃疡中的研究[D].合肥:安徽医科大学, 2017.
[14]李有佳,李骏,曾钊宇.自体富血小板纤维蛋白凝胶治疗糖尿病足溃疡的效果研究[J].中国医学创新,2018,15(6):36-39.DOI:10.3969/j.issn.1674-4985.2018.06.010.
[15]王澜,刘刚,李哲,等.富血小板纤维蛋白在合并潜行皮下窦道的慢性创面治疗中的临床应用[J].中华烧伤杂志,2018,34(9):637-642.DOI:10.3760/cma.j.issn.1009-2587.2018.09.014.
[16]Asser A.Autogenous Leucocyte-rich and Platelet-rich Fibrin for the Treatment of Leg Venous Ulcer: A Randomized Control Study[J]. Egypt J Surg,2018,37(3):316-321. DOI:10.4103/1110-1121.239205.
[17]Morton L M, Phillips T J. Wound Healing and Treating Wounds: Differential Diagnosis and Evaluation of Chronic Wounds[J]. J Am Acad Dermatol, 2016,74(4):589-605; quiz 605-606. DOI:10.1016/j.jaad.2015.08.068.
[18]Dohan E, Rasmusson L, Albrektsson T.Classification of Platelet Concentrates: From Pure Platelet-rich Plasma (P-PRP) to Leucocyte and Platelet-rich Fibrin (L-PRF)[J]. Trends Biotechnol,2009,27(3):158-167.DOI:10.1016/j.tibtech.2008.11.009
[19]Zhang J, Qi X, Luo S, et al.Clinical and Immunohistochemical Performance of Lyophilized Platelet-rich Fibrin (Ly-PRF) on Tissue Regeneration[J]. Clinical Implant Dent Relat Res,2017,19(3):466-477.DOI:10.1111/cid.12473.
[20]Bielecki T, Dohan E M, Everts A, et al.The Role of Leukocytes from L-PRP/L-PRF in Wound Healing and Immune Defense: A New Perspectives[J]. Curr Pharm Biotechnol,2012,13(7):1153-1162.DOI:10.2174/138920112800624373.
[21]Choukroun J, Diss A, Simonpieri A.et al.Platelet-rich Fibrin (PRF): A Second-generation Platelet Concentrate. Part IV: Clinical Effects on Tissue Healing[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(3):e56-60. DOI:10.1016/j.tripleo.2005.07.011.
[22]杨琴秋. 富血小板纤维蛋白(PRF)诱导口腔软组织缺损修复再生的实验研究[D].泸州:西南医科大学, 2015.
[23]Malta D C, Lser B P, Chueiri P S, et al.Health Care among Adults with Self-reported Diabetes Mellitus in Brazil, National Health Survey, 2013[J]. Rev Bras Epidemiol,2015,18(Suppl 2):17-32. DOI:10.1590/1980-5497201500060003.
[24]Bhattacharjee R, Sawatkar G, Vinay K.Platelet-rich Fibrin Dressings in Treating Non-healing Leg Ulcers[J]. J Am Acad Dermatol,2018,80(2):e31-e32.DOI:10.1016/j.jaad.2018.07.035.
[25]周春兰,刘颖,甄莉,等.慢性伤口患者基础疼痛及换药相关疼痛的调查分析[J].护理学杂志,2016,31(18):25-29.DOI:10.3870/j.issn.1001-4152.2016.18.025.
[26]吕娟,宁宁,叶霞,等.某院85名伤口治疗护士伤口疼痛认知及管理情况分析[J].护理学报,2012,19(1A):1-4.DOI:10.3969/j.issn.1008-9969.2012.01.001.
[27]陈可欣,龚力,何晓俐.门诊伤口换药与疼痛相关性分析[J].预防医学情报杂志,2017,33(11):1182-1185.
[28]O'Connell S, Hessler K, Dardik H. Cascade((R)) Autologous System Platelet-rich Fibrin Matrix in the Treatment of Chronic Leg Ulcers[J]. Adv Wound Care (New Rochelle),2012,1(1):52-55. DOI:10.1089/wound.2011.0290.
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