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血小板凝胶在口腔颌面外科中的应用:单中心经验。

Platelet gel in oral and maxillofacial surgery: a single-centre experience.

机构信息

Immunohaematology and Transfusion Medicine Unit, Pugliese Ciaccio Hospital, Catanzaro.

出版信息

Blood Transfus. 2012 Apr;10(2):200-4. doi: 10.2450/2012.0059-11. Epub 2012 Jan 24.

Abstract

BACKGROUND

Platelet gel is a blood product intended for non-transfusion, therapeutic purposes; it is produced by combining platelet concentrate with cryoprecipitate. Platelet gel stimulates tissue growth and is a key player in tissue regeneration. As an allogeneic product, platelet gel is obtained from the blood of a common type O blood donor, with a platelet count >200×10(3)/μL. Most of the beneficial effects of this product are due to the numerous growth factors (PDGF, TGF-β, IGF-1 and IGF-2, EGF, VEGF and FGF) contained in the alpha-granules of platelets. The aim of this study was to confirm that platelet gel is a valuable aid for the surgical repair of alveolar bone loss.

MATERIALS AND METHODS

Our study was carried out on 87 patients with inflammatory or dysembryoplastic osteolytic lesions >2 cm in diameter in jaw bones. For most patients the platelet gel was collected into a 450 mL bag and kept frozen at -40 °C until, whereas for a small group of patients the gel was prepared and activated in the sterile field of the operating theatre.

RESULTS

All of our patients reported a decrease in painful symptoms immediately after surgery. Follow-up showed considerable acceleration of the healing processes in soft tissues and faster bone regeneration.

CONCLUSION

Multicentre studies are needed in order to standardise the methods for producing platelet gel and the clinical use of this product. Furthermore, for research purposes in vitro studies are needed to increase knowledge on the functional network and platelet growth factors and also to investigate the biochemical and molecular mechanisms involved.

摘要

背景

血小板凝胶是一种非输血治疗用途的血液制品;它是通过将血小板浓缩物与冷沉淀结合制成的。血小板凝胶可刺激组织生长,是组织再生的关键因素。作为一种同种异体产品,血小板凝胶取自常见的 O 型血供体的血液,血小板计数>200×10(3)/μL。该产品的大多数有益效果归因于血小板α颗粒中包含的多种生长因子(PDGF、TGF-β、IGF-1 和 IGF-2、EGF、VEGF 和 FGF)。本研究旨在证实血小板凝胶是牙槽骨缺损手术修复的有价值的辅助手段。

材料和方法

我们的研究对象为 87 名患有炎症或发育不良溶骨性病变的患者,病变部位在颌骨,病变直径>2cm。对于大多数患者,血小板凝胶被收集到一个 450 毫升的袋子中,并在-40°C 下冷冻保存,直到需要使用。对于一小部分患者,在手术室的无菌区域制备和激活凝胶。

结果

所有患者在手术后立即报告疼痛症状减轻。随访显示软组织愈合过程明显加速,骨再生更快。

结论

需要进行多中心研究,以标准化生产血小板凝胶的方法和该产品的临床应用。此外,为了研究目的,需要进行体外研究,以增加对功能性网络和血小板生长因子的了解,并研究涉及的生化和分子机制。

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本文引用的文献

1
Autologous platelet gel in plastic surgery.
Aesthet Surg J. 2001 Jul;21(4):377-9. doi: 10.1067/maj.2001.118027.
2
Treatment of chronic venous leg ulcers by platelet gel.血小板凝胶治疗下肢慢性静脉溃疡
Dermatol Ther. 2008 Jul;21 Suppl 1:S13-7. doi: 10.1111/j.1529-8019.2008.00196.x.
3
Improved treatment of mandibular odontogenic cysts with platelet-rich gel.富血小板凝胶改善下颌牙源性囊肿的治疗
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Apr;105(4):423-9. doi: 10.1016/j.tripleo.2007.07.039. Epub 2008 Feb 21.
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Platelet gels and releasates.血小板凝胶和释放物。
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