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富血小板纤维蛋白:一种自体生物材料,可辅助治疗全喉切除术后的咽部修复。

Platelet-rich fibrin: an autologous biomaterial for healing assistance of pharyngeal repair in total laryngectomy.

机构信息

Otorhinolaryngology Department, Faculty of Medicine, Mansoura University, Mansoura, 35511, Egypt.

出版信息

Eur Arch Otorhinolaryngol. 2021 Feb;278(2):463-470. doi: 10.1007/s00405-020-06404-x. Epub 2020 Oct 3.

Abstract

OBJECTIVES

The aim of this study was to evaluate the potential role of platelet-rich fibrin (PRF) application on the pharyngeal repair on decreasing the incidence of pharyngocutaneous fistula (PCF) after total laryngectomy.

METHODS

This randomized controlled clinical trial was conducted on 67 patients with advanced laryngeal carcinoma who underwent total laryngectomy, over 2 years in the Otorhinolaryngology Department, Mansoura University Hospitals, Egypt. Patients were randomly assigned into two groups: PRF group (n = 35) and control group (n = 32). Risk factors for development of PCF as well as the incidence of PCF were studied in both groups.

RESULTS

There was no statistically significant difference between groups regarding demographic data, medical comorbidities, basal hemoglobin and albumin levels, data related to the tumor (location, grade and TNM staging) and surgical details (preoperative tracheotomy and neck dissection). However, regarding the incidence of PCF, there was a statistically significant difference between groups as shown in Table 2. PCF was detected in 2/35 patients (5.7%) in the PRF group and in 10/32 patients (31.3%) in the control group (p = 0.004).

CONCLUSION

PRF application on the pharyngeal repair after total laryngectomy enhances the healing process and consequently decreases the incidence of PCF.

摘要

目的

本研究旨在评估富血小板纤维蛋白(PRF)在喉全切除术后咽瘘修复中的潜在作用,以降低咽瘘(PCF)的发生率。

方法

本随机对照临床试验在埃及曼苏拉大学医院耳鼻喉科进行,共纳入 67 例接受喉全切除术的晚期喉癌患者,研究时间为 2 年以上。患者被随机分为 PRF 组(n=35)和对照组(n=32)。研究比较了两组患者的 PCF 发生的相关危险因素和发生率。

结果

两组患者的人口统计学数据、合并症、基础血红蛋白和白蛋白水平、肿瘤相关数据(位置、分级和 TNM 分期)和手术细节(术前气管切开和颈部清扫)均无统计学差异。然而,在 PCF 的发生率方面,两组之间存在统计学差异,如表 2 所示。PRF 组中有 2/35 例(5.7%)患者出现 PCF,而对照组中有 10/32 例(31.3%)患者出现 PCF(p=0.004)。

结论

PRF 应用于喉全切除术后咽修复可促进愈合过程,从而降低 PCF 的发生率。

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