富血小板血浆在创伤愈合和白癜风治疗中的应用：系统评价和荟萃分析。

OBJECTIVE

To critically assess the effect and safety of platelet-rich plasma (PRP) in chronic wounds and vitiligo.

METHODS

A systematic literature searching was performed. Results were expressed as weight mean difference (WMD) or risk ratio (RR) with 95% confidence intervals (CIs). Pooled estimates were performed using a fixed-effects model or random-effects model, depending on the heterogeneity among studies.

RESULTS

A total of 27 studies were included in this meta-analysis. In patients with chronic diabetic ulcers, PRP significantly increased proportion of complete wound healing, percentage of wound area healed, and shortened the complete wound healing. In venous ulcers, PRP improved the epithelialized area and percentage of wound area healed. In vitiligo, PRP had better results in degree of improvement and mean repigmentation than controls. Regarding the safety profile, PRP did not increase the risk of infection in patients with chronic diabetic ulcers. Meta-regression revealed that source of PRP and preparation method of PRP significantly affected the proportion of complete wound healing, whereas age, gender, country, duration of wound, and wound size had no impact on this outcome.

CONCLUSION

PRP is effective and safe, and can be used as a potential therapeutic adjunct or alternative treatment in chronic wounds of multiple etiologies and vitiligo.

目的

系统评估富血小板血浆（PRP）治疗慢性创面和白癜风的疗效和安全性。

方法

系统检索文献。结果以加权均数差（WMD）或风险比（RR）表示，95%置信区间（CI）。根据研究间的异质性，采用固定效应模型或随机效应模型进行汇总估计。

结果

共纳入 27 项研究。在慢性糖尿病性溃疡患者中，PRP 可显著提高完全愈合率、愈合面积百分比，并缩短完全愈合时间。在静脉性溃疡患者中，PRP 可增加上皮化面积和愈合面积百分比。在白癜风患者中，PRP 在改善程度和平均复色方面优于对照组。关于安全性，PRP 并未增加慢性糖尿病性溃疡患者感染的风险。Meta 回归显示，PRP 的来源和制备方法显著影响完全愈合率，而年龄、性别、国家、创面持续时间和创面大小对这一结果无影响。