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富血小板血浆治疗糖尿病足溃疡的疗效

Efficacy of Platelet-Rich Plasma in the Treatment of Diabetic Foot Ulcer.

作者信息

Azam Muhammad Saim, Azad Muhammad Hassan, Arsalan Muhammad, Malik Ahmed, Ashraf Raza, Javed Hamza

机构信息

General Surgery, CDA (Capital Development Authority) Hospital, Islamabad, PAK.

General Surgery, DHQ (District Headquarter) Hospital, Bahawalnagar, PAK.

出版信息

Cureus. 2024 May 23;16(5):e60934. doi: 10.7759/cureus.60934. eCollection 2024 May.

Abstract

Introduction Diabetic foot complications leading to limb amputations pose a global health concern. Platelet-rich plasma (PRP) gel has emerged as a promising method for ulcer healing, leveraging the growth factors provided by autologous PRP to enhance tissue healing. Therefore, we aimed to assess the frequency of the success of PRP therapy in the treatment of non-healing diabetic foot ulcers. Methods This quasi-experimental study, conducted in Lahore, Pakistan, from April 2021 to October 2022, enrolled 80 eligible individuals with non-responsive diabetic foot ulcers using a consecutive sampling technique. Inclusion criteria involved patients of both genders, aged 45-75 years, with unhealed diabetic foot ulcers, and exclusion criteria considered factors such as recurrent ulcers at the same site, smoking, and immunosuppressive or anticoagulant drug therapy. Baseline demographic details, ulcer measurements using a scale, and AutoCAD (Autodesk, Inc., San Francisco, California, United States)-assisted quantification of ulcer base were recorded. Autologous PRP injections were administered following strict aseptic protocols, with dressing changes and assessments performed at specified intervals over four weeks. Treatment success, defined as >90% healing after four weeks, was the primary outcome. Data analysis utilized IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States), employing post-stratification chi-square and t-tests where appropriate for significant differences. Results The mean age of the patients was 60.40 ± 9.72 years, the mean duration of diabetes was 9.48 ± 2.21 years, and the mean ulcer duration was 11.41 ± 1.63 months. The treatment success rate was 63.7%. Age, gender, and disease duration showed no significant impact on treatment success. However, patients with a normal BMI and shorter ulcer duration exhibited a significantly higher success rate (p <0.001 and p = 0.002, respectively). Conclusions This study reaffirms the efficacy of PRP in treating non-healing diabetic foot ulcers, aligning with previous research. Despite a slightly lower success rate compared to literature reports, PRP remains a promising agent for managing diabetic foot ulcers.

摘要

引言

导致肢体截肢的糖尿病足并发症是一个全球关注的健康问题。富血小板血浆(PRP)凝胶已成为一种有前景的溃疡愈合方法,利用自体PRP提供的生长因子来促进组织愈合。因此,我们旨在评估PRP疗法治疗不愈合糖尿病足溃疡的成功频率。

方法

这项准实验研究于2021年4月至2022年10月在巴基斯坦拉合尔进行,采用连续抽样技术招募了80名符合条件的不愈合糖尿病足溃疡患者。纳入标准包括年龄在45 - 75岁的男女患者,患有未愈合的糖尿病足溃疡,排除标准考虑了同一部位复发性溃疡、吸烟以及免疫抑制或抗凝药物治疗等因素。记录了基线人口统计学细节、使用量表进行的溃疡测量以及AutoCAD(美国加利福尼亚州旧金山欧特克公司)辅助的溃疡基底量化。按照严格的无菌方案进行自体PRP注射,并在四周内按指定间隔进行换药和评估。治疗成功定义为四周后愈合>90%,这是主要结局。数据分析使用IBM SPSS Statistics for Windows,版本26.0(2019年发布;美国纽约州阿蒙克市IBM公司),在适当时采用分层后卡方检验和t检验以分析显著差异。

结果

患者的平均年龄为60.40±9.72岁,糖尿病平均病程为9.48±2.21年,溃疡平均病程为11.41±1.63个月。治疗成功率为63.7%。年龄、性别和疾病病程对治疗成功无显著影响。然而,BMI正常且溃疡病程较短的患者成功率显著更高(分别为p<0.001和p = 0.002)。

结论

本研究再次证实了PRP在治疗不愈合糖尿病足溃疡方面的疗效,与先前研究一致。尽管与文献报道相比成功率略低,但PRP仍是治疗糖尿病足溃疡的一种有前景的药物。

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