【作者】 于德宝； 冯建忠； 王晓东； 张福仁；

【Author】 YU Debao;FENG Jianzhong;WANG Xiaodong;ZHANG Furen;Jinan Dermatosis Prevention and Control Hospital;Shandong Provincial Institute of Dermatology and Venereology;

【机构】 济南市皮肤病防治院； 山东省皮肤病性病研究所；

【摘要】 目的:麻风是由麻风分枝杆菌(Mycobacterium leprae,ML)侵犯人体皮肤与周围神经造成的慢性传染性疾病,因其对人体周围神经的损害,可造成不可逆的残疾。麻风杆菌侵犯人体周围神经后,可导致皮肤触觉、温度与痛觉的减退或丧失,在长期的压迫、外伤、感染情况下,易造成皮肤的溃疡,因神经失营养后,可致溃疡经久不愈,如何让麻风溃疡愈合,是一个较为困难的医学问题。我们在临床工作中尝试使用自体富血小板血浆疗法治疗麻风慢性下肢溃疡,旨在为难治性麻风溃疡寻找一种较现在常用方法更加有效的治疗手段。方法:通过问卷与现场调查,统计麻风患者中患有溃疡的人群,对没有发生癌变的溃疡给予富血小板血浆治疗,经病理证实癌变的溃疡,实施截肢手术治疗。采用麻风病人的自体血10-20ml,在无菌操作条件下,经2次离心后,获取5-10ml高浓度的富血小板血浆,在麻风溃疡周边及溃疡面内注射治疗,观察不同治疗次数情况下,麻风溃疡的愈合时间、愈合面积等溃疡情况,评价PRP疗治在治疗麻风溃疡中的效果。结果:使用自体富血小板血浆(Platelet-richplasma,PRP)疗法治疗13例患者的16处麻风溃疡,均取得了良好的治疗效果,其中10例病人的13处溃疡得到治愈,2例病人的溃疡面积缩小了80%以上。结论:PRP疗法治疗麻风溃疡简单、安全、有效,适宜于在全国范围内推广用于麻风溃疡的治疗。更多还原

【Abstract】 Objective:Leprosy is a chronic infectious disease caused by Mycobacterium leprosy(Mycobacterium leprae,ML) invading human skin and peripheral nerves.Because of its damage to human peripheral nerves,leprosy can cause irreversible disability.After leprosy bacilli invades the peripheral nerve of the human body,it can lead to the decrease or loss of skin touch,temperature and pain.Under the condition of long-term compression,trauma and infection,it is easy to cause skin ulcers,which can cause ulcers for a long time after nerve loss.How to make leprosy ulcer heal is a more difficult medical problem.In our clinical work,we try to use autologous Platelet-rich plasma therapy to treat leprosy chronic lower extremity ulcer,in order to find a more effective treatment for refractory leprosy ulcer than the commonly used methods.Methods:Through questionnaire and field investigation,the population with ulcer in leprosy patients was counted,the ulcer without canceration was treated with platelet-rich plasma,and the ulcer with canceration confirmed by pathology was treated with amputation.Using 10-20 ml autologous blood of leprosy patients,under aseptic operation conditions,after twice centrifugation,platelet-rich plasma with high concentration of 5-10 ml was obtained and injected around leprosy ulcer and within ulcer surface.under different treatment times,the healing time and area of leprosy ulcer were evaluated to evaluate the effect of PRP in the treatment of leprosy ulcer.Results:13 cases of leprosy foot ulcer were treated with autologous platelet-rich plasma(Platelet-rich plasma,PRP),and good results were obtained.Of these,16 ulcers were cured in 13 patients and the ulcer area was reduced by 80% in 2 patients.Conclusion:PRP therapy is simple,safe and effective in the treatment of leprosy ulcer,and it is suitable for the treatment of leprosy ulcer in the whole country.更多还原