汪淼 赵启明 陆海山

[摘要]目的：探討CGF（浓缩生长因子）在多种类型创面修复中的临床应用价值。方法：30例创面患者，随机分为CGF组与对照组，两组各包括6例慢性溃疡，5例皮肤软组织坏死，4例浅Ⅱ度伴部分深Ⅱ度烧伤，对照组采用清创去除坏死组织、抗生素抗感染、活血化瘀、换药等常规处理，CGF组在上述常规治疗的基础上同时行液态CGF注射和（或）湿敷及凝胶态CGF膜覆盖和（或）填塞治疗。运用SPSS 19.0软件进行统计学分析，对比两组创面愈合时间及瘢痕外形满意度。结果：CGF组慢性溃疡（14.83±2.93）d痊愈，对照组（32.00±3.58）d痊愈;CGF组皮肤软组织坏死（7.40±1.34）d痊愈，对照组（16.80±2.39）d痊愈;CGF组浅Ⅱ度伴部分深Ⅱ度烧伤9d痊愈，对照组（18.75±2.87）d痊愈。所有CGF组创面愈合时间均短于对照组，差异具有统计学意义（P<0.05）。CGF组术后外形总体满意率为100.00%（15/15），对照组为53.33%（8/15）。结论：不同性状CGF联合应用能有效促进创面愈合，加快创面愈合速度，提高创面愈合质量，控制感染，减轻瘢痕形成，且制备简单，操作便捷，在临床创面修复中具有很高的应用价值及前景。

[关键词]浓缩生长因子;创面修复;注射;湿敷;填塞;抗感染;慢性溃疡;皮肤软组织坏死;烧伤

Abstract： Objective  To explore the clinical application value of concentrated growth factor （CGF） in various types of wound repairing. Methods  Thirty patients with wounds were randomly divided into CGF group and control group. The two groups both included 6 cases of chronic ulcer， 5 cases of skin and soft tissue necrosis， and 4 cases of superficial second degree burn with deep partial-thickness burn. In the control group， patients were treated by debridement of necrotic tissues， antibiotics to prevent infection， activating blood circulation and removing blood stasis， dressing change and other routine treatments. In the CGF group， liquid CGF injection and/or hydropathic compressing， as well as gel CGF film covering and/or filling were performed simultaneously on the basis of the above conventional treatment. SPSS 19.0 software was used for statistical analysis to compare the time of wound healing and the satisfaction degree of scar shape between groups. Results  The healing time of chronic ulcer was （14.83±2.93）d and （32.00±3.58）d in the CGF group and in the control group. The healing time of skin and soft tissue necrosis was （7.40±1.34）d and （16.80±2.39）d in the CGF group and in the control group. Besides， the healing time of superficial second degree burn with deep partial-thickness burn was 9d in the CGF group， and that was （18.75±2.87）d in the control group. The wound healing time of all cases in the CGF group was shorter than those in the control group， the differences were statistically significant （P<0.05）. The overall satisfaction rate of scar shape was 100.00%（15/15） in CGF group and 53.33%（8/15） in control group. Conclusion  CGF with different characters can effectively promote wound healing， accelerate wound healing speed， improve wound healing quality， control infection， and alleviate scar formation. The procedure was easy to perform and should be considered worthwhile in clinical wound repairing.

Key words： CGF（concentrated growth factor）; wound healing; injection; hydropathic compressing; filling; anti-infection; chronic ulcer; necrosis of skin and soft tissue; burn

浓缩血小板技术用于临床目前多集中于富血小板血浆（Platelet-rich plasma，PRP）与富血小板纤维蛋白（Platelet-rich fibrin，PRF）。Sacco于2006年開发出新一代浓缩血小板技术即浓缩生长因子（Concentrated growth factor，CGF），富含更高浓度生长因子和CD34+细胞，随即被广泛应用于口腔科上颌窦提升、种植牙及骨缺损修复等方面，显示出良好的促进组织再生效应。相关临床报道也明确了CGF在治疗口腔溃疡、牙龈萎缩等方面的良好效应，但利用CGF对多种类型创面修复的技术方法探讨及临床疗效对比观察报道较少。2017年2月-2018年3月笔者使用Medifuge200变速离心机（Silfradent意大利）制备CGF，对多种类型创面行液态CGF（Liquid phase concentrated growth factor，LPCGF）与凝胶态CGF（Gel phase concentrated growth factor，GPCGF）联合治疗，在促进创面修复、组织再生及提高创面愈合质量等方面有着良好效果。……