目的：评估血细胞分离机单采制备自体富血小板血浆（PRP）治疗雄激素性脱发（AGA）的疗效及安全性。方法：纳入31例AGA患者，采用单采技术制备血小板浓度803~1669×10?/L的自体PRP，激活后行头皮注射治疗3次（间隔1个月）。于基线（T1）及每次治疗后1、2、3个月（T2~T4）评估毛发密度与不良反应。结果：患者均为男性。毛发密度由T1的（111.77±12.00）根/cm2升至T4的（133.74±16.34）根/cm2（均P＜0.001）。医师评估有效率80.6%，患者满意率74.2%。主要不良反应为注射部位出血、肿痛及灼热感，均自行缓解；1例出现额部及眼睑明显水肿，5 d后消退。结论：单采自体PRP治疗AGA疗效确切且安全。规范控制PRP制备质量及血小板浓度有助于优化疗效。

Objective: To evaluate the clinical efficacy and safety of autologous platelet-rich plasma (PRP) prepared via apheresis using a blood cell separator for the treatment of androgenetic alopecia (AGA). Methods: A total of 31 patients with AGA who completed the study were enrolled. Autologous PRP with a platelet concentration of 803-1669×10?/L was prepared using apheresis technology. After activation, the PRP was administered via intralesional scalp injections for a total of 3 sessions at 1-month intervals. Hair density changes and adverse reactions were evaluated at baseline (T1) and at 1, 2, and 3 months after the initial treatment (T2-T4). Results: All included patients were male. Hair density significantly increased from (111.77±12.00) hairs/cm2 at baseline to (133.74±16.34) hairs/cm2 at T4 (all P<0.001). The clinician-evaluated effective rate was 80.6%, and the patient satisfaction rate was 74.2%. The primary adverse reactions included hemorrhage, swelling, burning sensation, and transient pain at the injection site, all of which resolved spontaneously. Notably, 1 patient developed marked edema in the forehead and eyelids, which subsided spontaneously after approximately 5 days. Conclusion: Autologous PRP prepared via apheresis is effective and safe for the treatment of AGA. Standardized quality control of PRP preparation and platelet concentration may contribute to further optimizing the therapeutic outcomes.

目的 探讨富血小板血浆联合自体脂肪在大阴唇填充手术中的治疗效果。方法 选择2021年1月—12月在南昌大学第一附属医院整形外科就诊、希望通过自体脂肪移植技术改善大阴唇外观的23例女性患者,年龄23~59 岁,平均年龄（45.23±1.42）岁。依据术前与患者沟通的手术效果,将富血小板血浆和脂肪组织混合并进行注射填充;并分别使用GAIS评价量表、Likert评估量表及 FSFI问卷评估手术效果。结果 每例患者每侧大阴唇的注射量为20~35 mL,术后即刻效果均非常满意,未出现感染、血肿等术后并发症。术后6个月随访,所有患者大阴唇形态符合美学标准;GAIS 评价结果显示,完全改善率达82.61%,明显改善率为13.04%,轻度改善率为 4.35%;阴唇术后效果的满意情况显示,非常满意占86.96%,满意占13.04%,无不满意或非常不满意者;6个月后患者的平均FSFI评分（53.81分）高于术前（31.80分,P<0.001）。结论 富血小板血浆联合自体脂肪注射填充可纠正大阴唇容量缺损,临床疗效良好。

Objective To investigate the therapeutic effect of platelet-rich plasma combined with autologous fat in labia majora filling surgery．Methods From January to December 2021,23 female patients,aged 23-59,with an average age of（45.23±1.42）,were admitted to the Plastic Surgery Department of the First Affiliated Hospital of Nanchang University,hoping to improve the appearance of the labia major through autologous fat transplantation technology．According to the results of preoperative communication with the patient,platelet-rich plasma and adipocytes were mixed and injected to fill the labia majora．GAIS evaluation scale,Likert evaluation scale and FSFI questionnaire were used to evaluate the surgical effect．Results The injection amount of each side of labia majora in all patients was 20~35 mL,the immediate postoperative effect was very satisfactory,and there were no postoperative complications such as infection and hematoma．After 6 months of follow-up,all patients' labia majora morphology met the aesthetic standard．GAIS evaluation results showed that the complete improvement rate was 82.61%,the obvious improvement rate was 13.04%,and the mild improvement rate was 4.35%．The satisfaction of labial postoperative results showed that 86.96% of patients were very satisfied and 13.04% were satisfied,no dissatisfied or very dissatisfied．Six months afterwards,the patients' mean total FSFI score（53.81）was significantly higher than that of preoperation（31.8,P<0.001）．Conclusions Platelet-rich plasma combined with autologous fat injection can correct the labia majora volume defect and obtain satisfactory clinical effect．

目的 探讨透明质酸钠注射联合富含血小板的血浆治疗膝骨关节炎患者的效果。方法 收集2019年7月—2021年7月在本院就诊的膝骨关节炎患者120例,采用随机数字表法分组,即对照组、观察组,均60例。对照组患者注入富含血小板的血浆(4 mL),观察组患者注射透明质酸钠(2 mL)联合富含血小板的血浆(3.5 mL),1次/周,3次为1个疗程,共2～3疗程。统计2组患者膝关节功能、临床疗效及并发症发生率。结果 ①组内比较:治疗后2月、3月及6月平均Lysholm膝关节评分均升高,P<0.05;②组间比较:治疗前及治疗后2月,2组患者平均Lysholm膝关节评分比较,P>0.05,治疗后3月、6月,2组平均Lysholm膝关节评分比较,P<0.05。2组患者Lysholm膝关节评分均较治疗前有所改善,P<0.05;观察组疼痛评分(18.92±4.11、17.61±3.83)分、肿胀度评分(10.64±2.82、9.66±1.21)分均高于对照组疼痛评分(14.02±3.52、13.54±3.21)分、肿胀度评分(9.62±2.63、8.71±1.93)分(P<0.05)。观察组临床总有效率98.33%高于对照组临床总有效率88.33%(χ²=4.821,P=0.028)。经过6个月的随访后,2组均1例出现局部肿胀,未发生其他并发症。结论 透明质酸钠注射联合富含血小板的血浆治疗膝骨关节炎患者,可以有效改善患者膝关节功能,减轻患者疼痛及肿胀程度等,安全性高,值得推广应用。

Objective To investigate the effect of sodium hyaluronate injection combined with platelet-rich plasma in the treatment of patients with knee osteoarthritis. Methods A total of 120 patients with knee osteoarthritis who were treated in our hospital from July 2019 to July 2021 were collected and randomly divided into control group and observation group,60 cases each.The patients in the control group were injected with platelet-rich plasma(4 mL),and the patients in the observation group were injected with sodium hyaluronate(2 mL)combined with platelet-rich plasma(3.5 mL),once a week,3 times as a course of treatment,total 2-3 courses of treatment.The knee joint function,clinical efficacy and complication rates of the two groups were compared. Results ①Intra-group comparison:the average Lysholm knee joint scores were significantly increased in 2 months,3 months and 6 months after treatment,P<0.05. ②Comparison between groups:before and 2 months after treatment,the average Lysholm knee joint scores of the two groups were significantly increased (P<0.05). After 3 months and 6 months treatment,the comparison of the average Lysholm knee score between the two groups were statistic significant (P<0.05).The Lysholm knee joint scores in both groups were improved compared with those before treatment (P<0.05). Three months after treatment,the pain score(18.92±4.11, 17.61±3.83)and swelling score(10.64±2.82, 9.66±1.21)in the observation group were significantly higher than those in the control group(14.02±3.52, 13.54±3.21, 9.62±2.63, 8.71±1.93, P<0.05).The total clinical effective rate of the observation group was 98.33%,which was significantly higher than that of the control group (88.33%, χ²=4.821,P=0.028).After 6-month follow-up,local swelling occurred in 1 case in both groups,and no other complications occurred. Conclusions Sodium hyaluronate injection combined with platelet-rich plasma in the treatment of patients with knee osteoarthritis can effectively improve the knee joint function and reduce the pain and swelling of the patients.It is safe and worthy of popularization and application.

目的 探讨富血小板血浆(platelet-rich plasma, PRP)联合髓芯减压治疗早期膝关节自发性骨坏死(spontaneous osteonecrosis of the knee, SONK)的临床疗效。方法 回顾性分析我院2015年6月—2020年6月收治Koshino分期为Ⅰ、Ⅱ期的SONK患者,按治疗方法不同分为单纯髓芯减压组(对照组 21例)和PRP注射+髓芯减压组(PRP组 22例),比较2组患者治疗前、后1月、3月、6月、12月的VAS评分、WOMAC评分,评估术前和随访时膝关节功能,并观察记录有无并发症。结果 43例患者术后随访12～62个月,2组患者治疗后均无切口感染、关节感染、深静脉血栓等并发症。2组患者术前VAS评分、WOMAC评分比较无统计学意义(P>0.05);VAS评分、WOMAC评分在术后1、3、6 、12月较术前比较差异均有统计学意义(P<0.05);与对照组相比,PRP组术后3、6、12月的VAS评分降低(P＜0.05),PRP组在术后6、12月的WOMAC评分改善(P＜0.05)。PRP组、对照组的总体有效率分别为90.48%(19/21)、77.27%(17/22),差异有统计学意义(P＜0.05)。在完成治疗12个月后至今的随访中,对照组共有6例患者、PRP组仅2例患者行单髁置换。结论 富血小板血浆联合髓芯减压治疗早期SONK,安全有效,临床疗效优于单纯髓芯减压术。

Objective To investigate the clinical effect of platelet-rich plasma(PRP) combined with core decompression in the treatment of early spontaneous osteonecrosis of the knee(SONK). Methods A retrospective analysis of SONK patients with Koshino stage I and Ⅱ admitted to our hospital from June 2015 to June 2020 was carried out. According to the different treatment methods, patients were divided into core decompression group (control group, 21 patients), and knee joint cavity PRP injection combined with core decompression group (PRP group, 22 patients). The VAS scores and WOMAC scores before treatment, 1, 3, 6 and 12 months after surgery were compared between the two groups to assess the knee joint function, and observed whether there were complications. Results Forty-three patients were followed up for 12 to 62 months after the operation. After treatment, the two groups had no complications such as wound infection, joint infection, or deep vein thrombosis. The preoperative VAS score and WOMAC score of the two groups were not significantly different (P>0.05);compared with those before the operation, VAS score and WOMAC score were significantly different at 1, 3, 6, and 12 months after the operation (P<0.05); compared with the control group, the VAS score of the PRP group was significantly reduced at 3, 6, and 12 months after surgery (P<0.05), and the WOMAC score of the PRP group was significantly improved at 6 and 12 months after surgery (P<0.05). The overall effective rates of the PRP group and the control group were 90.48% (19/21) and 77.27% (17/22) respectively, and the difference between the two groups was statistically significant (P<0.05). In the follow-up 12 months after the completion of the treatment, 6 patients in the control group and 2 patients in the PRP group underwent unicondylar replacement. Conclusion The combination of platelet-rich plasma and core decompression in the treatment of early SONK was safe and effective, and the clinical effect was better than that of core decompression only.