Primary atrophic rhinitis (1Ry AR) chirwere chemhino chisingaperi chinoratidzwa nekurasikirwa kwemucociliary clearance function, kuvapo kwezvinonamira secretions uye yakaoma crusts, zvichitungamira kune yakajairwa kunhuwa kwakashata, kazhinji mativi maviri.Nhamba huru yenzira dzekurapa dzakaedzwa, asi hapasati pave nekubvumirana pakurapa kwenguva refu kwakabudirira kurapwa.Chinangwa chechidzidzo ichi ndechekuongorora kukosha kweplasma ine platelet-rich sechinhu chebiological stimulant mukusimudzira kuporeswa kweprimary atrophic rhinitis.
Munyori akabatanidza huwandu hwemakesi makumi manomwe nemasere akaonekwa aine primary atrophic rhinitis.Boka A (makesi) uye varwere vane maplatelet asina kunaka vakaitwa nasal endoscopy, Sino Nasal Outcome Test-25 mubvunzo, saccharin nguva yekuyedzwa kuongorora mucosal ciliary clearance rate, uye plasma mu biopsy specimen Boka B (kutonga) mwedzi 1 nemwedzi mitanhatu isati yaiswa. yeplatelet yakawanda yeplasma.
Zviratidzo zvinowanzoonekwa nevarwere vose muBoka A vasati vaiswa majekiseni eplatelet rich plasma yaisanganisira nasal scab, iyo yakaratidza kuvandudzwa kwe endoscopic uye kuderedza chiitiko, ne 36 kesi (92.30%);mutsigiri, 31 (79.48%);Kuvharwa kwemhino, makumi matatu (76.92%);Kurasikirwa kwekunhuwa, 17 (43.58%);Uye epistaxis, 7 (17.94%) kusvika kumhino, 9 (23.07%);Tsoka, 13 (33.33%);Nasal congestion, 14 (35.89%);Kurasikirwa kwekunhuwa, 13 (33.33%);Uye epistaxis, 3 (7.69%), mushure memwedzi mitanhatu, izvi zvinoratidzwa mukudzikira kweSino Nasal Outcome Test-25 mamakisi, ayo akaenzana makumi mana pamberi peplatelet yakapfuma plasma uye yakadzikira kusvika 9 mushure memwedzi mitanhatu.Saizvozvo, iyo mucociliary clearance nguva yakapfupikiswa zvakanyanya mushure mejekiseni replatelet rakapfuma plasma;Yekutanga avhareji saccharin yekufambisa nguva bvunzo yaive 1980 masekonzi, uye yakadzikira kusvika 920 masekondi 6 mwedzi mushure mejekiseni replatelet rakapfuma plasma.
Kushandiswa kweplatelet rakapfuma plasma sebiological agent inogona kunge iri nzira yekuvandudza zvishoma inokwanisa kugadzirisa kushaikwa kwenyama kuburikidza nekumwe tsvakiridzo.
Kune nzira ina huru dzekurapa atrophic rhinitis: kupfupisa mhango yemhino nezvinhu zvakasiyana-siyana uye anodyara, kusimudzira zvakajairika mucosal regeneration vachishandisa classic kana kuchinjwa Yang kuvhiyiwa, kuzora nasal mucosa, kana kunatsiridza nasal tsinga.Cavity.Dzimwe nzira dzakawanda dzekurapa dzakaedzwa, kusanganisira kudiridza nemumhino uye kudonha, glucose glycerol madonhwe emhino, parafini yemvura, estradiol mumafuta enzungu, anti ozaena mhinduro, mishonga inorwisa mabhakitiriya, iron, zinc, protein, vitamin supplements, vasodilators, prostheses, vaccines, placental extracts. kana acetylcholine, ine kana isina pilocarpine.Zvisinei, kushanda kwenzira idzi kunosiyana.Muchiitwa chekiriniki, kugezesa mhuno nemhino yekupfapfaidza ndiyo nzira inonyanya kushandiswa pakurapa zviratidzo zveatrophic rhinitis, sezvo ichikwanisa kunyorovesa mhino nekudzivirira kuputika.
Pakati penzira dziri pamusoro apa, kuvhiyiwa kweYang kwakavandudzwa kwakaratidzwa kuva nzira inoshanda uye inogara kwenguva refu yekurapa atrophic rhinitis.Zvisinei, kufema kwemuromo wakashama kunogona kukonzera kusagadzikana kuvarwere.Mafuta ekuzora uye ekuwedzera akaratidzwa kuve ane mashoma uye enguva pfupi mhedzisiro.Nokudaro, dzimwe nzira dzekusimudzira nasal mucosal regeneration kana angiogenesis dzakadzidzwa.
PRPinoumbwa nehuwandu hweplasma hunodarika huwandu hweplatelet muropa rose.PRP inowedzera zvinhu zvinokanganisa kukura kwenyama, kusiyanisa, uye kuporesa kwevanga, zvakadai seplatelet derived growth factor, kushandura kukura, fibroblast growth factor, endothelial growth factor, uye insulini-yakafanana nekukura chinhu.Nokudaro, PRP yakaratidza kuva nemigumisiro yakanaka inogamuchirwa muzvidzidzo zvakasiyana-siyana zvemakiriniki, zvinobudirira kukurudzira kuporesa kwemaronda uye kuvandudzwa kwetishu, kusanganisira mumunda we otolaryngology.Kunyanya kunyanya, zvakataurwa kuti PRP inoshanda pakuvandudza kuvandudzwa kwe tympanic membrane, mazwi ezwi uye tsinga dzechiso, pamwe nekuporesa mushure mekuvhiyiwa kwemyringoplasty kana endoscopic sinus.Pamusoro pezvo, chidzidzo chemutyairi chakaitwa makore mashoma apfuura kurapa atrophic rhinitis nejekiseni rePRP lipid musanganiswa.Mukuwedzera, PRP inoshandisa autologous ropa uye haina allergic kana immune rejection reactions.Inogona kugadzirirwa nyore nyore mukati memaminitsi mashomanana kuburikidza nemaitiro maviri e centrifugation.
Muchidzidzo ichi, takatsvaga jekiseni rePRP mu atrophic nasal mucosa, iyo yakavandudza mucosal cilia clearance uye zviratidzo munguva yekutevera kwemwedzi ye6, kunyanya kune vechidiki vaduku, vane migumisiro yakawanda yakaenzaniswa neboka revakuru.Muzviitiko zvakawanda zveatrophic rhinitis, kusanganisira vakwegura rhinitis, mucus secretion inoderedzwa.Naizvozvo, mucinous thickening inotungamirira kunonoka kubviswa kwemhino mucosal cilia.Kudzorera mvura kuburikidza nesaline spray kuchakanganisa maitiro e viscous mucus, uye kubviswa kwemhino mucosa cilia kuchadzorerwa kune imwe nhanho.Zvakadaro, basa rekunatswa nasal mucus mukugadzirisa zviratidzo zvemhino rinogona kushomeka.Nokudaro, kunyange zvazvo kuchengetedza nasal hydration inogonawo kuwedzera mucociliary clearance, chirongwa ichi chekurapa hachina kunyatsovandudza zviratidzo zvemhino.Mukuwedzera, kupfapfaidza nasal uye kudiridza kunoda physiological saline uye zvakakosha zviridzwa, uye zvinofanirwa kuitwa nguva dzose kudzora zviratidzo.Mukupesana, jekiseni rePRP rinongoda jekiseni rimwe chete kuti riwane mhedzisiro yakanaka.Mushure mejekiseni, ivhu re turbinate rinowedzera pakarepo.Zvisinei, pakushanya kunotevera kwevarwere vekunze (masvondo e2 gare gare), pakanga pasina mutsauko muhuwandu uye chimiro cheiyo yakaderera turbinate.Naizvozvo, kuwedzera kwenguva pfupi kwevhoriyamu kunokonzerwa nejekiseni kunoonekwa sekusina basa.Mukuwedzera, sezvakaratidzwa muchikamu chekuongorora cheSNOT-22, pakanga pasina kuvandudzwa kwakakosha mune zvepfungwa sub domain yePRP injection varwere.Mhedzisiro yacho haina kuperekedzwa nekuvandudzwa mune yemanzwiro sub domain, zvichiratidza kuti iyo placebo mhedzisiro yakanga isina kukosha mune chimwe chinhu.Kupfapfaidza nasal uye kudiridza kunoda physiological saline uye zvakakosha zviridzwa, uye zvinofanirwa kuitwa nguva dzose kudzora zviratidzo.Mukupesana, jekiseni rePRP rinongoda jekiseni rimwe chete kuti riwane mhedzisiro yakanaka.Mushure mejekiseni, ivhu re turbinate rinowedzera pakarepo.Zvisinei, pakushanya kunotevera kwevarwere vekunze (masvondo e2 gare gare), pakanga pasina mutsauko muhuwandu uye chimiro cheiyo yakaderera turbinate.Naizvozvo, kuwedzera kwenguva pfupi kwevhoriyamu kunokonzerwa nejekiseni kunoonekwa sekusina basa.Mukuwedzera, sezvakaratidzwa muchikamu chekuongorora cheSNOT-22, pakanga pasina kuvandudzwa kwakakosha mune zvepfungwa sub domain yePRP injection varwere.Mhedzisiro yacho haina kuperekedzwa nekuvandudzwa mune yemanzwiro sub domain, zvichiratidza kuti iyo placebo mhedzisiro yakanga isina kukosha mune chimwe chinhu.Kupfapfaidza nasal uye kudiridza kunoda physiological saline uye zvakakosha zviridzwa, uye zvinofanirwa kuitwa nguva dzose kudzora zviratidzo.Mukupesana, jekiseni rePRP rinongoda jekiseni rimwe chete kuti riwane mhedzisiro yakanaka.Mushure mejekiseni, ivhu re turbinate rinowedzera pakarepo.Zvisinei, pakushanya kunotevera kwevarwere vekunze (masvondo e2 gare gare), pakanga pasina mutsauko muhuwandu uye chimiro cheiyo yakaderera turbinate.Naizvozvo, kuwedzera kwenguva pfupi kwevhoriyamu kunokonzerwa nejekiseni kunoonekwa sekusina basa.Mukuwedzera, sezvakaratidzwa muchikamu chekuongorora cheSNOT-22, pakanga pasina kuvandudzwa kwakakosha mune zvepfungwa sub domain yePRP injection varwere.Mhedzisiro yacho haina kuperekedzwa nekuvandudzwa mune yemanzwiro sub domain, zvichiratidza kuti iyo placebo mhedzisiro yakanga isina kukosha mune chimwe chinhu.PRP jekiseni rinongoda jekiseni rimwe chete kuti uwane mhedzisiro yakanaka.Mushure mejekiseni, ivhu re turbinate rinowedzera pakarepo.Zvisinei, pakushanya kunotevera kwevarwere vekunze (masvondo e2 gare gare), pakanga pasina mutsauko muhuwandu uye chimiro cheiyo yakaderera turbinate.Naizvozvo, kuwedzera kwenguva pfupi kwevhoriyamu kunokonzerwa nejekiseni kunoonekwa sekusina basa.Mukuwedzera, sezvakaratidzwa muchikamu chekuongorora cheSNOT-22, pakanga pasina kuvandudzwa kwakakosha mune zvepfungwa sub domain yePRP injection varwere.Mhedzisiro yacho haina kuperekedzwa nekuvandudzwa mune yemanzwiro sub domain, zvichiratidza kuti iyo placebo mhedzisiro yakanga isina kukosha mune chimwe chinhu.PRP jekiseni rinongoda jekiseni rimwe chete kuti uwane mhedzisiro yakanaka.Mushure mejekiseni, ivhu re turbinate rinowedzera pakarepo.Zvisinei, pakushanya kunotevera kwevarwere vekunze (masvondo maviri gare gare), pakanga pasina mutsauko muhuwandu uye chimiro cheiyo yakaderera turbinate.Naizvozvo, kuwedzera kwenguva pfupi kwevhoriyamu kunokonzerwa nejekiseni kunoonekwa sekusina basa.Mukuwedzera, sezvakaratidzwa muchikamu chekuongorora cheSNOT-22, pakanga pasina kuvandudzwa kwakakosha mune zvepfungwa sub domain yePRP injection varwere.Mhedzisiro yacho haina kuperekedzwa nekuvandudzwa mune yemanzwiro sub domain, zvichiratidza kuti iyo placebo mhedzisiro yakanga isina kukosha mune chimwe chinhu.Iko hakuna mutsauko muhuwandu uye chimiro cheiyo yakaderera turbinate.Naizvozvo, kuwedzera kwenguva pfupi kwevhoriyamu kunokonzerwa nejekiseni kunoonekwa sekusina basa.Mukuwedzera, sezvakaratidzwa muchikamu chekuongorora cheSNOT-22, pakanga pasina kuvandudzwa kwakakosha mune zvepfungwa sub domain yePRP injection varwere.Mhedzisiro yacho haina kuperekedzwa nekuvandudzwa mune yemanzwiro sub domain, zvichiratidza kuti iyo placebo mhedzisiro yakanga isina kukosha mune chimwe chinhu.Iko hakuna mutsauko muhuwandu uye chimiro cheiyo yakaderera turbinate.Naizvozvo, kuwedzera kwenguva pfupi kwevhoriyamu kunokonzerwa nejekiseni kunoonekwa sekusina basa.Uye zvakare, sezvakaratidzwa mune iyo sub domain yekuongorora yeSNOT-22, pakanga pasina kukosha kwakakosha mune yemanzwiro sub domain yePRP jekiseni varwere.Mhedzisiro yacho haina kuperekedzwa nekuvandudzwa mune yemanzwiro sub domain, zvichiratidza kuti iyo placebo mhedzisiro yakanga isina kukosha mune chimwe chinhu.
Izvo zvinoramba zvichirwadza uye kusagadzikana zvine hukama zviratidzo zveatrophic rhinitis hazvisi zvakakomba mukurapa.Naizvozvo, kurasikirwa kwesocial-economic kunotariswa.Nekudaro, kubva pakuona kwevarwere chaivo, chirwere chinonetsa munzanga.Mukuwedzera, nekukwegura kwehuwandu, nhamba yevarwere vane senile rhinitis iri kuwedzera kuwedzera kwekuwedzera.Nokudaro, zvakakosha zvikuru kupa kurapa kwakakodzera kune atrophic rhinitis, kusanganisira vakwegura rhinitis.
Chinangwa chechidzidzo ichi ndechekukurudzira nzira itsva yekudzorerazve yekurapa atrophic rhinitis kuburikidza ne autologous PRP jekiseni, uye kuenzanisa kuvandudzwa kwezviratidzo pakati peboka rekurapa rePRP uye boka rekuchengetedza rinochengetedza richishandisa boka rinodzora.Nekuda kweatrophic rhinitis iri tsananguro yekiriniki, tsvakiridzo yakawanda inodiwa kuti infer maitiro ayo ekuita.Nekudaro, kuitira kudzivirira kurasikirwa kwemagariro nehupfumi uye kuderera kwehupenyu hwemurwere, zvinodikanwa kupa tsvakiridzo mhedzisiro ine inogona kurapa mhedzisiro.
Zvisinei, chidzidzo ichi chine zvipingamupinyi zvakawanda.Chidzidzo ichi chakagadzirwa zvinotarisirwa uye hachigone kudzorwa zvisina tsarukano sezvo vamwe vatori vechikamu vakaramba chirongwa chejekiseni remhuno.Panyaya yehutsika, mashandiro anokanganisa ezvinangwa zvedzidzo muboka rekutonga anofanirwa kuganhurirwa kuchengetedza kodzero uye zvido zvevarwere.Naizvozvo, kugovera varwere zvichienderana nezvavanoda kunoita kuti mhedzisiro yetsvakiridzo ive isina simba pane iyo inopiwa nezvidzidzo zvinodzorwa zvisina mwero.Mukuwedzera, yechipiri atrophic rhinitis inokonzerwa nekugadzirisa uye kubviswa kwechimiro chepakutanga chemhino.Kuita biopsy kunogona kuwedzera atrophy.Naizvozvo, kubva pakuona kwehutsika, hazvibviri kuita inowirirana nasal tishu biopsy mune varwere vane atrophic rhinitis.Mhedzisiro mushure memwedzi ye6 yekutevera inogona kunge isingamiriri mhedzisiro yenguva refu.Mukuwedzera, nhamba yevarwere vari muboka duku zvishoma.Nokudaro, tsvakurudzo yeramangwana inofanira kusanganisira varwere vakawanda vanoshandisa dhizaini yakarongeka yakarongwa pamusoro penguva yakareba yekutevera.
(Zviri muchinyorwa ichi zvakadhindwa patsva, uye isu hatipe chero vimbiso yechokwadi, kuvimbika kana kuzara kwezviri muchinyorwa chino, uye hatina mhosva yemafungiro echinyorwa ichi, ndapota nzwisisa.)
Nguva yekutumira: May-23-2023