Platelet Rich Plasma (PRP)
PRP yakakwezva kutarisa nekuti ine zvakasiyana-siyana zvekukura zvinhu, uye inoshandiswa zvakanyanya mukuvhiya maxillofacial, orthopedics, kuvhiyiwa kwepurasitiki, ophthalmology uye mamwe minda.Muna 2006, Uebel et al.kutanga akaedza pretreat follicular units kuti iparadzwe nePRP uye akacherechedza kuti kana ichienzaniswa nenzvimbo yekudzora scalp, nzvimbo yePRP-yakagadziriswa bvudzi yakapukunyuka yakapona 18.7 follicular units / cm2, apo boka rekutonga rakapona 16.4 follicular units./cm2, kuwanda kwakawedzera ne15.1%.Nokudaro, zvinofungidzirwa kuti zvinhu zvinokura zvinobudiswa nemaplatelet zvinogona kuita pamasero emasero ebvudzi rebvudzi, zvinokurudzira kusiyanisa kwemasero emasero uye kukurudzira kuumbwa kwemidzi mitsva yeropa.
Muna 2011, Takikawa et al.yakashandiswa yakajairika saline, PRP, heparin-protamine microparticles yakasanganiswa nePRP (PRP & D/P MPs) kune subcutaneous jekiseni revarwere veAGA kuti vagadzire zvidzoreso.Mhedzisiro yacho yakaratidza kuti nzvimbo yakachinjika yebvudzi muboka rePRP neboka rePRP&D/P MPs yakawedzera zvakanyanya, ma collagen fibers uye fibroblasts mumafollicles ebvudzi akawedzera pasi pemaikorosikopu, uye tsinga dzeropa dzakatenderedza. mafollicles ebvudzi akawedzera.
PRP yakapfuma muplatelet-yakatorwa kukura zvinhu.Aya mapuroteni anokosha anogadzirisa kutama kwesero, kusungirirwa, kupararira, uye kusiyanisa, kukurudzira kuunganidza kwe extracellular matrix, uye zvinhu zvakawanda zvinokura zvinoshingaira kukurudzira kukura kwebvudzi: kukura kwezvinhu muPRP zvinopindirana nebvudzi follicles.Iko kusanganiswa kwebulge stem masero kunokonzera kuwanda kwebvudzi follicles, kunogadzira follicular units, uye kunokurudzira kuvandudzwa kwebvudzi.Uye zvakare, inogona kumisikidza yakadzika rwizi cascade reaction uye kusimudzira angiogenesis.
Ikozvino Mamiriro ePRP muKurapa kweAGA
Hapasati paine kubvumirana pane nzira yekugadzirira uye platelet enrichment factor yePRP;marapiro ekurapa anosiyana muhuwandu hwekurapa, nguva yenguva, nguva yekudzoka, nzira yejekiseni, uye kana mishonga yakasanganiswa inoshandiswa.
Mapar et al.yaisanganisira 17 varwere vechirume vane danho IV kusvika VI (Hamilton-Norwood staging nzira), uye migumisiro yakaratidza hapana musiyano pakati PRP uye placebo jekiseni, asi chidzidzo chete akaita 2 jekiseni, uye nhamba marapirwo akanga diki.Mibairo yakavhurika kumibvunzo.;
Gkini et al akawana kuti varwere vane danho rezasi vakaratidza kuterera kwepamusoro kune PRP kurapwa;maonero aya akasimbiswa naQu et al, iyo yaisanganisira 51 varume uye 42 varwere vechikadzi vane danho II-V muvarume uye ini muvakadzi ~ Stage III (staging is Hamilton-Norwood uye Ludwig staging nzira), zvigumisiro zvinoratidza kuti PRP nhamba yakasiyana-siyana yevarwere vane zvikamu zvakasiyana-siyana zvevarume nevakadzi, asi kushanda kwepasi uye danho repamusoro riri nani, saka vatsvakurudzi vanokurudzira II, Stage III varume varwere uye danho I varwere vechikadzi vakabatwa nePRP.
Kubudirira Kupfumisa Factor
Misiyano yenzira dzekugadzirira dzePRP muchidzidzo chega chega zvakakonzera kupfumisa kwakasiyana kwePRP muchidzidzo chega chega, mazhinji acho akaiswa pakati pe2 uye 6 nguva.Platelet degranulation inoburitsa nhamba huru yekukura kwezvinhu, inogadzirisa kutama kwesero, kusungirirwa, kupararira uye kusiyanisa, kunomutsa bvudzi follicle cell proliferation, tissue vascularization, uye inosimudzira kuunganidzwa kwe extracellular matrix.Panguva imwecheteyo, iyo nzira ye microneedling uye yakaderera-simba laser therapy inoonekwa seInoburitsa inodzorwa kukuvara kwetishu uye inosimudzira yakasikwa platelet degranulation process, iyo inosarudza kunaka kwePRP kunoenderana nebasa rayo rehupenyu.Naizvozvo, zvakakosha kuti uongorore kushanda kwePRP.Zvimwe zvidzidzo zvinotenda kuti PRP ine hupfumi hwenguva dze1-3 inonyanya kushanda pane yakakwirira yekupfumisa fold, asi Ayatollahi et al.yakashandisa PRP ine hupfumi hwekugadzirisa kwe1.6 nguva yekurapa, uye zvigumisiro zvakaratidza kuti kurapwa kwevarwere veAGA kwakanga kusingabatsiri, uye vaitenda kuti PRP Kugadziriswa kunobudirira kunofanira kuva 4 ~ 7 nguva.
Nhamba yeMarapirwo, Nguva Yekupindirana uye Nguva Yekudzoka
Zvidzidzo zveMapar et al.uye Puig et al.vose vakawana migumisiro yakaipa.Nhamba yemishonga yePRP mune idzi mbiri dzekudzidza protocols yaiva 1 uye 2 nguva, maererano, iyo yakanga yakaderera pane zvimwe zvidzidzo (kunyanya 3-6 nguva).Picard et al.vakawana kuti kushanda kwePRP kwakasvika pakakwirira mushure mekurapa kwe3 kusvika ku5, saka vakatenda kuti kurapwa kunopfuura katatu kunogona kudiwa kuvandudza zviratidzo zvekurasika kwebvudzi.
Ongororo yeGupta neCarviel yakawana kuti mazhinji ezvidzidzo zvaivepo zvaive nemazuva ekurapa kwemwedzi we1, uye nekuda kwehuwandu hushoma hwezvidzidzo, mhedzisiro yekurapa nemajekiseni ePRP epamwedzi haina kuenzaniswa nemamwe majekiseni ejekiseni, senge vhiki nevhiki PRP jekiseni.
Chidzidzo chakaitwa naHausauer naJones [20] chakaratidza kuti zvidzidzo zvakagamuchira majekiseni emwedzi nemwedzi zvakave nekuvandudzwa kukuru kwebvudzi nhamba kana ichienzaniswa nehuwandu hwejekiseni mwedzi yose ye3 (P <0.001);Schiavone et al.[21] akagumisa kuti, Kurapa kunofanira kudzokororwa 10 kumwedzi 12 mushure mekupera kwenzira yekurapa;Vemamwe Marudzi et al.yakateverwa kwemakore 2, nguva yakareba yekutevera pakati pezvidzidzo zvose, uye yakawana kuti vamwe varwere vakadzoka zvakare pamwedzi we12 (4 / 20 kesi), uye muvarwere ve16 Zviratidzo zvinonyanya kutaurwa mumwedzi.
Mukutevera kwaSclafani, zvakaonekwa kuti kushanda kwevarwere kwakaderera zvakanyanya mwedzi 4 mushure mekupera kwekurapa.Picard et al.akataura nezvemigumisiro uye akapa mazano anoenderana nekurapa: mushure menguva yakajairika yemishonga mitatu yemwedzi 1, kurapwa kunofanira kuitwa katatu nguva dzose.Mwedzi wega wega kurapwa kwakanyanya.Zvisinei, Sclafani haana kutsanangura muyero weplatelet enrichment yezvigadziriso zvinoshandiswa mukurapa.Muchidzidzo ichi, 8-9 ml yeplatelet-rich fibrin matrix gadziriro dzakagadzirwa kubva ku18 ml yeropa reperipheral (iyo yakabviswa PRP yakawedzerwa kune CaCl2 vacuum chubhu, uye fibrin glue yakaiswa mufibrin glue. jekiseni risati raumbwa) , tinotenda kuti kupfumiswa kweplatelet mukugadzirira uku kunogona kunge kuri kure nekukwana, uye humwe uchapupu hunodiwa kuti hutsigire.
Jekiseni Nzira
Nzira zhinji dzemajekiseni ijekiseni remukati meganda uye jekiseni rezasi.Vatsvakurudzi vakakurukura maitiro ehutungamiri nzira pakurapa maitiro.Gupta naCarviel vakakurudzira jekiseni rezasi.Vamwe vatsvakurudzi vanoshandisa intradermal jekiseni.Intradermal jekiseni inogona kunonoka kupinda kwePRP muropa, kuderedza chiyero chemetabolism, kurebesa nguva yekuita kwenzvimbo, uye kuwedzera kukurudzira kwedermis kukurudzira kukura kwebvudzi.uye kudzika hakuna kufanana.Isu tinokurudzira kuti nzira yejekiseni yeNappage inofanirwa kushandiswa zvakanyanya pakuita majekiseni emukati kuti isabatanidze pesvedzero yekusiyana kwejekiseni, uye tinokurudzira kuti varwere vaveure bvudzi ravo pfupi kuti vatarise kwaienda bvudzi, uye gadzirisa kona yekuisa tsono nenzira kwayo. kutungamira kwekukura kuitira kuti tsono yetsono isvike yakatenderedza bvudzi follicle, nekudaro ichiwedzera iyo yemunharaunda PRP concentration mubvudzi follicle.Aya mazano pamusoro penzira dzejekiseni ndedzekutarisa chete, sezvo pasina zvidzidzo zvinoenzanisa zvakananga zvakanakira nekuipira nzira dzakasiyana dzejekiseni.
Combination Therapy
Jha et al.yakashandisa PRP yakasanganiswa ne microneedling uye 5% minoxidil yakasanganiswa therapy kuratidza kushanda kwakanaka mune zvose chinangwa uchapupu uye murwere kuzviongorora.Tichiri kutarisana nematambudziko mukugadzirisa marapirwo ekurapa kwePRP.Kunyange zvazvo zvidzidzo zvakawanda zvinoshandisa nzira dzehutano uye dzehuwandu hwekuongorora zviratidzo zvekuvandudza mushure mekurapa, zvakadai sekuverenga bvudzi rekupedzisira, vellus hair count, hair count, density, thickness, etc., nzira dzekuongorora dzinosiyana zvakasiyana;kuwedzera, kugadzirira kwePRP Hapana chiyero chakafanana maererano nenzira, kuwedzera activator, centrifugation nguva uye kukurumidza, platelet concentration, nezvimwewo;marapirwo ekurapa anosiyana-siyana muhuwandu hwekurapa, nguva yenguva, nguva yekudzoka, nzira yejekiseni, uye kana kubatanidza mishonga;kusarudzwa kwemasampuli muchidzidzo hakusi Stratification nezera, murume kana mukadzi, uye dhigirii realopecia zvakawedzera kudzima kuongororwa kwePRP kurapwa mhedzisiro.Mune ramangwana, zvidzidzo zvakakura-sample-self-controlled zvidzidzo zvichiri kudiwa kujekesa maitiro akasiyana-siyana ekurapa, uye nekuwedzera stratified kuongororwa kwezvinhu zvakaita sezera remurwere, murume kana mukadzi, uye dhigirii rekurasikirwa kwebvudzi rinogona kuvandudzwa zvishoma nezvishoma.
(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: Aug-02-2022