Platelet Rich Plasma (PRP)
External humeral epicondylitis chirwere chakajairika chekiriniki chinoratidzwa nekurwadziwa padivi regokora.Iyo inonyengera uye iri nyore kudzokorora, izvo zvinogona kukonzera kurwadziwa kwepamberi uye kuderera kwesimba remaoko, uye zvinokanganisa zvakanyanya hupenyu hwezuva nezuva nebasa revarwere.Kune nzira dzakasiyana dzekurapa dze lateral epicondylitis yehumerus, ine mhedzisiro dzakasiyana.Hapana nzira yakajairika yekurapa parizvino.Platelet rich plasma (PRP) ine simba rakanaka pakugadzirisa pfupa uye tendon, uye yakashandiswa zvakanyanya kurapa kunze humeral epicondylitis.
Zvinoenderana nehukuru hweyero yekubvumidzwa kwekuvhota, yakakamurwa kuita mamakisi matatu:
100% inobvumirana zvizere (Level I)
90% ~ 99% kubvumirana kwakasimba (Chikamu II)
70% ~ 89% vanobvumirana (Chikamu III)
PRP Concept uye Application Ingredient Zvinodiwa
(1) Pfungwa: PRP inotorwa neplasma.Yayo platelet concentration yakakwira kupfuura yekutanga.Iyo ine huwandu hukuru hwekukura zvinhu uye cytokines, iyo inogona zvinobudirira kukurudzira kugadzirisa kwematishu uye kupora.
(2) Zvinodikanwa zvekushandisa zvinongedzo:
① Mushonga weplatelet wePRP mukurapa kwekunze humeral epicondylitis inokurudzirwa kuva (1000 ~ 1500) × 109 / L (3-5 nguva dzekutanga kusungirirwa);
② Inofarira kushandisa PRP yakapfuma mumasero machena eropa;
③ Activator activation yePRP haina kukurudzirwa.
(Inokurudzirwa kusimba: Chikamu I; nhanho yeuchapupu hwemabhuku: A1)
Kudzora Kwehutano hwePRP Kugadzirira Technology
(1) Zvinodiwa zvevashandi: Kugadzirira uye kushandiswa kwePRP kunofanira kuitwa nevashandi vezvokurapa vane zvikwereti zvevanachiremba vane marezinesi, vanamukoti vane marezinesi uye vamwe vashandi vezvokurapa vakakodzera, uye inofanira kuitwa mushure mekudzidziswa kwakasimba kweaseptic operation uye PRP kugadzirira kudzidziswa.
(2) Zvishandiso: PRP ichagadzirirwa nekushandisa gadziriro yekugadzirira yeChikamu chechitatu chemishonga yezvokurapa.
(3) Nzvimbo yekushanda: Kurapa kwePRP ibasa rinoparadza, uye kugadzirira kwayo uye kushandiswa kunokurudzirwa kuti zviitwe mune imwe nzvimbo yekurapa inokosha kana muimba yekushanda inosangana nezvinodiwa zvekutonga kwekunzwa.
(Yakakurudzirwa kusimba: Chikamu I; nhanho yeuchapupu hwemabhuku: Chikamu E)
Zviratidzo uye Contraindications yePRP
(1) Zvinoratidza:
① PRP kurapwa haina zvakajeka zvinodikanwa zverudzi rwebasa rehuwandu, uye inogona kutariswa kuti iitwe muvarwere vane kudiwa kwakanyanya (sevanhu vazhinji vemitambo) uye kudiwa kwakaderera (sevashandi vemuhofisi, vashandi vemhuri, nezvimwe. );
② Varwere vane pamuviri uye vanoyamwisa vanogona kushandisa PRP nekuchenjerera kana kurapa kwepanyama kusingabatsiri;
③ PRP inofanirwa kutariswa kana iyo isiri-operative kurapwa yehumeral epicondylitis isingashande kweanopfuura mwedzi ye3;
④ Mushure mekunge PRP kurapwa kwashanda, varwere vane kudzoka zvakare vanogona kufunga kuishandisa zvakare;
⑤ PRP inogona kushandiswa 3 mwedzi mushure mejekiseni re steroid;
⑥ PRP inogona kushandiswa kurapa extensor tendon chirwere uye chikamu chetendon kubvarura.
(2) Zvinopesana zvachose: ① thrombocytopenia;② Bundu rakashata kana utachiona.
(3) Relative contraindications: ① varwere vane abnormal blood coagulation uye kutora anticoagulant zvinodhaka;② Anemia, hemoglobin<100 g/L.
(Yakakurudzirwa kusimba: Chikamu II; nhanho yeuchapupu hwemabhuku: A1)
PRP Injection Therapy
Kana jekiseni rePRP richishandiswa kurapa lateral epicondylitis yehumerus, zvinokurudzirwa kushandisa hutungamiri hwe ultrasound.Inokurudzirwa kupinza 1 ~ 3 ml yePRP panzvimbo uye kumativi ekukuvara.Jekiseni rimwe chete rinokwana, kazhinji haripfuuri katatu, uye nguva yejekiseni ndeye 2 ~ 4 mavhiki.
(Inokurudzirwa kusimba: Chikamu I; nhanho yeuchapupu hwemabhuku: A1)
Kushandiswa kwePRP muKushanda
Shandisa PRP pakarepo mushure mekuchenesa kana suturing chironda panguva yekuvhiyiwa;Mafomu emuyero anoshandiswa anosanganisira PRP kana akasanganiswa neplatelet rich gel (PRF);PRP inogona kuiswa mujojo yetendon bone, iyo tendon inotarisa nzvimbo panzvimbo dzakawanda, uye PRF inogona kushandiswa kuzadza tendon defect nzvimbo uye kuvhara tendon pamusoro.Chiyero chacho chiri 1-5ml.Hazvikurudzirwi kubaya PRP mugomba rekubatana.
(Yakakurudzirwa kusimba: Chikamu II; nhanho yeuchapupu hwemabhuku: Chikamu E)
PRP Dzinoenderana Nyaya
(1) Pain management: Mushure mePRP kurapwa kwekunze humeral epicondylitis, acetaminophen (paracetamol) uye opioid isina simba inogona kuonekwa kuderedza marwadzo evarwere.
(2) Countermeasures yemaitiro akaipa: kurwadziwa kwakanyanya, hematoma, utachiona, kuoma kwekubatana uye mamwe mamiriro ezvinhu mushure mePRP kurapwa kunofanira kushingaira kubatwa, uye zvirongwa zvekurapa zvinobudirira zvinofanira kuumbwa mushure mekuvandudza laboratory uye imaging kuongorora uye kuongorora.
(3) Chiremba kutaurirana nemurwere uye dzidzo yehutano: Pamberi uye mushure mekurapwa kwePRP, ita zvizere kutaurirana nachiremba-murwere uye dzidzo yehutano, uye kusaina fomu remvumo ine ruzivo.
(4) Kugadzirisa chirongwa: hapana kugadzirisa kunodiwa mushure mePRP jekiseni kurapwa, uye mabasa anokonzera marwadzo anofanira kudziviswa mukati maawa 48 mushure mekurapa.Elbow flexion uye kuwedzera kunogona kuitwa maawa makumi mana nemasere gare gare.Mushure mekuvhiyiwa kwakabatanidzwa nePRP, chirongwa chekugadzirisa mushure mekushanda chinofanira kupiwa pakutanga.
(Yakakurudzirwa kusimba: Chikamu I; nhanho yeuchapupu hwemabhuku: Chikamu E)
References:Chin J Trauma, Nyamavhuvhu 2022, Vol.38, No. 8, Chinese Journal of Trauma, Nyamavhuvhu 2022
(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: Nov-28-2022