Platelet-rich plasma (PRP) parizvino inoshandiswa zvakanyanya munzvimbo dzakasiyana dzekurapa.Mumakore achangopfuura, kushandiswa kwePRP mumapfupa emapfupa kwakakwezva kutarisisa kwakawanda, uye kushandiswa kwayo munzvimbo dzakasiyana-siyana dzakadai sekuvandudzwa kwetishu, kuporesa maronda, kugadzirisa mavanga, kuvhiyiwa kwepurasitiki uye kunaka kwave kwakawedzera.Muchinyorwa chemazuva ano, tichaongorora biology yePRP, maitiro ayo ekuita, uye kusarudzwa kwePRP kuti tinzwisise zviri nani zvinogona uye zvisingafaniri kuitwa nePRP.
Nhoroondo ye PRP
PRP inonziwo platelet-rich plasma (PRP), platelet-rich growth factor (GFS) uye platelet-rich fibrin (PRF) matrix.Pfungwa uye tsanangudzo yePRP yakatanga mumunda wehematology.Hematologists vakagadzira izwi rokuti PRP muma1970, kunyanya kurapa varwere vane thrombocytopenia nekubudisa maplatelet uye kuwedzera kuwedzerwa ropa.
Makore gumi gare gare, PRP yakatanga kushandiswa mukuvhiya maxillofacial sePRF.Fibrin ine adhesive uye homeostatic properties, uye PRP ine anti-inflammatory properties iyo inokurudzira kuwedzera kwesero.Zvadaro, PRP yakatanga kushandiswa zvakanyanya musculoskeletal field yekukuvara kwemitambo uye yakawana maitiro akanaka ekurapa.Nekuda kwekuti zvinonangwa zvekurapa zvinonyanya kuve vatambi vane hunyanzvi, zvakakwezva kutarisisa zvakanyanya munhau uye yakashandiswa zvakanyanya mumunda wemishonga yemitambo.Zvadaro, PRP yakasimudzirwa zvishoma nezvishoma mu orthopedics, kuvhiyiwa, kuvhiyiwa kwevana, gynecology, urology, plastiki uye cosmetic kuvhiyiwa uye ophthalmology.
Platelet Biology
Peripheral masero eropa anosanganisira masero matsvuku eropa, masero machena eropa uye maplatelet, ese anotorwa kubva kune yakajairika pluripotent stem cell iyo inogona kusiyanisa mumasero akasiyana mutsara.Aya maseru mitsara ane precursor maseru anogona kupatsanura nekukura.Maplatelet anotorwa kubva mumwongo webhonzo uye ane nucleated disc-shaped masero ehukuru hwakasiyana, ane avhareji yedhayamita inosvika 2 μm, uye ndiwo masero mashoma eropa.Platelet kuverenga muropa rinotenderera rinobva pa150,000 kusvika 400,000 per microliter.Maplatelets ane akati wandei akakosha ekuvanzika granules, ayo ane matatu makuru: dense granules, o-granules, uye lysosomes.Imwe neimwe platelet ine 50-80 zvidimbu.
Tsanangudzo yePRP
Mukupedzisa, PRP ndeye biological product, iyo yakanyanyisa plasma ine yakanyanya kukwirira kweplatelet concentration kupfuura iyo iri muropa reperipheral.PRP haina kungova nehuwandu hwemaplatelet, asiwo ine zvinhu zvose zvekubatanidza, kusanganisira mutsara wekukura kwezvinhu, chemokines, cytokines uye mapuroteni eplasma.
PRP inotorwa kubva muropa remukati rinotorwa nenzira dzakasiyana siyana dzekugadzirira marabhoritari.Mushure mekugadzirira, maererano nemhando dzakasiyana-siyana dzemagetsi, masero matsvuku eropa, PRP, uye PPP muzvikamu zveropa zvinoparadzaniswa zvakatevedzana.MuPRP, kunze kwehuwandu hwehuwandu hweplatelet, inofanirwawo kufunga kuti ine leukocytes uye kana yakashandiswa.Zvichienderana neaya maficha, akasiyana PRP marudzi akakodzera akasiyana pathological mamiriro akatemerwa.
Zvishandiso zvinoverengeka zvekutengesa zviripo iye zvino zvinogona kurerutsa kugadzirira kwePRP.Aya maPRP zvishandiso anowanzo gadzira 2-5 peta yepamusoro PRP platelet concentration.Kunyange zvazvo mumwe angafunga kuti iyo yakakwirira yeplatelet concentration uye yakakwirira yehuwandu hwekukura, zviri nani kurapa kunofanira kuva, izvi hazvisati zvasimbiswa, uye 3-5 nguva iyo kusungirirwa kunowanzoonekwa kwakakodzera.
Zvishandiso zvekutengesa zvine mukana wekuve wakamisikidzwa uye zviri nyore, asi zvine miganhu yezvishandiso zvawo.Vamwe havagone kubvisa tsvina chaiyo zvakanaka, uye mamwe maPRP ekugadzirira haana kukwirira mukufungisisa.Chaizvoizvo, zvese zvekutengesa midziyo haigone kugadzirirwa yega uye nemazvo.Iri ndiro dambudziko guru nemidziyo yakaenzana.Parizvino, tekinoroji chete yakasarudzika yekugadzirira marabhoritari inogona kuvhara zvese zvinodiwa nemurwere, izvo zvine zvinodiwa zvakanyanya pahunyanzvi hwerabhoritari.
Iyo Classification yePRP
Muna 2006, Everts et al vakaronga pfungwa yeleukocyte-rich PRP.Naizvozvo, PRP inogona kukamurwa kuita mhando mbiri zvichienderana nenhamba yeleukocyte irimo: PRP ine urombo leukocytes uye PRP ine akapfuma leukocytes.
1) Platelet-rich plasma ine high concentration ye leukocytes, inonzi L-PRP (Leukocyte Platelet-Rich Plasma, ine shoma shoma yemasero matsvuku eropa), inonyanya kushandiswa kune maronda anoramba, chirwere cheshuga, gout nekusapora. maronda, kugadziriswa kwebhonzo, kusabatanidzwa, kuzvimba kwemwongo uye kumwe kurapwa kwekiriniki.
2) Platelet-rich plasma isina kana kuti ine yakaderera yakawanda ye leukocytes inonzi P-PRP (Pure Platelet-Rich Plasma, isina masero matsvuku eropa), inonyanya kushandiswa kukuvara kwemitambo uye zvirwere zvinopera, kusanganisira kukuvara kwemeniscus, ligament uye tendon kukuvara. , tennis gokora, ibvi Arthritis, cartilage degeneration, lumbar disc herniation nezvimwe zvirwere.
3) Mushure mokunge PRP yemvura inoshandiswa ne thrombin kana calcium, gel-like PRP kana PRF inogona kuumbwa.(Yakatanga kugadzirirwa naDohan et al. muFrance)
Muna 2009, Dohan Ehrenfest et al.yakarongwa 4 classifications zvichienderana nekuvapo kana kusavapo kwemasero emasero (akadai seleukocytes) uye fibrin chimiro:
1) Pure PRP kana leukocyte-varombo PRP: PRP yakagadzirirwa haina leukocytes, uye zvinyorwa zvefibrin mushure mekushanda zvakaderera.
2) Masero machena eropa uye PRP: ane masero machena eropa, uye zvinyorwa zvefibrin mushure mekushanda zvakaderera.
3) Pure PRF kana leukocyte-varombo PRF: gadziriro haina leukocytes uye ine high-density fibrin.Zvigadzirwa izvi zvinouya muchimiro cheiyo activated gels uye hazvigone kushandiswa kubaya jekiseni.
4) Leukocyte-rich fibrin uye PRF: ine leukocytes uye high-density fibrin.
Muna 2016, Magalon et al.yakaronga iyo DEPA classification (dose, kunyatsoita, kuchena, activation), inotarisa PRP platelet count, kuchena kwechigadzirwa, uye platelet activation.
1. Platelet jekiseni dose: Verenga nekuwanza maplatelet concentration nehuwandu hweplatelet.Zvinoenderana nejekiseni rejekiseni (mumabhiriyoni kana mamirioni emaplatelet), inogona kukamurwa kuita (a) yakanyanya kuwanda: 5 bhiriyoni;(b) chipimo chepamusoro: kubva pamabhiriyoni matatu kusvika kumabhiriyoni mashanu;(c) mwero wepakati: kubva pabhiriyoni kusvika kumabhiriyoni matatu;(d) dosi yakaderera: isingasviki bhiriyoni imwe.
2. Kunyatsogadzirira: chikamu chezvikamu zveplatelet zvakaunganidzwa kubva muropa.(a) Kubudirira kwechishandiso chepamusoro: mwero wekudzoreredza platelet> 90%;(b) yepakati mudziyo kunyatsoshanda: platelet kudzoreredza mwero pakati pe70-90%;(c) yakaderera mudziyo kunyatsoshanda: kudzoreredza mwero pakati pe30-70%;(d) Kushanda kwemidziyo kwakadzikira zvakanyanya: mwero wekudzoreredza uri pasi pe30%.
3. PRP kuchena: Inobatana nehukama hwemaplatelet, masero machena eropa uye masero matsvuku eropa muPRP.Tinozvitsanangura se (a) PRP yakachena kwazvo:> 90% maplatelet ane chokuita ne erythrocytes uye leukocytes muPRP;(b) PRP yakachena: 70-90% maplatelet;(c) heterogeneous PRP: % maplatelet Pakati pe30-70%;(d) Ropa rose PRP: chikamu cheplatelet muPRP chiri pasi pe30%.
4. Activation maitiro: kana kushandisa maplatelet ane exogenous coagulation zvinhu, zvakadai autologous thrombin kana calcium chloride.
(Zviri muchinyorwa ichi zvakaburitswa.)
Nguva yekutumira: May-16-2022