Primary atrophic rhinitis (1Ry AR) ndi matenda osatha a m'mphuno omwe amadziwika ndi kutayika kwa ntchito ya mucociliary, kukhalapo kwa zotupa zomata ndi zowuma zowuma, zomwe zimapangitsa kuti pakhale fungo loyipa, lomwe nthawi zambiri limalumikizana.Njira zambiri zochiritsira zayesedwa, koma palibe mgwirizano pa chithandizo chamankhwala chokhalitsa bwino.Cholinga cha kafukufukuyu ndikuwunika kufunikira kwa plasma wochuluka wa mapulateleti monga cholimbikitsa chamoyo cholimbikitsa kuchira kwa primary atrophic rhinitis.
Wolembayo adaphatikizanso milandu 78 yopezeka ndi matenda oyamba atrophic rhinitis.Gulu A (milandu) ndi odwala omwe ali ndi mapulateleti osauka adadutsa m'mphuno endoscopy, mafunso a Sino Nasal Outcome Test-25, kuyesa nthawi ya saccharin kuti awone kuchuluka kwa chilolezo cha mucosal ciliary, ndi plasma mu biopsy specimen Gulu B (kuwongolera) mwezi umodzi ndi miyezi 6 isanachitike. plasma wochuluka wa mapulateleti.
Zizindikiro zodziwika bwino zomwe odwala onse mu Gulu A asanachitike jekeseni wa plasma wolemera wa platelet anali nkhanambo ya m'mphuno, yomwe inawonetsa kusintha kwa endoscopic ndi kuchepa kwa zochitika, ndi milandu 36 (92.30%);wotsatira, 31 (79.48%);Kutsekeka kwa mphuno, 30 (76.92%);Kutayika kwa fungo, 17 (43.58%);Ndipo epistaxis, 7 (17.94%) mpaka nkhanambo ya m'mphuno, 9 (23.07%);Mapazi, 13 (33.33%);Kusokonekera kwa mphuno, 14 (35.89%);Kutayika kwa fungo, 13 (33.33%);Ndipo epistaxis, 3 (7.69%), pambuyo pa miyezi 6, izi zikuwonekera pakuchepa kwa Sino Nasal Outcome Test-25 score, yomwe inali pafupifupi 40 pamaso pa plasma wolemera wa platelet ndikutsika mpaka 9 pambuyo pa miyezi 6.Mofananamo, mucociliary chilolezo nthawi kwambiri adzafupikitsidwa pambuyo jekeseni wa kupatsidwa zinthu za m`mwazi wolemera plasma;Mayeso oyambira nthawi yoyendera saccharin anali masekondi a 1980, ndipo adatsika mpaka masekondi 920 patatha miyezi 6 jekeseni wa plasma wolemera wa platelet.
Kugwiritsiridwa ntchito kwa plasma wolemera wa plasma monga biological agent kungakhale njira yatsopano yowononga pang'ono yomwe ingathetse bwino kuperewera kwa zakudya m'thupi mwa kufufuza kwina.
Pali njira zinayi zazikulu zochizira atrophic rhinitis: kuchepetsa mphuno ndi zinthu zosiyanasiyana ndi ma implants, kulimbikitsa kusinthika kwa mucosal pogwiritsa ntchito opaleshoni yapamwamba kapena yosinthidwa ya Yang, kudzoza mucosa ya m'mphuno, kapena kuwongolera mitsempha yamagazi.Cavity.Njira zina zambiri zochizira zayesedwa, kuphatikiza kuthirira m'mphuno ndi kuthirira, glucose glycerol madontho amphuno, parafini yamadzimadzi, estradiol mumafuta a mtedza, mankhwala a anti ozaena, maantibayotiki, chitsulo, zinki, mapuloteni, mavitamini owonjezera, vasodilator, prostheses, katemera, zotulutsa za placenta. kapena acetylcholine, kapena popanda pilocarpine.Komabe, mphamvu za njirazi zimasiyanasiyana.Pazachipatala, kutsuka m'mphuno ndi utsi wa m'mphuno ndiyo njira yomwe imagwiritsidwa ntchito pochiza zizindikiro za atrophic rhinitis, chifukwa imatha kunyowetsa mphuno ndi kuteteza kukwapula.
Mwa njira zomwe tafotokozazi, opaleshoni ya Yang yowongoka yatsimikiziridwa kuti ndi njira yothandiza komanso yokhalitsa pochiza atrophic rhinitis.Komabe, kupuma kotsegula pakamwa kungayambitse kusapeza bwino kwa odwala.Mafuta odzola ndi zowonjezera awonetsedwa kuti ali ndi zotsatira zochepa komanso zazing'ono.Choncho, njira zina zolimbikitsira kusinthika kwa m'mphuno kapena angiogenesis zaphunziridwa.
PRPamapangidwa ndi plasma woipa kuposa kupatsidwa zinthu za m`mwazi m`magazi athunthu.PRP imapangitsa zinthu zomwe zimakhudza kukula kwa minofu, kusiyanitsa, ndi machiritso a zipsera, monga platelet derived growth factor, kusintha kukula, fibroblast kukula factor, endothelial growth factor, ndi insulin-like kukula factor.Choncho, PRP yatsimikiziridwa kuti ili ndi zotsatira zabwino zovomerezeka m'maphunziro osiyanasiyana azachipatala, kulimbikitsa bwino machiritso a mabala ndi kusinthika kwa minofu, kuphatikizapo m'munda wa otolaryngology.Mwachindunji, zanenedwa kuti PRP imathandizira kukonzanso kwa tympanic nembanemba, zingwe za mawu ndi mitsempha ya nkhope, komanso machiritso pambuyo pa myringoplasty kapena opaleshoni ya endoscopic sinus.Kuphatikiza apo, kafukufuku woyendetsa ndege adachitika zaka zingapo zapitazo pochiza atrophic rhinitis ndi jakisoni wa PRP lipid osakaniza.Kuonjezera apo, PRP imagwiritsa ntchito magazi a autologous ndipo ilibe zotsutsana kapena zokana chitetezo cha mthupi.Itha kukonzedwa mosavuta mkati mwa mphindi zingapo kudzera munjira ziwiri za centrifugation.
Mu phunziro ili, tinafufuza jekeseni wa PRP mu atrophic nasal mucosa, yomwe inapangitsa kuti mucosal cilia chilolezo chikhale bwino komanso zizindikiro pa nthawi yotsatiridwa ya miyezi ya 6, makamaka kwa odwala achichepere, ndi zotsatira zodziwika bwino poyerekeza ndi gulu la okalamba.Nthawi zambiri atrophic rhinitis, kuphatikizapo okalamba rhinitis, ntchofu katulutsidwe yafupika.Choncho, mucinous thickening kumabweretsa anachedwa chilolezo cha m`mphuno mucosal cilia.Kubwezeretsanso madzi kudzera mu utsi wa saline kudzakhudzanso mawonekedwe a viscous mucus, ndipo kuchotsedwa kwa nasal mucosa cilia kudzabwezeretsedwanso kumlingo wina.Komabe, ntchito ya ntchofu ya m’mphuno yochepetsedwa pothetsa zizindikiro za m’mphuno ikhoza kukhala yochepa.Choncho, ngakhale conservative nasal hydration ingathandizenso kuti mucociliary chilolezo, chithandizo ichi sichinasinthe kwambiri zizindikiro za m'mphuno.Komanso, mphuno kutsitsi ndi ulimi wothirira amafuna zokhudza thupi saline ndi zida zapadera, ndipo ayenera kuchitidwa mosalekeza kulamulira zizindikiro.Mosiyana, jekeseni wa PRP umangofunika jekeseni imodzi kuti mukwaniritse zotsatira zabwino.Pambuyo pa jekeseni, kuchuluka kwa turbinate kumawonjezeka nthawi yomweyo.Komabe, paulendo wotsatira wodwala kunja (masabata a 2 pambuyo pake), panalibe kusiyana kwa voliyumu ndi mawonekedwe a turbinate otsika.Chifukwa chake, kuwonjezeka kwakanthawi kwa voliyumu komwe kumachitika chifukwa cha jakisoni kumaonedwa ngati kosayenera.Kuonjezera apo, monga momwe tawonetsera mu gawo laling'ono la SNOT-22, panalibe kusintha kwakukulu mu gawo laling'ono la odwala jekeseni wa PRP.Zotsatira sizinaperekedwe ndi kusintha kwa gawo laling'ono lamalingaliro, zomwe zikuwonetsa kuti zotsatira za placebo sizinali zofunikira pamtundu wina.Kupopera mphuno ndi ulimi wothirira amafuna zokhudza thupi saline ndi zida zapadera, ndipo ayenera kuchitidwa mosalekeza kulamulira zizindikiro.Mosiyana, jekeseni wa PRP umangofunika jekeseni imodzi kuti mukwaniritse zotsatira zabwino.Pambuyo pa jekeseni, kuchuluka kwa turbinate kumawonjezeka nthawi yomweyo.Komabe, paulendo wotsatira wodwala kunja (masabata a 2 pambuyo pake), panalibe kusiyana kwa voliyumu ndi mawonekedwe a turbinate otsika.Chifukwa chake, kuwonjezeka kwakanthawi kwa voliyumu komwe kumachitika chifukwa cha jakisoni kumaonedwa ngati kosayenera.Kuonjezera apo, monga momwe tawonetsera mu gawo laling'ono la SNOT-22, panalibe kusintha kwakukulu mu gawo laling'ono la odwala jekeseni wa PRP.Zotsatira sizinaperekedwe ndi kusintha kwa gawo laling'ono lamalingaliro, zomwe zikuwonetsa kuti zotsatira za placebo sizinali zofunikira pamtundu wina.Kupopera mphuno ndi ulimi wothirira amafuna zokhudza thupi saline ndi zida zapadera, ndipo ayenera kuchitidwa mosalekeza kulamulira zizindikiro.Mosiyana, jekeseni wa PRP umangofunika jekeseni imodzi kuti mukwaniritse zotsatira zabwino.Pambuyo pa jekeseni, kuchuluka kwa turbinate kumawonjezeka nthawi yomweyo.Komabe, paulendo wotsatira wodwala kunja (masabata a 2 pambuyo pake), panalibe kusiyana kwa voliyumu ndi mawonekedwe a turbinate otsika.Chifukwa chake, kuwonjezeka kwakanthawi kwa voliyumu komwe kumachitika chifukwa cha jakisoni kumaonedwa ngati kosayenera.Kuonjezera apo, monga momwe tawonetsera mu gawo laling'ono la SNOT-22, panalibe kusintha kwakukulu mu gawo laling'ono la odwala jekeseni wa PRP.Zotsatira sizinaperekedwe ndi kusintha kwa gawo laling'ono lamalingaliro, zomwe zikuwonetsa kuti zotsatira za placebo sizinali zofunikira pamtundu wina.Jakisoni wa PRP amangofunika jekeseni imodzi kuti mukwaniritse zotsatira zabwino.Pambuyo pa jekeseni, kuchuluka kwa turbinate kumawonjezeka nthawi yomweyo.Komabe, paulendo wotsatira wodwala kunja (masabata a 2 pambuyo pake), panalibe kusiyana kwa voliyumu ndi mawonekedwe a turbinate otsika.Chifukwa chake, kuwonjezeka kwakanthawi kwa voliyumu komwe kumachitika chifukwa cha jakisoni kumaonedwa ngati kosayenera.Kuonjezera apo, monga momwe tawonetsera mu gawo laling'ono la SNOT-22, panalibe kusintha kwakukulu mu gawo laling'ono la odwala jekeseni wa PRP.Zotsatira sizinaperekedwe ndi kusintha kwa gawo laling'ono lamalingaliro, zomwe zikuwonetsa kuti zotsatira za placebo sizinali zofunikira pamtundu wina.Jakisoni wa PRP amangofunika jekeseni imodzi kuti mukwaniritse zotsatira zabwino.Pambuyo pa jekeseni, kuchuluka kwa turbinate kumawonjezeka nthawi yomweyo.Komabe, paulendo wotsatira wodwala kunja (masabata a 2 pambuyo pake), panalibe kusiyana kwa voliyumu ndi mawonekedwe a turbinate otsika.Chifukwa chake, kuwonjezeka kwakanthawi kwa voliyumu komwe kumachitika chifukwa cha jakisoni kumaonedwa ngati kosayenera.Kuonjezera apo, monga momwe tawonetsera mu gawo laling'ono la SNOT-22, panalibe kusintha kwakukulu mu gawo laling'ono la odwala jekeseni wa PRP.Zotsatira sizinaperekedwe ndi kusintha kwa gawo laling'ono lamalingaliro, zomwe zikuwonetsa kuti zotsatira za placebo sizinali zofunikira pamtundu wina.Palibe kusiyana kwa voliyumu ndi mawonekedwe a turbinate otsika.Chifukwa chake, kuwonjezeka kwakanthawi kwa voliyumu komwe kumachitika chifukwa cha jakisoni kumaonedwa ngati kosayenera.Kuonjezera apo, monga momwe tawonetsera mu gawo laling'ono la SNOT-22, panalibe kusintha kwakukulu mu gawo laling'ono la odwala jekeseni wa PRP.Zotsatira sizinaperekedwe ndi kusintha kwa gawo laling'ono lamalingaliro, zomwe zikuwonetsa kuti zotsatira za placebo sizinali zofunikira pamtundu wina.Palibe kusiyana kwa voliyumu ndi mawonekedwe a turbinate otsika.Chifukwa chake, kuwonjezeka kwakanthawi kwa voliyumu komwe kumachitika chifukwa cha jakisoni kumaonedwa ngati kosayenera.Kuonjezera apo, monga momwe tawonetsera mu gawo laling'ono la SNOT-22, panalibe kusintha kwakukulu mu gawo laling'ono la odwala jekeseni wa PRP.Zotsatira sizinaperekedwe ndi kusintha kwa gawo laling'ono lamalingaliro, zomwe zikuwonetsa kuti zotsatira za placebo sizinali zofunika kwambiri.
Zizindikiro za atrophic rhinitis ndi zowawa zosalekeza sizikhala zovuta kwambiri pamankhwala.Choncho, kutayika kwa chikhalidwe cha anthu ndi chuma sikuwerengeka.Komabe, kuchokera kwa odwala enieni, ndi matenda ovuta kwambiri pamagulu.Kuonjezera apo, ndi kukalamba kwa anthu, chiwerengero cha odwala omwe ali ndi senile rhinitis chikuwonjezeka kwambiri.Choncho, ndikofunika kwambiri kupereka chithandizo choyenera cha atrophic rhinitis, kuphatikizapo okalamba rhinitis.
Cholinga cha phunziroli ndikulingalira njira yatsopano yotsitsimutsa yochizira atrophic rhinitis kudzera mu jekeseni wa autologous PRP, ndi kuyerekezera kusintha kwa zizindikiro pakati pa gulu la mankhwala a PRP ndi gulu lachidziwitso chodziletsa pogwiritsa ntchito gulu lolamulira.Chifukwa cha atrophic rhinitis kukhala tanthauzo lachipatala, kafukufuku wochulukirapo akufunika kuti afotokoze momwe amachitira.Komabe, pofuna kupewa kutayika kwa chikhalidwe cha anthu komanso kuchepa kwa moyo wa odwala, ndikofunikira kupereka zotsatira za kafukufuku zomwe zingakhale ndi chithandizo chamankhwala.
Komabe, phunziroli lili ndi malire angapo.Kafukufukuyu adapangidwa moyembekezera ndipo sangathe kulamulidwa mwachisawawa popeza ena adakana pulogalamu ya jakisoni wa m'mphuno.Pazachikhalidwe, ntchito zowononga zolinga zamaphunziro mu gulu lolamulira ziyenera kukhala zoletsedwa kuteteza ufulu ndi zofuna za odwala.Choncho, kupatsa odwala malinga ndi zomwe amakonda kumapangitsa kuti zotsatira zafukufuku zikhale zofooka kusiyana ndi zomwe zimaperekedwa ndi maphunziro oyendetsedwa mwachisawawa.Komanso, yachiwiri atrophic rhinitis amayamba ndi mapindikidwe ndi kuchotsa choyambirira m`mphuno dongosolo.Kuchita biopsy kungapangitse atrophy.Choncho, malinga ndi chikhalidwe cha anthu, n'zosatheka kupanga biopsy ya minofu ya m'mphuno mwa odwala omwe ali ndi atrophic rhinitis.Zotsatira pambuyo pa miyezi 6 yotsatiridwa sizingasonyeze zotsatira za nthawi yaitali.Kuonjezera apo, chiwerengero cha odwala m'gulu laling'ono ndi chochepa.Choncho, kafukufuku wamtsogolo ayenera kuphatikizapo odwala ambiri omwe amagwiritsa ntchito ndondomeko yoyendetsedwa mwachisawawa pa nthawi yayitali yotsatila.
(Zomwe zili m'nkhaniyi zidasindikizidwanso, ndipo sitikupereka chitsimikizo chotsimikizika kapena chotsimikizika pakulondola, kudalirika kapena kukwanira kwa zomwe zili m'nkhaniyi, ndipo sitili ndi udindo pamalingaliro ankhaniyi, chonde mvetsetsani.）
Nthawi yotumiza: May-23-2023