Platelet Rich Plasma (PRP)
PRP yakopa chidwi chifukwa ili ndi zinthu zosiyanasiyana za kukula, ndipo imagwiritsidwa ntchito kwambiri pa opaleshoni ya maxillofacial, orthopedics, opaleshoni ya pulasitiki, ophthalmology ndi zina.Mu 2006, Uebel et al.poyamba adayesa pretreat ma follicular units kuti alowetsedwe ndi PRP ndipo adawona kuti poyerekeza ndi malo oyendetsa scalp, malo opangira tsitsi a PRP adapulumuka ma 18.7 follicular units / cm2, pamene gulu lolamulira linapulumuka 16.4 follicular units./cm2, kachulukidweko adakula ndi 15.1%.Choncho, akuganiza kuti zinthu zomwe zimakula zomwe zimatulutsidwa ndi mapulateleti zimatha kuchitapo kanthu pazitsulo zamtundu wa tsitsi la tsitsi, zimalimbikitsa kusiyanitsa kwa maselo a tsinde ndikulimbikitsa mapangidwe a mitsempha yatsopano ya magazi.
Mu 2011, Takikawa et al.amagwiritsira ntchito saline wamba, PRP, heparin-protamine microparticles pamodzi ndi PRP (PRP & D / P MPs) kuti jekeseni wa subcutaneous wa odwala AGA kukhazikitsa maulamuliro.Zotsatira zake zidawonetsa kuti gawo lozungulira tsitsi la gulu la PRP ndi gulu la PRP&D/P la MP lidachulukirachulukira, ulusi wa collagen ndi ma fibroblasts m'mitsempha yatsitsi zidachulukira pansi pa maikulosikopu, ndipo mitsempha yamagazi mozungulira zitsitsi zatsitsi zidachuluka.
PRP ili ndi zinthu zambiri zomwe zimachokera ku platelet.Mapuloteni ofunikirawa amayang'anira kusamuka kwa maselo, kugwirizanitsa, kufalikira, ndi kusiyanitsa, kumalimbikitsa kudzikundikira kwa matrix owonjezera, ndi zinthu zambiri za kukula zimalimbikitsa kukula kwa tsitsi: kukula kwa PRP kumagwirizana ndi ma follicles a tsitsi.Kuphatikizika kwa ma cell stem cell kumapangitsa kuchulukana kwa ma follicles atsitsi, kupanga ma follicular unit, ndikulimbikitsa kusinthika kwa tsitsi.Kuphatikiza apo, imatha kuyambitsa kutsika kwamadzi komanso kulimbikitsa angiogenesis.
Mkhalidwe Wamakono wa PRP mu Chithandizo cha AGA
Palibe kuvomerezana pa njira yokonzekera ndi platelet enrichment factor of PRP;njira zochizira zimasiyanasiyana malinga ndi kuchuluka kwa chithandizo, nthawi yapakati, nthawi yopumira, njira ya jakisoni, komanso ngati mankhwala ophatikizana amagwiritsidwa ntchito.
Mapar et al.anaphatikizapo odwala aamuna a 17 omwe ali ndi gawo IV mpaka VI (njira ya Hamilton-Norwood staging), ndipo zotsatira zake sizinawonetse kusiyana pakati pa PRP ndi jekeseni wa placebo, koma phunziroli linangopanga jekeseni wa 2, ndipo chiwerengero cha mankhwala chinali chochepa kwambiri.Zotsatira zake ndi zotseguka kwa mafunso.;
Gkini et al adapeza kuti odwala omwe ali ndi siteji yotsika amasonyeza kukhudzidwa kwakukulu kwa chithandizo cha PRP;Malingaliro awa adatsimikiziridwa ndi Qu et al, omwe adaphatikizapo odwala 51 aamuna ndi a 42 omwe ali ndi siteji ya II-V mwa amuna ndi ine mwa akazi ~ Stage III (staging ndi Hamilton-Norwood ndi Ludwig staging njira), zotsatira zimasonyeza kuti PRP kusiyana kwakukulu kwa chiwerengero cha odwala omwe ali ndi magawo osiyanasiyana a amuna ndi akazi, koma mphamvu ya siteji yotsika ndi yapamwamba ndi yabwino, kotero ochita kafukufuku amalangiza II , Odwala aamuna a Gawo la III ndi odwala siteji I odwala amathandizidwa ndi PRP.
Factor Yothandiza Kwambiri
Kusiyanitsa kwa njira zokonzekera za PRP mu phunziro lililonse kunapangitsa kuti pakhale zolemeretsa zosiyana za PRP mu phunziro lililonse, zomwe zambiri zinali pakati pa 2 ndi 6 nthawi.Platelet degranulation imatulutsa zinthu zambiri za kukula, imayang'anira kusamuka kwa maselo, kugwirizanitsa, kufalikira ndi kusiyanitsa, kumapangitsa kuti tsitsi likhale lopangidwa ndi ma cell a follicle, minofu ya vascularization, ndikulimbikitsa kudzikundikira kwa extracellular matrix.Panthawi imodzimodziyo, njira ya microneedling ndi low-energy laser therapy imatengedwa kuti ndi Amapanga kuwonongeka kwa minofu yoyendetsedwa ndi kumapangitsa kuti mapulateleti awonongeke, omwe amatsimikizira ubwino wa mankhwala a PRP amadalira ntchito yake yamoyo.Chifukwa chake, ndikofunikira kuyang'anira kuchuluka kwa PRP.Kafukufuku wina akukhulupirira kuti PRP yokhala ndi nthawi yowonjezera ya 1-3 ndiyothandiza kwambiri kuposa khola lapamwamba lolemeretsa, koma Ayatollahi et al.adagwiritsa ntchito PRP yokhala ndi nthawi yowonjezera ya 1.6 kuti athandizidwe, ndipo zotsatira zake zimasonyeza kuti chithandizo cha odwala AGA sichinali chothandiza, ndipo amakhulupirira kuti PRP Kukonzekera kothandiza kuyenera kukhala 4 ~ 7 nthawi.
Chiwerengero cha Chithandizo, Nthawi Yopuma ndi Nthawi Yopuma
Maphunziro a Mapar et al.ndi Puig et al.onse adapeza zotsatira zoyipa.Chiwerengero cha mankhwala a PRP mu ndondomeko ziwiri za phunziroli chinali 1 ndi 2 nthawi, motero, zomwe zinali zochepa kusiyana ndi maphunziro ena (makamaka 3-6 nthawi).Picard ndi al.anapeza kuti mphamvu ya PRP inafika pachimake pambuyo pa chithandizo cha 3 mpaka 5, kotero iwo amakhulupirira kuti mankhwala oposa 3 angakhale ofunikira kuti athetse zizindikiro za kutayika tsitsi.
Kuwunika kwa Gupta ndi Carviel kunapeza kuti maphunziro ambiri omwe analipo anali ndi nthawi ya chithandizo cha mwezi wa 1, ndipo chifukwa cha kuchepa kwa maphunziro, zotsatira za chithandizo ndi jekeseni wa PRP pamwezi sizinafanane ndi maulendo ena a jekeseni, monga jekeseni wa PRP mlungu uliwonse.
Kafukufuku wa Hausauer ndi Jones [20] adawonetsa kuti anthu omwe adalandira jekeseni pamwezi anali ndi kusintha kwakukulu kwa chiwerengero cha tsitsi poyerekeza ndi mafupipafupi a jekeseni miyezi yonse ya 3 (P <0.001);Schiavone et al.[21] adatsimikiza kuti, Chithandizo chiyenera kubwerezedwa 10 kwa miyezi 12 pambuyo pa kutha kwa mankhwala;Amitundu et al.kutsatiridwa kwa zaka 2, nthawi yayitali kwambiri yotsatizana pakati pa maphunziro onse, ndipo adapeza kuti odwala ena adabwereranso pa miyezi 12 (milandu ya 4/20), ndipo mwa odwala 16 Zizindikiro zimawonekera kwambiri m'miyezi.
Pakutsata kwa Sclafani, zidapezeka kuti mphamvu ya odwala idatsika kwambiri miyezi 4 pambuyo pomaliza maphunziro.Picard ndi al.anatchula zotsatira ndi kupereka lolingana mankhwala malangizo: pambuyo ochiritsira imeneyi ya 3 mankhwala 1 mwezi, mankhwala ayenera kuchitidwa 3 zina.pamwezi tima mankhwala.Komabe, Sclafani sanafotokoze chiŵerengero cha kuchuluka kwa mapulateleti a mankhwala omwe amagwiritsidwa ntchito pochiza.Mu phunziroli, 8-9 ml ya mankhwala opangidwa ndi matrix olemera a fibrin opangidwa ndi mapulateleti anakonzedwa kuchokera ku 18 ml ya magazi ozungulira (PRP yotengedwa inawonjezeredwa ku chubu cha vacuum ya CaCl2, ndipo guluu wa fibrin anayikidwa mu guluu wa fibrin. jakisoni asanapangidwe) , timakhulupirira kuti kuchulukitsitsa kwa mapulateleti m’kukonzekera kumeneku kungakhale kosakwanira, ndipo pakufunika umboni wowonjezereka wochirikiza zimenezo.
Jekeseni Njira
Njira zambiri za jakisoni ndi jakisoni wa intradermal ndi subcutaneous jekeseni.Ofufuzawo adakambirana za momwe njira yoyendetsera ntchito imakhudzidwira pakuchiritsa.Gupta ndi Carviel adalimbikitsa jakisoni wa subcutaneous.Ofufuza ena amagwiritsa ntchito jakisoni wa intradermal.Jekeseni wa intradermal amatha kuchedwetsa kulowa kwa PRP m'magazi, kuchepetsa kuchuluka kwa kagayidwe kachakudya, kutalikitsa nthawi ya zochitika zakomweko, ndikuwonjezera kukopa kwa dermis kulimbikitsa kukula kwa tsitsi.ndi kuya sikufanana.Timalimbikitsa kuti njira ya jakisoni wa Nappage iyenera kugwiritsidwa ntchito mosamalitsa popanga jakisoni wa intradermal kuti asamakhudzidwe ndi kusiyana kwa jakisoni, ndipo timalimbikitsa kuti odwala amete tsitsi lawo lalifupi kuti ayang'ane komwe tsitsi likupita, ndikusintha momwe singano imakhalira molingana ndi momwe imakhalira. mayendedwe akukula kotero kuti nsonga ya singano ifikire kuzungulira tsitsi, potero kukulitsa ndende ya PRP m'malo atsitsi.Malingaliro awa okhudza njira za jakisoni ndi zongonena chabe, popeza palibe maphunziro omwe amafanizira mwachindunji ubwino ndi kuipa kwa njira zosiyanasiyana za jakisoni.
Chithandizo Chophatikiza
Jha et al.anagwiritsa ntchito PRP pamodzi ndi microneedling ndi 5% minoxidil kuphatikiza mankhwala kusonyeza mphamvu zabwino zonse umboni wa zolinga ndi wodwalayo kudzipenda.Timakumanabe ndi zovuta pakukhazikitsa njira zochiritsira za PRP.Ngakhale kuti maphunziro ambiri amagwiritsa ntchito njira zoyenera komanso zowonjezereka kuti aone kusintha kwa zizindikiro pambuyo pa chithandizo, monga kuwerengera tsitsi lomaliza, chiwerengero cha tsitsi la vellus, chiwerengero cha tsitsi, kachulukidwe, makulidwe, ndi zina zotero, njira zowunika zimasiyana mosiyanasiyana;kuphatikizapo, kukonzekera PRP Palibe yunifolomu muyezo wa njira, kuwonjezera activator, centrifugation nthawi ndi liwiro, platelet ndende, etc.;njira zochizira zimasiyanasiyana malinga ndi kuchuluka kwa mankhwala, nthawi yapakati, nthawi yobwezeretsa, njira ya jakisoni, komanso ngati kuphatikiza mankhwala;Kusankhidwa kwa zitsanzo mu phunziroli sikuli Stratification ndi zaka, jenda, ndi digiri ya alopecia inasokonezanso kuwunika kwa zotsatira za chithandizo cha PRP.M'tsogolomu, maphunziro odziletsa a zitsanzo zazikuluzikulu akufunikabe kuti afotokoze magawo osiyanasiyana a mankhwala, ndipo kusanthula kwapadera kwa zinthu monga zaka za odwala, jenda, ndi kutayika kwa tsitsi kumatha kusintha pang'onopang'ono.
(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: Aug-02-2022