Platelet Rich Plasma (PRP)
External humeral epicondylitis ndi matenda odziwika bwino omwe amadziwika ndi ululu kumbali ya m'mphepete mwa chigongono.Ndizobisika komanso zosavuta kubwereza, zomwe zingayambitse kupweteka kwa msana ndi kuchepa kwa mphamvu ya dzanja, ndipo zimakhudza kwambiri moyo watsiku ndi tsiku ndi ntchito za odwala.Pali njira zosiyanasiyana zochizira lateral epicondylitis ya humerus, ndi zotsatira zosiyana.Palibe njira yokhazikika yochiritsira pakadali pano.Platelet rich plasma (PRP) imakhala ndi zotsatira zabwino pakukonza mafupa ndi tendon, ndipo yakhala ikugwiritsidwa ntchito kwambiri pochiza epicondylitis yakunja ya humeral.
Malinga ndi kuchuluka kwa chivomerezo cha mavoti, amagawidwa m'magulu atatu:
100% amavomereza kwathunthu (Level I)
90% ~ 99% ndi mgwirizano wamphamvu (Level II)
70% ~ 89% amavomereza (Level III)
Lingaliro la PRP ndi Zofunikira Zogwiritsira Ntchito
(1) Lingaliro: PRP ndi plasma yochokera.Magulu ake a mapulateleti ndi apamwamba kuposa oyambira.Lili ndi zinthu zambiri zomwe zimakula komanso ma cytokines, omwe amatha kulimbikitsa kukonzanso kwa minofu ndikuchiritsa.
(2) Zofunikira pazosakaniza zomwe zimagwiritsidwa ntchito:
① Kuphatikizika kwa mapulateleti a PRP pochiza epicondylitis ya humeral yakunja kumalimbikitsidwa kukhala (1000 ~ 1500) × 109/L (nthawi 3-5 ya ndende yoyambira);
② Kukonda kugwiritsa ntchito PRP yolemera mu maselo oyera a magazi;
③ Kutsegula kwa PRP sikuvomerezeka.
(Kulimba kovomerezeka: Level I; umboni wa zolemba: A1)
Kuwongolera Ubwino wa PRP Preparation Technology
(1) Zofunikira za anthu ogwira ntchito: Kukonzekera ndi kugwiritsa ntchito PRP kuyenera kuchitidwa ndi ogwira ntchito zachipatala omwe ali ndi ziyeneretso za madokotala ovomerezeka, anamwino ovomerezeka ndi ogwira ntchito zachipatala oyenerera, ndipo ayenera kuchitidwa pambuyo pa maphunziro okhwima a aseptic opaleshoni ndi maphunziro a kukonzekera PRP.
(2) Zipangizo: PRP idzakonzedwa pogwiritsa ntchito njira yokonzekera zipangizo zovomerezeka za Class III.
(3) Malo ogwirira ntchito: Chithandizo cha PRP ndi ntchito yowonongeka, ndipo kukonzekera kwake ndi kugwiritsiridwa ntchito kwake kukulimbikitsidwa kuti kuchitidwe m'chipinda chapadera chachipatala kapena chipinda chogwiritsira ntchito chomwe chimakwaniritsa zofunikira za kuwongolera maganizo.
(Kulimba kovomerezeka: Level I; umboni wa zolembalemba: Level E)
Zizindikiro ndi zotsutsana za PRP
(1) Zizindikiro:
① Chithandizo cha PRP chilibe zofunikira zomveka za mtundu wa ntchito ya anthu, ndipo chitha kuganiziridwa kuti chimachitika kwa odwala omwe akufuna kwambiri (monga gulu lamasewera) komanso kufunikira kochepa (monga ogwira ntchito muofesi, ogwira ntchito m'mabanja, ndi zina zambiri. );
② Odwala oyembekezera ndi oyamwitsa angagwiritse ntchito PRP mosamala pamene chithandizo cha thupi sichigwira ntchito;
③ PRP iyenera kuganiziridwa pamene chithandizo chosagwiritsidwa ntchito cha humeral epicondylitis sichigwira ntchito kwa miyezi yoposa 3;
④ Pambuyo pa chithandizo cha PRP chikugwira ntchito, odwala omwe akubwereranso angaganizirenso kugwiritsa ntchito;
⑤ PRP ikhoza kugwiritsidwa ntchito miyezi 3 pambuyo pa jekeseni wa steroid;
⑥ PRP ikhoza kugwiritsidwa ntchito pochiza matenda a tendon extensor ndi kung'ambika pang'ono kwa tendon.
(2) Mtheradi zotsutsana: ① thrombocytopenia;② Chotupa choopsa kapena matenda.
(3) Chibale contraindications: ① odwala matenda magazi coagulation ndi kumwa anticoagulant mankhwala;② kuchepa magazi, hemoglobin <100 g/L.
(Kulimba kovomerezeka: Level II; mulingo waumboni wa zolemba: A1)
PRP Injection Therapy
Pamene jekeseni ya PRP imagwiritsidwa ntchito pochiza lateral epicondylitis ya humerus, tikulimbikitsidwa kugwiritsa ntchito malangizo a ultrasound.Ndikoyenera kubaya 1 ~ 3 ml ya PRP pafupi ndi malo ovulala.Jekeseni imodzi ndiyokwanira, nthawi zambiri osapitilira 3, ndipo nthawi ya jakisoni ndi masabata a 2-4.
(Kulimba kovomerezeka: Level I; umboni wa zolemba: A1)
Kugwiritsa ntchito PRP pakugwira ntchito
Gwiritsani ntchito PRP mwamsanga mutatha kuchotsa kapena kuchotsa chotupa panthawi ya opaleshoni;Mafomu a mlingo omwe amagwiritsidwa ntchito ndi PRP kapena ophatikizidwa ndi gel olemera a platelet (PRF);PRP ikhoza kubayidwa mumtundu wa fupa la tendon, malo owonetsetsa a tendon pazigawo zingapo, ndipo PRF ingagwiritsidwe ntchito kudzaza malo osokonezeka a tendon ndikuphimba pamwamba pa tendon.Mlingo wa mankhwalawa ndi 1-5 ml.Sitikulimbikitsidwa kubaya PRP mumphako.
(Kulimba kolangizidwa: Gawo II; mulingo waumboni wa zolemba: Level E)
Zokhudzana ndi PRP
(1) Kusamalira ululu: Pambuyo pa chithandizo cha PRP cha epicondylitis yakunja ya humeral, acetaminophen (paracetamol) ndi opioid ofooka angaganizidwe kuti achepetse ululu wa odwala.
(2) Zotsutsana ndi zotsatira zoyipa: kupweteka kwakukulu, hematoma, matenda, kuuma kwa mgwirizano ndi zina pambuyo pa chithandizo cha PRP chiyenera kuchitidwa mwakhama, ndipo ndondomeko zochiritsira zogwira mtima ziyenera kupangidwa pambuyo pa kukonza ma laboratory ndi kujambula kujambula ndi kufufuza.
(3) Kuyankhulana ndi dokotala ndi maphunziro a zaumoyo: Asanayambe kapena atatha chithandizo cha PRP, yesetsani kulankhulana ndi dokotala ndi odwala komanso maphunziro a zaumoyo, ndikusayina fomu yovomerezeka yodziwitsidwa.
(4) Ndondomeko yokonzanso: palibe kukonzanso kumafunika pambuyo pa chithandizo cha jekeseni wa PRP, ndipo ntchito zopweteka ziyenera kupeŵedwa mkati mwa maola 48 pambuyo pa chithandizo.Kupindika kwa chigongono ndi kukulitsa kumatha kuchitika maola 48 pambuyo pake.Pambuyo pa opaleshoni pamodzi ndi PRP, ndondomeko yokonzanso pambuyo pa opaleshoni iyenera kuperekedwa patsogolo.
(Kulimba kovomerezeka: Level I; umboni wa zolembalemba: Level E)
Zolozera:Chin J Trauma, Ogasiti 2022, Vol.38, No. 8, Chinese Journal of Trauma, August 2022
(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: Nov-28-2022