Wholesale Kugwiritsa Ntchito PRP M'magawo Osiyanasiyana ndi Momwe Mungasankhire L-PRP ndi P-PRP Wopanga ndi Wopereka |Manson

Kugwiritsa Ntchito kwaPlatelet Rich Plasma (PRP)M'magawo osiyanasiyana ndi Momwe Mungasankhire PRP Wolemera mu Maselo Oyera a Magazi (L-PRP) ndi PRP Osauka mu Maselo Oyera a Magazi (P-PRP)

Kupeza kwaposachedwa kwaumboni wambiri wamtengo wapatali kumathandizira kugwiritsa ntchito jekeseni wa LR-PRP pochiza lateral Epicondylitis ndi LP-PRP pofuna kuchiza bondo Articular bone.Umboni wapakatikati umathandizira kugwiritsa ntchito jekeseni ya LR-PRP ya patellar tendinosis ndi jekeseni ya PRP ya Plantar fasciitis ndi ululu wa malo opereka chithandizo patellar tendon transplantation BTB ACL kumanganso.Palibe umboni wokwanira wotsimikizira nthawi zonse PRP ya rotator cuff tendinosis, hip Articular bone osteoarthritis kapena high ankle sprain.Umboni wamakono umasonyeza kuti PRP ilibe mphamvu pochiza matenda a tendon Achilles, kuvulala kwa minofu, kupasuka kwakukulu kapena fupa losagwirizana ndi fupa, opaleshoni yowonjezera ya rotator, kukonza tendon ya Achilles, ndi kumanganso ACL.

Kuchuluka kwa mapulateleti owerengeka ndi 150000 mpaka 350000 / μ L. Kusintha kwa machiritso a mafupa ndi minyewa yofewa kwasonyezedwa, ndi mapulateleti okhazikika omwe amafika ku 1000000 / μ L. Akuyimira katatu kapena kasanu kuwonjezeka kwa zinthu za kukula.Kukonzekera kwa PRP nthawi zambiri kumagawanika kukhala PRP yolemera mu maselo oyera a magazi (LR-PRP), omwe amatanthauzidwa ngati ndende ya neutrophil pamwamba pa maziko, ndi PRP osauka m'maselo oyera a magazi (LP-PRP), omwe amatchedwa maselo oyera a magazi (neutrophil) pansi pa maziko. .

Chithandizo cha Zovulala za Tendon

Kugwiritsiridwa ntchito kwa PRP pochiza kuvulala kwa tendon kapena matenda a tendon kwakhala mutu wa maphunziro angapo, ndipo ma cytokines ambiri omwe amapezeka mu PRP amakhudzidwa ndi njira zowonetsera zomwe zimachitika panthawi ya machiritso a kutupa, kufalikira kwa maselo, ndi kukonzanso minofu yotsatira.PRP ikhoza kulimbikitsanso mapangidwe a mitsempha yatsopano ya magazi, yomwe imatha kuonjezera magazi ndi zakudya zomwe zimafunikira kuti maselo apangidwenso ndi minofu yowonongeka, komanso kubweretsa maselo atsopano ndikuchotsa zinyalala ku minofu yowonongeka.Njira zogwirira ntchitozi zingakhale zogwirizana kwambiri ndi tendinosis yosatha, pomwe zochitika zamoyo sizimachiritsa machiritso a minofu.Kuwunika kwaposachedwa komanso kusanthula kwa meta kunatsimikizira kuti kubaya PRP kumatha kuchiza tendinosis yodziwika bwino.

Epicondylitis pambuyo pake

PRP yayesedwa ngati njira yothandizira odwala omwe ali ndi lateral Epicondylitis omwe sali othandiza mu physiotherapy.Pakufufuza kwakukulu kotereku, Mishra et al.Mu kafukufuku woyembekezeredwa wa Cohort, odwala 230 omwe sanayankhe ku Conservative management of lateral Epicondylitis kwa miyezi yosachepera 3 adayesedwa.Wodwalayo analandira chithandizo cha LR-PRP, ndipo pa masabata a 24, jekeseni ya LR-PRP inagwirizanitsidwa ndi kusintha kwakukulu kwa ululu poyerekeza ndi gulu lolamulira (71.5% vs 56.1%, P = 0.019), komanso kuchepa kwakukulu kwa kuchuluka kwa odwala omwe amafotokoza kutha kwa chigongono chotsalira (29.1% vs 54.0%, P=0.009).Pamasabata a 24, odwala omwe amathandizidwa ndi LR-PRP adawonetsa kusintha kwakukulu komanso kowerengeka poyerekeza ndi jakisoni wowongolera wamankhwala am'deralo.

Kafukufuku wam'mbuyo wasonyeza kuti LR-PRP ingaperekenso mpumulo wokhalitsa kwa zizindikiro za lateral Epicondylitis poyerekeza ndi jekeseni wa Corticosteroid, kotero imakhala ndi zotsatira zochiritsira zowonjezereka.PRP ikuwoneka ngati njira yothandiza yochizira Epicondylitis yakunja.Umboni wapamwamba kwambiri umasonyeza nthawi yaifupi komanso ya nthawi yayitali.Umboni wabwino kwambiri womwe ulipo umasonyeza kuti LR-PRP iyenera kukhala njira yoyamba yothandizira.

Patellar Tendinosis

Maphunziro osasinthika amathandizira kugwiritsa ntchito LR-PRP pochiza matenda osachiritsika a patellar tendon.Draco ndi al.Odwala makumi awiri ndi atatu omwe ali ndi patellar tendinosis omwe analephera kasamalidwe ka Conservative adayesedwa.Odwala anapatsidwa mwachisawawa kuti alandire singano zowuma zotsogoleredwa ndi ultrasound kapena jekeseni wa LR-PRP, ndipo adatsatiridwa kwa> masabata a 26.Kupyolera muyeso ya VISA-P, gulu lachipatala la PRP linawonetsa kusintha kwakukulu kwa zizindikiro pa masabata a 12 (P = 0.02), koma kusiyana sikunali kofunika pa> masabata a 26 (P = 0.66), kusonyeza kuti ubwino wa PRP wa matenda a patellar tendon kungakhale kusintha kwa zizindikiro zoyamba.Vitrano et al.Ubwino wa jakisoni wa PRP pochiza matenda osachiritsika a patellar tendon poyerekeza ndi mawonekedwe a extracorporeal shock wave therapy (ECSWT) adanenedwanso.Ngakhale kuti panalibe kusiyana kwakukulu pakati pa magulu pakutsatira kwa mwezi wa 2, gulu la PRP linawonetsa kusintha kwakukulu pa 6 ndi miyezi ya 12 yotsatila, kupitirira ECSWT monga momwe amachitira VISA-P ndi VAS, ndikuyesa Blazina. kuchuluka kwa miyezi 12 yotsatiridwa (onse P <0.05).

Ndemangayi ikuyang'ana zolemba zamakono zamakono zogwiritsira ntchito plasma (PRP), kuphatikizapo leukocyte rich PRP (LR PRP) ndi leukocyte poor PRP (LP PRP), kuti apange malingaliro okhudzana ndi umboni wa matenda osiyanasiyana a musculoskeletal.

yambitsani

Platelet rich plasma (PRP) ndi autologous plasma ya munthu kukonzekera komwe kumawonjezera ndende ya mapulateleti mwa centrifuging kuchuluka kwa magazi a wodwalayo.Mapulateleti mu α Particles (TGF- β 1. PDGF, bFGF, VEGF, EGF, IGF-1) ali ndi kuchuluka kwakukulu kwa zinthu zokulirapo ndi oyimira pakati, omwe amayang'aniridwa kudzera munjira ya centrifugation kumasula kuchuluka kwa suprabiological kwa zinthu izi kukula ndi ma cytokines. ku malo ovulala ndikuwonjezera machiritso achilengedwe.Kuchuluka kwa mapulateleti owerengeka ndi 150000 mpaka 350000 / μ L. Kusintha kwa machiritso a mafupa ndi minyewa yofewa kwasonyezedwa, ndi mapulateleti okhazikika omwe amafika ku 1000000 / μ L. Akuyimira katatu kapena kasanu kuwonjezeka kwa zinthu za kukula.

Kukonzekera kwa PRP nthawi zambiri kumagawidwa m'magulu a PRP olemera mu maselo oyera a magazi (LR-PRP), omwe amadziwika kuti ndi neutrophil concentrations pamwamba pa chiyambi, ndi kukonzekera kwa PRP osauka m'maselo oyera a magazi (LP-PRP), omwe amatchedwa maselo oyera a magazi (neutrophil) pansi pazoyambira.

Kukonzekera ndi Kupanga

Palibe mgwirizano wamba pakupanga kwabwino kwa PRP kwa chigawo cha magazi, ndipo pakali pano pali machitidwe ambiri amalonda a PRP pamsika.Choncho, malinga ndi machitidwe osiyanasiyana amalonda, pali kusiyana kwa ndondomeko zosonkhanitsira za PRP ndi zizindikiro zokonzekera, kupatsa dongosolo lililonse la PRP makhalidwe apadera.Machitidwe amalonda amasiyana kwambiri pakugwira ntchito kwa mapulateleti, njira yolekanitsa (gawo limodzi kapena magawo awiri a centrifugation), liwiro la centrifugation, ndi mtundu wa kachitidwe ka chubu ndi ntchito.Kawirikawiri, musanayambe centrifugation, magazi athunthu amasonkhanitsidwa ndikusakanikirana ndi anticoagulant factor kuti alekanitse maselo ofiira a magazi (RBCs) ndi plasma-poor plasma (PPP) ndi "erythrocyte sedimentation brown layer" yomwe imakhala ndi mapulateleti okhazikika ndi maselo oyera a magazi.Njira zosiyanasiyana zimagwiritsidwa ntchito kulekanitsa mapulateleti, omwe amatha kubayidwa mwachindunji m'thupi la wodwalayo kapena "kuyambitsa" powonjezera calcium chloride kapena thrombin, zomwe zimapangitsa kuti mapulateleti awonongeke komanso kutulutsidwa kwa zinthu zakukula.Zinthu ziwiri zokhudzana ndi odwala, kuphatikizapo kayendetsedwe ka mankhwala ndi njira zokonzekera dongosolo la malonda, zimakhudza mapangidwe enieni a PRP, komanso kusintha kumeneku kwa mapangidwe a PRP pofotokozera momwe PRP imathandizira.

Kumvetsetsa kwathu kwapano ndikuti PRP yokhala ndi kuchuluka kwa maselo oyera a magazi, omwe ndi PRP olemera mu maselo oyera amagazi (neutrophils), amalumikizidwa ndi zotsatira zoyambitsa kutupa.Kuwonjezeka kwa maselo oyera a magazi (neutrophils) mu LR-PRP kumagwirizananso ndi kuwonjezeka kwa ma cytokines a catabolic, monga interleukin-1 β, Tumor Necrosis Factor α Ndi metalloproteinases, zomwe zingagwirizane ndi anabolic cytokines zomwe zili m'mapulateleti.Zotsatira zachipatala ndi zotsatira za ma cell a mitundu yosiyanasiyana ya PRP, kuphatikizapo maselo oyera a magazi, akufotokozedwabe.Ndemanga iyi ikufuna kuyesa umboni wabwino kwambiri womwe umapezeka paziwonetsero zosiyanasiyana zachipatala zamitundu yosiyanasiyana ya PRP.

Achilles Tendon Matenda

Mayesero angapo a mbiri yakale alephera kusonyeza kusiyana kwa zotsatira zachipatala pakati pa PRP ndi placebo okha pochiza Achilles tendinitis.Mayesero aposachedwapa olamulidwa mwa Randomized anayerekezera mndandanda wa majekeseni anayi a LP-PRP ndi jekeseni wa placebo pamodzi ndi pulogalamu ya centrifugal load rehabilitation.Poyerekeza ndi gulu la placebo, gulu lachipatala la PRP linasonyeza kusintha kwakukulu kwa ululu, ntchito, ndi zochitika zamagulu nthawi zonse pa nthawi yonse yotsatila ya 6.Kafukufukuyu adapezanso kuti jekeseni wamkulu wa voliyumu imodzi (50 mL) ya 0.5% Bupivacaine (10 mL), methylprednisolone (20 mg) ndi saline yakuthupi (40 mL) anali ndi kusintha kofananira, koma poganizira za mankhwalawa, chisamaliro chiyenera kutengedwa. kuwona kwachiwopsezo chowonjezereka cha kuphulika kwa tendon pambuyo pa jekeseni wa steroid.

Rotator Cuff Tendinosis

Pali maphunziro ochepa apamwamba pa jekeseni wa PRP mu chithandizo chosachita opaleshoni cha matenda a rotator cuff tendon.Kafukufuku wowerengeka wofalitsidwa ayerekezera zotsatira zachipatala za jekeseni wa subacromial wa PRP ndi placebo ndi Corticosteroid, ndipo palibe phunziro lomwe layesa jekeseni wachindunji wa PRP mu tendon yokha.Casey Buren et al.Zinapezeka kuti panalibe kusiyana kwa zotsatira zachipatala poyerekeza ndi jekeseni mchere wamthupi pansi pa nsonga ya mapewa.Komabe, kuyesa koyang'aniridwa mwachisawawa kunapeza kuti jakisoni awiri a LR-PRP milungu inayi iliyonse amachepetsa ululu poyerekeza ndi jakisoni wa placebo.Shams et al.Kuwongolera kofananira kwa jekeseni wa subacromial PRP ndi Corticosteroid pakati pa Xi'an Ontario RC index (WORI), index pain disability index (SPDI) ndi VAS pamapewa ndi mayeso a Neer adanenedwa.

Pakalipano, kafukufuku wasonyeza kuti jekeseni PRP pansi pa nsonga ya mapewa ali ndi kusintha kwakukulu mu zotsatira zomwe zanenedwa za odwala omwe ali ndi matenda a rotator cuff tendon.Maphunziro ena omwe amafunikira kutsatiridwa kwa nthawi yayitali, kuphatikizapo kuyesa jekeseni mwachindunji wa PRP mu tendons.Majekeseni a PRP awa awonetsedwa kuti ndi otetezeka ndipo akhoza kukhala njira ina ya jekeseni wa Corticosteroid mu rotator cuff tendinosis.

Plantar Fasciitis

Mayesero angapo olamulidwa mwachisawawa adayesa jekeseni wa PRP wa Plantar fasciitis yosatha.Kuthekera kwa PRP monga chithandizo cha jekeseni m'deralo kumachepetsa nkhawa zokhudzana ndi jekeseni wa Corticosteroid, monga atrophy of fashion pads kapena kupasuka kwa plantar fascia.Kufufuza kwaposachedwapa kwa meta kunayesa kuyerekezera pakati pa jekeseni wa PRP ndi jekeseni wa Corticosteroid, ndipo anapeza kuti jekeseni wa PRP ndi njira yotheka yogwiritsira ntchito jekeseni wa Corticosteroid malinga ndi mphamvu zake.Kafukufuku wina watsimikizira kukwera kwa PRP.

Opaleshoni yophatikizidwa ndi PRP

Kukonza Mapewa a Mapewa

Maphunziro angapo apamwamba azachipatala adayesa kugwiritsa ntchito zinthu za PRP mu Arthroscopy kukonza misozi ya rotator cuff.Kafukufuku wambiri adaphunzira makamaka kugwiritsa ntchito kukonzekera kwa mapulateleti olemera a fibrin kuti apititse patsogolo (PRFM), pomwe maphunziro ena adabaya PRP mwachindunji pamalo okonzera.Pali kusiyana kwakukulu mu PRP kapena PRFM formulations.Zotsatira zotsata odwala zidapezedwa, monga University of California, Los Angeles (UCLA), American Shoulder and Elbow Association (ASES), Constant Shoulder Score, Simple Shoulder Test (SST) mphambu, ndi ululu wa VAS, komanso cholinga chachipatala. deta monga mphamvu ya rotator cuff ndi mapewa ROM adasonkhanitsidwa kuti ayese kusiyana kwa zotsatira zogwira ntchito.Maphunziro ambiri paokha awonetsa kusiyana pang'ono pamiyeso yazotsatirazi mu PRP poyerekeza ndi kukonza kwa munthu payekha [monga mapepala a Arthroscopy rotator cuff kukonza.Kuphatikiza apo, kusanthula kwakukulu kwa meta ndi kuwunika kotsimikizika kwaposachedwa kwatsimikizira kuti kukonza kwa Arthroscopy kwa mapewa [PRP] kulibe phindu lalikulu pakukulitsa mabere.Komabe, deta yochepa imasonyeza kuti imakhala ndi zotsatira zina zochepetsera ululu wa perioperative, zomwe zimakhala chifukwa cha anti-inflammatory properties za PRP.

Kusanthula kwamagulu ang'onoang'ono kunasonyeza kuti pakati ndi misozi yaing'ono yothandizidwa ndi Arthroscopy kukonzanso mizere iwiri, jekeseni wa PRP ukhoza kuchepetsa kung'ambika, motero kupeza zotsatira zabwino.Qiao et al.Zinapezeka kuti PRP ndi yopindulitsa kuchepetsa mlingo wa kung'ambika kwa misozi yaing'ono ndi yayikulu yozungulira poyerekeza ndi opaleshoni yokha.

Mayesero achipatala osawerengeka komanso kusanthula kwakukulu kwa meta kumasonyeza kusowa kwa umboni wogwiritsira ntchito PRP ndi PRFM monga kulimbikitsanso kukonzanso makapu a rotator.Kufufuza kwina kwamagulu ang'onoang'ono kumasonyeza kuti kukonza mizere iwiri kungakhale ndi ubwino wothandizira misozi yaying'ono kapena yochepetsetsa.PRP ingathandizenso kuchepetsa ululu wa postoperative.

Achilles Tendon Kukonza

Maphunziro a preclinical awonetsa kuti PRP ili ndi zotsatira zolimbikitsa pakulimbikitsa machiritso a kupasuka kwa tendon Achilles.Komabe, umboni wotsutsana umalepheretsa kutembenuka kwa PRP monga chithandizo chothandizira cha adjuvant kwa pachimake Achilles tendon rupture mwa anthu.Mwachitsanzo, mu kafukufuku wina, zotsatira zapangidwe ndi zogwira ntchito za odwala omwe ali ndi vuto la tendon Achilles omwe amachiritsidwa ndi opanda PRP anali ofanana.Mosiyana, Zou et al.Pakafukufuku wotsatiridwa mwachisawawa, odwala 36 adalembedwanso omwe adakumana ndi vuto la kuphulika kwa tendon la Achilles ndi popanda jekeseni wa LR-PRP.Odwala mu gulu la PRP anali ndi minofu yabwino ya isokinetic pa miyezi ya 3, ndipo anali ndi SF-36 ndi Leppilahti zambiri pa 6 ndi miyezi 12, motero (onse P <0.05).Kuonjezera apo, maulendo ophatikizana a ankle mu gulu la PRP adakulanso kwambiri nthawi zonse pa 6, 12, ndi miyezi 24 (P <0.001).Ngakhale kuti mayesero apamwamba a zachipatala amafunikira, jekeseni wa PRP monga chithandizo cha opaleshoni ya kukonzanso kwa tendon Achilles pachimake sikuwoneka ngati kopindulitsa.

Opaleshoni ya Anterior Cruciate Ligament

Kuchita bwino kwa opaleshoni ya anterior cruciate ligament (ACL) sikungodalira luso lokhalokha (monga kuyika kwa tunnel ndi kukonza matabwa), komanso kuchiritsa kwachilengedwe kwa ACL grafts.Kafukufuku wokhudzana ndi kugwiritsidwa ntchito kwa PRP mu opaleshoni yomanganso ACL akuyang'ana njira zitatu zamoyo: (1) kugwirizanitsa mafupa a mafupa pakati pa matope ndi tibial ndi timitsempha yachikazi, (2) kusasitsa kwa gawo lophatikizana la graft, ndi (2) kusasitsa kwa gawo lophatikizana la graft, ndi (2) 3) machiritso ndi kuchepetsa ululu pamalo okolola.

Ngakhale kuti maphunziro angapo ayang'ana pa kugwiritsa ntchito jekeseni wa PRP mu opaleshoni ya ACL m'zaka zisanu zapitazi, pakhala maphunziro awiri apamwamba okha.Kafukufuku wam'mbuyo adawonetsa kuti umboni wosakanikirana umathandizira kuphatikizika kwa maselo a Osteoligamous okhwima okhwima kapena okhwima omwe amagwiritsa ntchito jekeseni wa PRP, koma umboni wina wasonyezedwa kuti umathandizira ululu pamalo opereka chithandizo.Ponena za kugwiritsidwa ntchito kwa PRP kupititsa patsogolo kugwirizanitsa mafupa a fupa, deta yaposachedwa ikuwonetsa kuti PRP ilibe phindu lachipatala mu kukulitsa kwa ngalandeyo kapena kuphatikiza mafupa a ma grafts.

Mayesero aposachedwa azachipatala awonetsa zotulukapo zolimbikitsa zowawa zapamalo opereka ndi machiritso pogwiritsa ntchito PRP.Sajas et al.Kuwona kupweteka kwapambuyo kwa mawondo pambuyo pa autologous ACL kumanganso fupa la patella bone (BTB), zinapezeka kuti poyerekeza ndi gulu lolamulira, kupweteka kwapambuyo kwa mawondo kunachepetsedwa panthawi yotsatila mwezi wa 2.

Kafukufuku wochulukirapo akufunika kuti afufuze zotsatira za PRP pa kuphatikiza kwa ACL graft, kusasitsa, ndi ululu wa malo opereka chithandizo.Komabe, panthawiyi, kafukufuku wasonyeza kuti PRP ilibe chithandizo chachikulu chachipatala pa kuphatikizika kwa graft kapena kusasitsa, koma maphunziro ochepa awonetsa zotsatira zabwino zochepetsera ululu m'dera la opereka tendon patellar.

Osteoarthritis

Anthu amakhudzidwa kwambiri ndi mphamvu ya PRP intra-articular jekeseni mu chithandizo chosapanga opaleshoni cha bondo Articular bone osteoarthritis.Shen et al.Meta-analysis of 14 randomized clinical trials (RCTs) kuphatikizapo odwala 1423 anachitidwa kuti afanizire PRP ndi maulamuliro osiyanasiyana (kuphatikizapo placebo, hyaluronic acid, jekeseni wa Corticosteroid, mankhwala a m'kamwa ndi mankhwala a Homeopathy).Kusanthula kwa Meta kunawonetsa kuti panthawi yotsatiridwa kwa miyezi 3, 6 ndi 12, chiwerengero cha Osteoarthritis index (WOMAC) cha Western Ontario University ndi McMaster University chinakula kwambiri (= 0.02, 0.04, <0.001, motsatira).Kusanthula kwamagulu a PRP kutengera kuopsa kwa mawondo osteoarthritis kunasonyeza kuti PRP imakhala yothandiza kwambiri kwa odwala omwe ali ndi OA yofatsa mpaka yochepetsetsa.Wolembayo amakhulupirira kuti ponena za mpumulo wa ululu ndi zotsatira za odwala, jekeseni wa intra articular PRP ndi wothandiza kwambiri kuposa majekeseni ena ochiritsira osteoarthritis.

Riboh et al.adapanga meta-analysis kuti afanizire ntchito ya LP-PRP ndi LR-PRP pochiza mawondo osteoarthritis, ndipo adapeza kuti poyerekeza ndi HA kapena placebo, jekeseni ya LP-PRP ikhoza kusintha kwambiri chiwerengero cha WOMAC.Ferrado et al.anaphunzira jekeseni wa LR-PRP, kapena anapeza kuti panalibe kusiyana kwa chiwerengero poyerekeza ndi jekeseni wa HA, kutsimikiziranso kuti LP-PRP ikhoza kukhala chisankho choyamba chochiza zizindikiro za Osteoarthritis.Maziko ake achilengedwe atha kukhala m'magulu achibale a kutupa ndi oyimira pakati omwe ali mu LR-PRP ndi LP-PRP.Pamaso pa LR-PRP, mkhalapakati wotupa TNF- α, IL-6, IFN- ϒ Ndi IL-1 β Kuwonjezeka kwakukulu, pamene jekeseni wa LP-PRP amawonjezera IL-4 ndi IL-10, omwe ali odana ndi kutupa. oyimira pakati.Zimapezeka kuti IL-10 imathandiza kwambiri pochiza matenda a hip osteoarthritis, ndipo ingalepheretsenso mkhalapakati wotupa TNF- α, IL-6 ndi IL-1 β Kutulutsa ndikuletsa njira yotupa mwa neutralizing nuclear factor kB ntchito.Kuphatikiza pa zotsatira zake zoipa pa chondrocytes, LR-PRP ikhozanso kulephera kuthandizira zizindikiro za Osteoarthritis chifukwa cha zotsatira zake pa maselo a synovial.Braun ndi al.Zinapezeka kuti kuchiza maselo a synovial ndi LR-PRP kapena maselo ofiira a magazi kungayambitse kupanga mkhalapakati wotsutsa-kutupa komanso kufa kwa maselo.

Intra articular jakisoni wa LP-PRP ndi njira yotetezeka yochizira, ndipo pali umboni wa Level 1 kuti ukhoza kuchepetsa zizindikiro zowawa ndikuwonjezera ntchito ya odwala omwe ali ndi bondo Articular bone osteoarthritis.Maphunziro okulirapo komanso otsatiridwa nthawi yayitali amafunikira kuti adziwe momwe angagwiritsire ntchito nthawi yayitali.

Osteoarthritis ya Hip

Mayesero anayi okha achipatala opangidwa mwachisawawa poyerekeza ndi jekeseni wa PRP ndi jekeseni wa hyaluronic acid (HA) pofuna kuchiza nyamakazi ya m'chiuno.Zotsatira zake ndi kuchuluka kwa ululu wa VAS, kuchuluka kwa WOMAC, ndi Harris hip joint score (HHS).

Batalya et al.adapeza kusintha kwakukulu m'masukulu a VAS ndi HHS pa 1, 3, 6, ndi miyezi 12.Kusintha kwakukulu kunachitika pa miyezi ya 3, ndipo zotsatira zake zidachepa pang'onopang'ono pambuyo pake [72].Zotsatira za miyezi ya 12 zidakali bwino kwambiri poyerekeza ndi chiwerengero choyambirira (P <0.0005);Komabe, panalibe kusiyana kwakukulu pakati pa magulu a PRP ndi HA.

Di Sante et al.adawona kuti chiwerengero cha VAS cha gulu la PRP chinakula kwambiri pa masabata a 4, koma chinabwereranso kumayambiriro kwa masabata a 16.Panalibe kusiyana kwakukulu pamagulu a VAS pakati pa gulu la HA pa masabata a 4, koma panali kusintha kwakukulu pa masabata a 16.Dalari et al.Tidawunika momwe PRP imakhudzira jakisoni wa HA, komanso kuyerekeza kuphatikiza kwa jekeseni wa HA ndi PRP pazochitika zonse ziwiri.Gulu la PRP linapezeka kuti lili ndi chiwerengero chochepa kwambiri cha VAS pakati pa magulu onse atatu pa nthawi zonse zotsatila (miyezi 2, miyezi 6, ndi miyezi 12).PRP inalinso ndi zotsatira zabwinoko za WOMAC pa miyezi 2 ndi 6, koma osati pa miyezi 12.Doria et al.Kuyesedwa kwachipatala kosawerengeka kosawerengeka kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiriwekegwidwe kachitidwe kawonekedwe kabwino kachitidwe kachitidwe kachitidwe kufanane ndi odwala omwe analandira majekeseni atatu otsatizana mlungu uliwonse a PRP ndi majekeseni atatu otsatizana a HA.Kafukufukuyu adapeza kusintha kwa HHS, WOMAC, ndi VAS zambiri m'magulu a HA ndi PRP panthawi ya 6 ndi 12 mwezi wotsatira.Komabe, nthawi zonse, panalibe kusiyana kwakukulu pakati pa magulu awiriwa.Palibe kafukufuku wasonyeza kuti jekeseni wa intra-articular wa PRP m'chiuno uli ndi zotsatira zoipa, ndipo onse atsimikiza kuti PRP ndi yotetezeka.

Ngakhale kuti detayi ndi yochepa, jekeseni wa intra-articular wa PRP pochiza hip Articular bone osteoarthritis yatsimikiziridwa kuti ndi yotetezeka, ndipo imakhala ndi mphamvu zina zochepetsera ululu ndi kupititsa patsogolo ntchito, monga momwe zimayesedwera ndi zotsatira zomwe zanenedwa ndi odwala.Kafukufuku wambiri wasonyeza kuti PRP ikhoza kuchepetsa ululu poyambirira poyerekeza ndi HA;Komabe, monga PRP ndi HA ali ndi mphamvu zofanana kwambiri pa miyezi 12, ubwino uliwonse woyambirira umawoneka wofooka pakapita nthawi.Popeza kuti maphunziro angapo a zachipatala ayesa kugwiritsa ntchito PRP mu hip OA, umboni wochuluka kwambiri umafunika kuti mudziwe ngati PRP ingagwiritsidwe ntchito ngati njira ina yoyendetsera Conservative kuti achedwetse ntchito ya hip Articular bone osteoarthritis.

Ankle Sprain

Mayesero awiri okha achipatala omwe adakwaniritsa njira zathu zophatikizira amayesa kugwiritsa ntchito PRP mu ankle sprain.Roden et al.Mayesero achipatala opangidwa ndi akhungu awiri akhungu omwe amayendetsedwa mwachisawawa adachitidwa kwa odwala omwe ali ndi vuto la ankle sprain mu ED, kuyerekeza jekeseni wotsogoleredwa ndi ultrasound wa anesthetic ya m'deralo LR-PRP ndi saline ndi jekeseni wa anesthesia wamba.Iwo sanapeze kusiyana kwakukulu kwa chiwerengero cha ululu wa VAS kapena kutsika kwa limb function scale (LEFS) pakati pa magulu awiriwa.

Laval et al.mwachisawawa ochita masewera othamanga a 16 omwe adapezeka kuti ali ndi mitsempha yambiri ya m'chiuno kuti alandire chithandizo cha ultrasound chotsogoleredwa ndi LP-PRP pa nthawi yoyamba ya chithandizo, ndi jekeseni mobwerezabwereza ya ndondomeko yokonzanso pamodzi kapena ndondomeko yosiyana yokonzanso masiku 7 pambuyo pake.Odwala onse adalandira njira yofananira yothandizira kukonzanso komanso njira zochepetsera.Kafukufukuyu anapeza kuti gulu la LP-PRP linayambiranso mpikisano mu nthawi yochepa (masiku 40.8 vs. 59.6 masiku, P <0.006).

PRP ikuwoneka kuti siigwira ntchito pachimake ankle sprain.Ngakhale umboni wochepa umasonyeza kuti jekeseni ya LP-PRP ingakhudze bondo lapamwamba la othamanga apamwamba.

Kuvulala Kwa Minofu

Kugwiritsiridwa ntchito kwa PRP pochiza kuvulala kwa minofu kwawonetsa umboni wosamveka bwino wachipatala.Mofanana ndi machiritso a tendon, masitepe a machiritso a minofu amaphatikizapo kuyankha kotupa koyambirira, kutsatiridwa ndi kuchuluka kwa maselo, kusiyanitsa, ndi kukonzanso minofu.Hamid ndi al.Phunziro limodzi lopanda khungu lopangidwa mwachisawawa linachitidwa pa odwala 28 omwe ali ndi vuto la grade 2 hamstring, poyerekeza jekeseni wa LR-PRP ndi mapulani okonzanso ndi kukonzanso kokha.Gulu lomwe limalandira chithandizo cha LR-PRP linatha kuchira ku mpikisano mofulumira (nthawi yochuluka m'masiku, 26.7 vs. 42.5, P = 0.02), koma silinapeze kusintha kwapangidwe.Kuonjezera apo, zotsatira zazikulu za placebo mu gulu lachipatala zingasokoneze zotsatirazi.M'mayesero oyendetsedwa ndi akhungu awiri, Reurink et al.Tinayesa odwala 80 ndikuyerekeza jekeseni wa PRP ndi jekeseni wa saline wa placebo.Odwala onse adalandira chithandizo chamankhwala chokhazikika.Wodwalayo adatsatiridwa kwa miyezi ya 6 ndipo panalibe kusiyana kwakukulu pa nthawi ya kuchira kapena kuvulazidwanso.Njira yabwino ya PRP yopititsa patsogolo machiritso a minofu m'njira zoyenera zachipatala akadali ovuta ndipo kafukufuku wamtsogolo ayenera kuchitidwa.

Management of Fractures ndi Non Union

Ngakhale kuti pali umboni wokwanira wotsimikizira kuti PRP imathandizira kuchiritsa mafupa, palibe mgwirizano wachipatala wothandizira kugwiritsa ntchito nthawi zonse PRP kulimbikitsa machiritso a mafupa.Ndemanga yaposachedwa pa PRP ndi chithandizo chopweteka kwambiri cha fracture chinawonetsa ma RCT atatu omwe sanawonetsere phindu potsatira zotsatira za ntchito, pamene maphunziro awiri adawonetsa zotsatira zachipatala zapamwamba.Mayesero ambiri mu ndemanga iyi (6/8) adaphunzira mphamvu ya PRP pamodzi ndi mankhwala ena achilengedwe (monga maselo a mesenchymal stem ndi / kapena mafupa a mafupa) kuti apititse patsogolo machiritso a fracture.

Mfundo yogwira ntchito ya plasma-rich rich plasma (PRP) ndiyo kupereka zinthu za kukula ndi ma cytokines omwe ali m'mapulateleti omwe ali ndi kuchuluka kwa thupi.Mu mankhwala a musculoskeletal, PRP ndi njira yodalirika yothandizira yomwe ili ndi umboni woonekeratu wotetezeka.Komabe, umboni wa mphamvu zake ndi wosakanizika ndipo zimadalira kwambiri zosakaniza ndi zizindikiro zenizeni.Mayesero apamwamba kwambiri komanso akuluakulu azachipatala m'tsogolomu ndi ofunikira kuti apange malingaliro athu pa PRP.

(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: Jul-24-2023