Mbiri ya Platelet Rich Plasma (PRP)

Za Platelet Rich Plasma (PRP)

Platelet-rich plasma (PRP) ili ndi chithandizo chofananira ndi maselo oyambira ndipo pakali pano ndi imodzi mwazinthu zochiritsira zodalirika kwambiri mu mankhwala obwezeretsa.Amagwiritsidwa ntchito kwambiri m'magawo osiyanasiyana azachipatala, kuphatikizapo cosmetic dermatology, orthopedics, sports medicine ndi opaleshoni.

Mu 1842, m’magazi munapezeka zinthu zina kupatulapo maselo ofiira ndi oyera a magazi, zomwe zinadabwitsa anthu a m’nthawi yake.Julius Bizozero anali woyamba kutcha mapulateleti atsopano "le piastrine del sangue" - mapulateleti.Mu 1882, adalongosola ntchito ya mapulateleti mu coagulation mu m'galasi ndi kukhudzidwa kwawo mu etiology ya thrombosis mu vivo.Anapezanso kuti makoma a mitsempha yamagazi amalepheretsa kuphatikizika kwa mapulateleti.Wright anapita patsogolo kwambiri pakupanga njira zochiritsira zopatsa thanzi potulukira ma macrokaryocyte, omwe ndi kalambulabwalo wa mapulateleti.Kumayambiriro kwa zaka za m'ma 1940, asing'anga adagwiritsa ntchito "zotulutsa" za embryonic zopangidwa ndi kukula ndi ma cytokines kulimbikitsa machiritso a bala.Kuchiritsa mabala mwachangu komanso moyenera ndikofunikira kuti ma opaleshoni apambane.Chifukwa chake, Eugen Cronkite et al.adayambitsa kuphatikiza kwa thrombin ndi fibrin m'mitsempha yapakhungu.Pogwiritsa ntchito zigawo zomwe zili pamwambazi, kugwirizanitsa kolimba ndi kokhazikika kwa chotchinga kumatsimikiziridwa, chomwe chimagwira ntchito yofunika kwambiri pa opaleshoni yamtunduwu.

Kumayambiriro kwa zaka za m’ma 1900, madokotala anazindikira kufunika kofulumira kuika magazi m’mapulateleti pofuna kuchiza thrombocytopenia.Izi zadzetsa kuwongolera kwa njira zokonzekeretsa mapulateleti.Kuphatikizika ndi zinthu za m'mapulateleti kungathandize kuti odwala asakhetse magazi.Panthaŵiyo, madokotala ndi akatswiri a hematologists a m’ma laboratory anayesa kukonzekeretsa mapulateleti kuti aikidwe magazi.Njira zopezera ma concentrate zakula mwachangu ndipo zapita patsogolo kwambiri, popeza mbale zodzipatula zimataya mphamvu zake ndipo ziyenera kusungidwa pa 4 ° C ndikugwiritsidwa ntchito mkati mwa 24 h.

Zida ndi njira

M'zaka za m'ma 1920, citrate idagwiritsidwa ntchito ngati anticoagulant kuti apeze mapulateleti.Kupita patsogolo pakukonzekera kwa mapulateleti kumachulukirachulukira muzaka za m'ma 1950 ndi 1960 pomwe zotengera zamagazi zapulasitiki zosinthika zidapangidwa.Mawu akuti "plasma-rich plasma" adagwiritsidwa ntchito koyamba ndi Kingsley et al.mu 1954 kunena za ma platelet concentrate omwe amagwiritsidwa ntchito poika magazi.Mapangidwe oyamba a PRP a banki yamagazi adawonekera m'ma 1960 ndipo adadziwika mu 1970s.Chakumapeto kwa zaka za m'ma 1950 ndi 1960, "EDTA platelet mapaketi" anagwiritsidwa ntchito.Setiyi ili ndi thumba la pulasitiki lokhala ndi magazi a EDTA omwe amalola kuti mapulateleti akhazikitsidwe ndi centrifugation, omwe amatsalira pang'ono a plasma pambuyo pa opaleshoni.

Zotsatira

Zimaganiziridwa kuti kukula kwa zinthu (GFs) ndizinthu zina za PRP zomwe zimatulutsidwa kuchokera ku mapulateleti ndipo zimagwira ntchito yake.Lingaliro ili linatsimikiziridwa mu 1980s.Zikuoneka kuti mapulateleti amamasula mamolekyu a bioactive (GFs) kuti akonze minofu yowonongeka, monga zilonda zapakhungu.Mpaka pano, maphunziro angapo omwe akuwunika nkhaniyi achitika.Chimodzi mwazinthu zomwe zaphunziridwa kwambiri pankhaniyi ndi kuphatikiza kwa PRP ndi hyaluronic acid.Epidermal growth factor (EGF) inapezedwa ndi Cohen mu 1962. Ma GF otsatirawa anali platelet-derived growth factor (PDGF) mu 1974 ndi vascular endothelial growth factor (VEGF) mu 1989.

Ponseponse, kupita patsogolo kwamankhwala kwadzetsanso kupita patsogolo kofulumira kwa mapulateleti.Mu 1972, Matras adagwiritsa ntchito mapulateleti koyamba ngati chosindikizira kuti akhazikitse magazi a homeostasis panthawi ya opaleshoni.Kuphatikiza apo, mu 1975, Oon ndi Hobbs anali asayansi oyamba kugwiritsa ntchito PRP pamankhwala okonzanso.Mu 1987, Ferrari et al adagwiritsa ntchito plasma yokhala ndi mapulateleti ambiri ngati gwero lokhazikika la kuikidwa magazi pa opaleshoni yamtima, potero amachepetsa kutayika kwa magazi, kusokonezeka kwa magazi kwa zotumphukira zama pulmonary, komanso kugwiritsa ntchito zinthu zamagazi.

Mu 1986, Knighton et al.anali asayansi oyamba kufotokoza njira yowonjezeretsa mapulateleti ndipo adayitcha autologous platelet-derived wound healing factor (PDWHF).Kuyambira kukhazikitsidwa kwa protocol, njirayi yakhala ikugwiritsidwa ntchito kwambiri muzamankhwala okongoletsa.PRP yakhala ikugwiritsidwa ntchito mumankhwala obwezeretsa kuyambira kumapeto kwa 1980s.

Kuphatikiza pa opaleshoni yambiri ndi opaleshoni ya mtima, opaleshoni ya maxillofacial inali malo ena omwe PRP inadziwika kumayambiriro kwa zaka za m'ma 1990.PRP idagwiritsidwa ntchito kupititsa patsogolo kulumikizana kwa graft pakumanganso kwa mandibular.PRP yayambanso kugwiritsidwa ntchito m'mano ndipo yakhala ikugwiritsidwa ntchito kuyambira kumapeto kwa zaka za m'ma 1990 kuti ipititse patsogolo mgwirizano wa implants wa mano ndi kulimbikitsa kusinthika kwa mafupa.Kuphatikiza apo, guluu wa fibrin anali zinthu zodziwika bwino zomwe zidayambika panthawiyo.Kugwiritsiridwa ntchito kwa PRP m'mano kunapangidwanso ndi kupangidwa kwa mapulateleti olemera kwambiri a fibrin (PRF), a platelet concentrate omwe safuna kuwonjezeredwa kwa anticoagulants, ndi Choukroun.

PRF idadziwika kwambiri koyambirira kwa zaka za m'ma 2000, ndikuchulukirachulukira kwakugwiritsa ntchito njira zamano, kuphatikiza kusinthika kwa minofu ya hyperplastic gingival ndi zilema za periodontal, kutsekedwa kwa bala, kuchiritsa kwa gingival, ndi manja ochotsa.

Kambiranani

Anitua mu 1999 adalongosola kugwiritsa ntchito PRP kulimbikitsa kusinthika kwa mafupa panthawi ya kusinthana kwa plasma.Ataona ubwino wa chithandizocho, asayansiwo anafufuzanso za nkhaniyi.Mapepala ake otsatirawa anafotokoza zotsatira za magazi amenewa pa zilonda zapakhungu zosatha, zoikamo mano, machiritso a tendon, ndi kuvulala kwa masewera a mafupa.Mankhwala angapo omwe amachititsa PRP, monga calcium chloride ndi bovine thrombin, akhala akugwiritsidwa ntchito kuyambira 2000.

Chifukwa cha zinthu zake zabwino kwambiri, PRP imagwiritsidwa ntchito mu orthopaedics.Zotsatira za kafukufuku woyamba wozama za zotsatira za kukula kwa minofu ya tendon yaumunthu zinasindikizidwa mu 2005. Thandizo la PRP panopa likugwiritsidwa ntchito pofuna kuchiza matenda osokonekera komanso kulimbikitsa machiritso a tendon, ligaments, minofu ndi cartilage.Kafukufuku akusonyeza kuti kupitiriza kutchuka kwa njirayi mu mafupa a mafupa kungakhalenso kokhudzana ndi kugwiritsidwa ntchito kawirikawiri kwa PRP ndi akatswiri a masewera.Mu 2009, kafukufuku woyesera nyama adasindikizidwa omwe adatsimikizira lingaliro lakuti PRP imayang'ana kwambiri kuchiritsa machiritso a minofu.Njira yoyendetsera ntchito ya PRP pakhungu pakali pano ndi nkhani ya kafukufuku wozama wa sayansi.

PRP yakhala ikugwiritsidwa ntchito bwino mu cosmetic dermatology kuyambira 2010 kapena kale.Pambuyo jekeseni PRP, khungu limawoneka laling'ono ndipo hydration, kusinthasintha ndi mtundu zimakhala bwino kwambiri.PRP imagwiritsidwanso ntchito popititsa patsogolo kukula kwa tsitsi.Pali mitundu iwiri ya PRP yomwe ikugwiritsidwa ntchito panopa pochiza kukula kwa tsitsi - plasma yosagwira ntchito ya platelet-rich (A-PRP) ndi plasma yochuluka ya platelet (AA-PRP).Komabe, Amitundu et al.adawonetsa kuti kuchuluka kwa tsitsi komanso kuwerengera tsitsi kumatha kupitilizidwa pobaya jakisoni wa A-PRP.Kuphatikiza apo, zatsimikiziridwa kuti kugwiritsa ntchito chithandizo cha PRP musanayambe kuyika tsitsi kumatha kukulitsa kukula kwa tsitsi ndi kachulukidwe ka tsitsi.Kuphatikiza apo, mu 2009, kafukufuku adawonetsa kuti kugwiritsa ntchito kusakaniza kwa PRP ndi mafuta kumatha kupititsa patsogolo kuvomereza kumezanitsa kwamafuta ndikukhala ndi moyo, zomwe zingapangitse zotsatira za opaleshoni ya pulasitiki.

Zomwe zapeza posachedwa kuchokera ku Cosmetic Dermatology zikuwonetsa kuti kuphatikiza kwa PRP ndi CO2 laser therapy kumatha kuchepetsa zipsera za acne kwambiri.Momwemonso, PRP ndi microneedling zinapangitsa kuti collagen ikhale yokonzedwa bwino pakhungu kuposa PRP yokha.Mbiri ya PRP siifupikitsa, ndipo zomwe zapeza zokhudzana ndi gawo ili la magazi ndizofunika kwambiri.Madokotala ndi asayansi akufufuza mwachangu njira zatsopano zochiritsira.Monga njira, PRP imagwiritsidwa ntchito m'magawo ambiri azachipatala, kuphatikizapo gynecology, urology, ndi ophthalmology.

Mbiri ya PRP ndi osachepera zaka 70.Choncho, njirayo imakhazikitsidwa bwino ndipo ingagwiritsidwe ntchito kwambiri pamankhwala.

(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.）