Platelet-rich plasma (PRP) panopa amagwiritsidwa ntchito kwambiri m'madera osiyanasiyana azachipatala.M'zaka zaposachedwapa, kugwiritsa ntchito PRP mu mafupa a mafupa kwakopa chidwi kwambiri, ndipo kugwiritsidwa ntchito kwake m'madera osiyanasiyana monga kusinthika kwa minofu, kuchiritsa mabala, kukonza zipsera, opaleshoni ya pulasitiki ndi kukongola kwakhala kokulirapo.M'nkhani yamasiku ano, tidzasanthula biology ya PRP, njira yake yochitira zinthu, ndi gulu la PRP kuti timvetse bwino zomwe zingatheke ndi zomwe siziyenera kuchitidwa ndi PRP.
Mbiri ya PRP
PRP imadziwikanso kuti plasma-rich plasma (PRP), platelet-rich growth factor (GFS) ndi matrix-rich fibrin (PRF) matrix.Lingaliro ndi kufotokozera kwa PRP kunayamba m'munda wa hematology.Akatswiri a magazi anayambitsa mawu akuti PRP m'zaka za m'ma 1970, makamaka pofuna kuchiza odwala omwe ali ndi thrombocytopenia mwa kuchotsa mapulateleti ndi kuwonjezera magazi.
Zaka khumi pambuyo pake, PRP inayamba kugwiritsidwa ntchito pa opaleshoni ya maxillofacial monga PRF.Fibrin ili ndi zomatira komanso homeostatic properties, ndipo PRP ili ndi anti-inflammatory properties zomwe zimalimbikitsa kukula kwa maselo.Pambuyo pake, PRP inayamba kugwiritsidwa ntchito kwambiri m'magulu a minofu ndi mafupa ovulala pamasewera ndikupeza zotsatira zabwino zochiritsira.Chifukwa chakuti zolinga zochiritsira zimakhala makamaka akatswiri othamanga, zakopa chidwi chambiri muzofalitsa ndipo zakhala zikugwiritsidwa ntchito kwambiri pazamankhwala amasewera.Pambuyo pake, PRP idalimbikitsidwa pang'onopang'ono m'mafupa, opaleshoni, opaleshoni ya ana, gynecology, urology, opaleshoni yapulasitiki ndi yodzikongoletsera ndi ophthalmology.
Platelet Biology
Maselo ozungulira magazi amaphatikizapo maselo ofiira a magazi, maselo oyera a magazi ndi mapulateleti, onse amachokera ku selo lodziwika bwino la pluripotent stem cell lomwe lingathe kusiyanitsa m'magulu osiyanasiyana a maselo.Maselo amenewa amakhala ndi ma cell omwe amatha kugawikana ndi kukhwima.Mapulateleti amachokera ku mafupa a mafupa ndipo ndi maselo opangidwa ndi ma nucleated disc a kukula kosiyana, ndi mainchesi pafupifupi 2 μm, ndipo ndi maselo a magazi ochepa kwambiri.Ma platelet amawerengera m'magazi oyenda bwino kuyambira 150,000 mpaka 400,000 pa microlita imodzi.Mapulateleti ali ndi ma granules angapo ofunikira achinsinsi, omwe pali atatu akuluakulu: ma granules, o-granules, ndi ma lysosomes.Mapulateleti aliwonse amakhala ndi tinthu tating'ono 50-80.
Tanthauzo la PRP
Pomaliza, PRP ndi mankhwala achilengedwe, omwe ndi plasma yokhazikika yomwe imakhala yochuluka kwambiri ya platelet kusiyana ndi magazi ozungulira.PRP sikuti imakhala ndi mapulateleti ochuluka, komanso imakhala ndi zinthu zonse zowonongeka, kuphatikizapo mndandanda wa zinthu zomwe zimakula, chemokines, cytokines ndi mapuloteni a plasma.
PRP imachokera ku magazi ozungulira omwe amatengedwa ndi njira zosiyanasiyana zokonzekera ma laboratory.Pambuyo pokonzekera, molingana ndi ma gradients osiyanasiyana, maselo ofiira a magazi, PRP, ndi PPP m'magulu a magazi amasiyanitsidwa motsatizana.Mu PRP, kuwonjezera pa kuchuluka kwa mapulateleti, m'pofunikanso kuganizira ngati ili ndi leukocyte komanso ngati imatsegulidwa.Kutengera mbali izi, mitundu yosiyanasiyana ya PRP yoyenera kusiyanasiyana kwamatenda amatsimikiziridwa.
Zida zingapo zamalonda zilipo zomwe zingapangitse kukonzekera kwa PRP kukhala kosavuta.Zida za PRP izi nthawi zambiri zimatulutsa kuchuluka kwa mapulateleti a PRP 2-5.Ngakhale wina angaganize kuti kuchulukitsidwa kwa mapulateleti komanso kuchuluka kwa kukula kwa zinthu, ndiye kuti chithandizo chamankhwala chiyenera kukhala chabwinoko, izi sizinakhazikitsidwe, ndipo nthawi 3-5 kuchuluka kwake kumawonedwa koyenera.
Zida zamalonda zili ndi mwayi wokhala wokhazikika komanso wosavuta, koma zili ndi malire pazida zawo.Ena sangathe kuchotsa zonyansa zinazake bwino, ndipo zokonzekera zina za PRP sizokwera kwambiri.Kwenikweni, zida zonse zamalonda sizingakonzedwe payekha komanso molondola.Ili ndilo vuto lalikulu ndi zipangizo zokhazikika.Pakalipano, luso lamakono lokonzekera la labotale lokhalokha lomwe lingathe kukwaniritsa zosowa zonse za odwala, zomwe zimakhala ndi zofunikira kwambiri paukadaulo wa labotale.
Kugawika kwa PRP
Mu 2006, Everts et al adapereka lingaliro la PRP yolemera kwambiri ya leukocyte.Choncho, PRP ikhoza kugawidwa m'magulu awiri malinga ndi chiwerengero cha leukocyte chomwe chilipo: PRP yokhala ndi leukocytes osauka ndi PRP yokhala ndi leukocytes olemera.
1) Madzi a m'magazi a Platelet omwe ali ndi kuchuluka kwa leukocyte, omwe amatchedwa L-PRP (Leukocyte Platelet-Rich Plasma, yomwe ili ndi maselo ofiira ochepa a magazi), amagwiritsidwa ntchito makamaka pa mabala otsutsa, phazi la matenda a shuga, gout ndi osachiritsika. zilonda, kukonza fupa, nonunion, kutupa m`mafupa ndi zina mankhwala mankhwala.
2) Plasma yolemera kwambiri ya Platelet popanda kapena yotsika kwambiri ya leukocyte imatchedwa P-PRP (Pure Platelet-Rich Plasma, yopanda maselo ofiira a magazi), makamaka yomwe imagwiritsidwa ntchito kuvulala kwa masewera ndi matenda osokonezeka, kuphatikizapo kuvulala kwa meniscus, kuvulala kwa ligament ndi tendon. , chigongono cha tenisi, nyamakazi ya bondo, kuwonongeka kwa cartilage, lumbar disc herniation ndi matenda ena.
3) Pambuyo pa PRP yamadzimadzi imayendetsedwa ndi thrombin kapena calcium, gel-ngati PRP kapena PRF ikhoza kupangidwa.(Choyamba chokonzedwa ndi Dohan et al. ku France)
Mu 2009, Dohan Ehrenfest et al.adakonza magulu a 4 kutengera kupezeka kapena kusapezeka kwa ma cell (monga leukocyte) ndi kapangidwe ka fibrin:
1) PRP yoyera kapena leukocyte-osauka PRP: PRP yokonzekera ilibe leukocyte, ndipo zomwe zili mu fibrin pambuyo poyambitsa ndizochepa.
2) Maselo oyera a magazi ndi PRP: ali ndi maselo oyera a magazi, ndipo zomwe zili mu fibrin pambuyo poyambitsa ndizochepa.
3) PRF yoyera kapena PRF ya leukocyte-osauka: kukonzekera kulibe leukocyte ndipo kumakhala ndi fibrin yapamwamba kwambiri.Zogulitsazi zimabwera ngati ma gels otsegulidwa ndipo sangathe kugwiritsidwa ntchito jekeseni.
4) Leukocyte-rich fibrin ndi PRF: yokhala ndi leukocytes ndi high-density fibrin.
Mu 2016, Magalon et al.adakonza za gulu la DEPA (mlingo, kuchita bwino, chiyero, kuyambitsa), kuyang'ana kuwerengera kwa mapulateleti a PRP, kuyera kwazinthu, ndi kuyambitsa mapulateleti.
1. Mlingo wa jakisoni wa mapulateleti: Werezerani mwa kuchulukitsa kuchuluka kwa mapulateleti ndi kuchuluka kwa mapulateleti.Malinga ndi mlingo wobayidwa (mu mabiliyoni kapena mamiliyoni a mapulateleti), ukhoza kugawidwa mu (a) mlingo waukulu kwambiri:> 5 biliyoni;(b) mlingo waukulu: kuchokera pa 3 biliyoni kufika pa 5 biliyoni;(c) mlingo wapakatikati: kuchokera pa 1 biliyoni kufika pa 3 biliyoni;(d) mlingo wochepa: zosakwana 1 biliyoni.
2. Kukonzekera bwino: chiŵerengero cha mapulateleti otengedwa m’mwazi.(a) Kugwiritsa ntchito bwino kwa chipangizocho: kuchira kwa mapulateleti> 90%;(b) mphamvu yapakatikati ya chipangizo: kuchira kwa mapulateleti pakati pa 70-90%;(c) otsika chipangizo mphamvu: mlingo kuchira pakati 30-70%;(d) Kugwiritsa ntchito bwino kwa zida ndizotsika kwambiri: chiwongola dzanja ndi chochepera 30%.
3. Chiyero cha PRP: Chimagwirizana ndi chiwerengero cha mapulateleti, maselo oyera a magazi ndi maselo ofiira a magazi mu PRP.Timalongosola kuti (a) PRP yoyera kwambiri:> 90% mapulateleti okhudzana ndi erythrocytes ndi leukocytes mu PRP;(b) PRP yoyera: 70-90% mapulateleti;(c) PRP yosawerengeka:% mapulateleti Pakati pa 30-70%;(d) PRP yamagazi athunthu: kuchuluka kwa mapulateleti mu PRP ndi ochepera 30%.
4. Kutsegula ndondomeko: kaya yambitsa mapulateleti ndi exogenous coagulation zinthu, monga autologous thrombin kapena calcium kolorayidi.
(Zomwe zili m'nkhaniyi zatulutsidwanso.)
Nthawi yotumiza: May-16-2022