IngabeI-PRPumsebenzi ngempela?
01. Imiphumela yemijovo ye-PRP ebusweni
Iminyaka yesikhumba somuntu ngenxa yokuwohloka kwezingqimba ze-collagen ne-elastin ngaphansi kwesikhumba.Lo monakalo ubonakala ngendlela yemigqa emihle, imibimbi kanye nama-creases ebunzini, emakhoneni wamehlo, phakathi kwamashiya kanye nasemlonyeni.Ungase futhi ubone ama-creases emahlombe.Lo mphumela uvela lapho ubuqotho besakhiwo se-collagen fibers buguguleka ngenxa yezici zangaphakathi nangaphandle.Ukugxila okuphezulu kwezici zokukhula ku-PRP yokulungisa ubuso be-collagen futhi kusebenze ama-fibroblasts, kuvuselele isikhumba futhi kubuyisele ukubukeka kwayo kobusha.
02. Ngaphambi nangemuva kwe-PRP Ukwelashwa Kwezinwele
Ukuhlola ukusebenza kahle kwe-PRP ekulahlekeni kwezinwele, odokotela benza ukuhlolwa kokuhluthula izinwele eqenjini elingahleliwe leziguli.Babamba izinwele ezingaba ngu-50 kuya kwezingama-60 bazisuse ekhanda.Ngaphambi kokwelashwa, iziguli eziningi zalahlekelwa izinwele ezingaba ngu-10.Phinda ukuhlolwa kokudonsa izinwele ngemva kweseshini emine ye-PRP amaviki angu-6 ngokuhlukana.Iziguli zibike ukuncipha okuphawulekayo kokuqothuka kwezinwele ngemicu emi-3 kuphela ehlukene nesikhumba.Ngaphezu kwalokho, udokotela umaka ingxenye ethile yesikhumba ukuze ihlolwe.I-PRP ngaphambi nangemva kokuhlolwa ibonise mayelana nezinwele zezinwele ze-71 kanye nezinwele ezingaphezu kwe-93 endaweni, ngokulandelana.
03. Imiphumela ye-PRP Knee Injection
Odokotela bahlola iqembu leziguli ezine-osteoarthritis eliqinisekiswe yi-MRI.Isiguli ngasinye sathola umjovo owodwa noma emibili ye-PRP yamadolo ngaphansi kwe-patella.Odokotela bahlola isimo sabo ngamaviki angu-6, izinyanga ezingu-3, nezikhawu zezinyanga ezingu-6.Bathole ukuthi iziguli zabhekana nobuhlungu obuncane kakhulu kanye nokuhamba okungcono phakathi neviki le-6 kuya kwezinyanga ze-3.Ukusebenza kwedolo nakho kuthuthuke kakhulu.Ezinyangeni eziyisithupha kamuva, imiphumela yayingcono kakhulu kunangaphambi kokuhlinzwa, nakuba amazinga obuhlungu nemisebenzi ayengakathuthuki.
04. Ukubuyekezwa kwe-PRP kweIzindunakanye naMaka
icala lethu
I-PRP yokwelashwa kwezinduna zesikhumba
Phuma!Umnumzane wezinduna
Ngokuya ngobulukhuni beqhubu kanye nomonakalo eliwubangele esikhunjeni, izibazi zezinduna zingavela ngezinhlobonhlobo, njengemoto yebhokisi, i-ice pick, nemoto eginqikayo.Ukufaka i-PRP kuze kufike ku-1 mm ngaphansi kwesibazi kungasiza ekuqedeni unomphela izibazi zezinduna.Uma kudingeka, udokotela angase asebenzise izinaliti ezinhle ukuze aphule izicubu zesibazi esiqinile kanye nama-keloid esibazini ukuze bakwazi ukusabela kangcono ekwelashweni.
I-Microneedling ingenye indlela esetshenziselwa ukuletha i-serum esikhumbeni.Izici zokukhula ku-PRP serum zilungisa ungqimba lwe-collagen ngaphansi kwesikhumba.Isikhumba sizuza ukubonakala kwephimbo elilinganayo njengoba lolu ungqimba lukhiqiza amaseli amasha futhi lugxume phakathi kwamaviki angu-4 kuya kwangu-6.Ukwelashwa okulandelwa njalo kungasiza ekubuyiseleni isikhumba.
05. Ukubuyekezwa Kokwelashwa Kwe-PRP Kokulimala Kwe-Tendon
Abasubathi bavame ukuhlushwa ukulimala kwe-elbow tendon, ukulimala kwe-rotator cuff, nezinyembezi ze-Achilles tendon (njengabadlali bethenisi nabagijimi).Ukuvuvukala kwethenda ye-patellar endaweni yamadolo kungenye ukulimala okuvamile.Ngaphezu kwamazinga ahlukahlukene obuhlungu, abasubathi babhekana nokuvuvukala, ubunzima bokunyakaza, nomsindo ophumayo lapho uhambisa ilunga elithintekile.
Imijovo ye-PRP yokulimala kwezemidlalo ebekwe endaweni ethintekile ingasiza ukuphulukisa ukulimala okusha nokungapheli.Ngemva kwesonto lokwanda kokuvuvukala ngokushesha ngemva komjovo we-PRP, isiguli sabona ukuthuthukiswa kancane kancane emavikini angu-5 alandelayo.Ngokwelapha isibazi esiqinile, i-PRP serum ingasheshisa ukuphulukiswa.Ngenxa yalokho, ubuhlungu nokuvuvukala kuyancishiswa kanye nokuhamba okuthuthukisiwe.
06. Imijovo ye-PRP yokulimala kwe-ligament kanye nemisipha
Kuye ngokuthi yimiphi imisipha ethile abayisebenzisa kaningi phakathi nemidlalo yabo, abagijimi abaqeqeshiwe bangase babone ukulimala kwe-ligament, muscle, kanye nezicubu ezixhumeneyo.Amadolo nethanga kanye nama-sprains, kanye nama-hamstrings ahlukumezekile, ngokuvamile abangela ukuvuvukala kanye nobunzima bokunyakaza.Ukujova i-PRP emisipha ethintekile kungasiza ukusheshisa ukuphulukiswa.Ngale ndlela, abasubathi banganciphisa isikhathi sokutakula futhi babuyele enkundleni ngokushesha.Odokotela abenza i-PRP ngaphambi nangemva kokuskena babonise ukuphulukiswa kwesilonda okuphawulekayo.
07. Ukubuyekezwa Kwemijovo ye-PRP Yokungazali
Ucwaningo lwenziwe eqenjini labesifazane abaneminyaka engaphezu kuka-40. Imizamo yangaphambili yokubasiza ukuba bakhulelwe ngokufaka imibungu ye-IVF yehlule ngoba ulwelwesi lwesibeletho belungajiyile ngokwanele.Lesi simo sivimbela i-implant ukuthi ingahlangani esibelethweni futhi ingabangela ukuphuphuma kwesisu.Ngosizo lwenhlanganisela yemijovo ye-PRP kanye nezithako ze-hormone, odokotela bayakwazi ukugqugquzela ukuthuthukiswa kolwelwesi lwesibeletho.
Ukwelashwa kwe-PRP kusiza ukuthola ubukhulu obuyi-7mm ukuya ku-8mm ukuze abesifazane bakwazi ukuthwala ukukhulelwa kwabo kuze kube sekugcineni.Imijovo ye-PRP yokungazali ingasiza ekulungiseni ama-ovari nezibeletho kwabesifazane abasebasha, ibavumele ukuthi bakhule futhi bakhulule amaqanda anempilo.Odokotela bavuna amaqanda bawalungiselela ukufakelwa i-IVF, okwaholela ekuzalweni komntwana ophile kahle.
08. PRPimibuthano emnyamangaphambi nangemuva
Ukuguga, izici zemvelo, ukuntuleka kokulala nokugula konke kungaba nomthelela ekwakhekeni kwemibuthano emnyama namehlo akhukhumele.Iziguli zingase futhi zibone isikhumba esixegayo ngaphansi kwamehlo noma lokho okubonakala kuwuketshezi ezikhwameni zamehlo.Imijovo ye-PRP ingasiza ngazo zonke lezi zimo ngokudala imithambo yegazi emisha esikhumbeni esithambile.Le mithambo yegazi yondla indawo ngomoya omusha kanye nezakhamzimba futhi isuse uketshezi olunqwabelene, ubuthi nokungcola.
Le miphumela yangaphambi nangemuva ye-PRP ikhombisa ngokusobala ukuthi ukungapheleli kwesikhumba okufana ne-hyperpigmentation, imibimbi kanye nesikhumba esimangele kunyamalele, kwembula amehlo acwebezelayo.I-PRP iphinde ibuyisele izingqimba ze-collagen ne-elastin esikhumbeni, ibuyisela ukuqina kwayo.
Ngaphambi nangemva kwe-PRP
Lezi ngaphambi nangemva kwezithombe zemijovo ye-PRP zibonisa ngokucacile ukuthi lapho ukwelashwa kwe-PRP kwenziwa udokotela oqinisekisiwe ochwepheshe, kunamandla okusiza abantu abanezimo ezihlukahlukene zezokwelapha nezimonyo.Ngaphezu kwalezi zimo ezingenhla, i-PRP iyaziwa ukusiza ekwelapheni kwesilonda, ukwakheka kwamathambo kanye nokufakelwa kwamazinyo okuphumelelayo ekunakekelweni kwamazinyo ngisho nokuhlinzwa kwenhliziyo evulekile.Eminyakeni ezayo, ukwelashwa kwe-PRP kungase futhi kube neminye imihlahlandlela yomtholampilo ehlukahlukene yokusetshenziswa kwe-plasma ecebile ngeplatelet (PRP) kuma-orthopedics ukukhuthaza ukulungiswa kwamathambo.
Ukuphuka ukuhlehliswa kabusha kobuqotho noma ukuqhubeka kwethambo.Ukuphuka okungakapholi ngemva kwezinyanga ezingu-9 futhi kungabonisi zimpawu zokuphola phakathi nezinyanga ezi-3 kubizwa ngokuthi i-nonnunion.Kunezizathu eziningi zokubambezeleka kwenyunyana yokuphuka noma ukungavumelani, njengokukhubazeka kwamathambo, ukutheleleka, ukungondleki kahle, ukulungiswa okungazinzile, kanye nokuphazamiseka kokunikezwa kwegazi esiphunzini.
Kunezici eziningi zobungozi zokuqhekeka ngenkambo ende yesifo, inyunyana ebambezelekile noma ukungaziphathi kahle, futhi ukwelashwa kunzima.Inyunyana ebambezelekile noma ukungahlukani kokwephuka kuveza ubuhlungu, ukulahlekelwa ukusebenza, nokuhlanekezela kwengqondo, okuholela ekuncipheni kwezinga lempilo, ukungakwazi ukusebenza, nokuncipha kwemali engenayo ezigulini.Thola izici eziyingozi zokuphulukisa ukubambezeleka ngokushesha ngangokunokwenzeka, unikeze ukungenelela okufika ngesikhathi, futhi wehlise nezindleko zokwelashwa.Ucwaningo selukhombisile ukuthi ukubhema nesifo sikashukela yizici eziyingozi zokulibaziseka kwenyunyana, futhi ukusetshenziswa kwezidakamizwa ezilwa nokuvuvukala (ama-NSAID) nakho kungabangela ukubambezeleka kwenyunyana yokuphuka.Ngaphezu kwalokho, ukulimala kwezicubu ezithambile kanye nesifo se-vascular kuholela ezinkingeni zokuphuka, okwandisa ingozi yokubambezeleka kwenyunyana noma ukungahambisani.
Ukusetshenziswa kwe-platelet ecebile ye-plasma (PRP) kuthuthukisa umphumela wokwelapha wokuphulukisa ukuphuka.I-PRP itholakala egazini eliphelele le-autologous, elicutshungulwa ku-vitro ukuze lenze ukulungiswa okuqukethe i-platelet-concentrated, equkethe izici ezihlukahlukene zokukhula ezikhiqizwa ngesikhathi sokulungiswa kwemvelo kokulimala kwamathambo.Ucwaningo luye lwabonisa ukuthi i-PRP inomphumela wokukhuthaza i-osteogenesis, engakhuthaza ukuphulukiswa nokulungiswa kwama-fractures, ukukhubazeka kwamathambo, i-nonunion, i-osteonecrosis, i-osteoporosis, ukuchithwa komgogodla, ukutheleleka kwamathambo kanye nokuphazamiseka kwe-osteogenesis.Imihlahlandlela yokusebenza kwemitholampilo iyithuluzi elingcono kakhulu lokuthi odokotela neziguli benze izinqumo zomtholampilo, ngomgomo omkhulu wokuxilongwa nokwelashwa kwezifo okusezingeni eliphezulu, okunengqondo nokuphumelelayo.Ngokucwaninga okwandayo kanye nokusetshenziswa kwe-PRP emkhakheni wamathambo, ubufakazi obusha bezokwelapha obusekelwe emtholampilo buye bakhiqizwa eminyakeni yamuva.Ukuze kulawulwe kangcono ukusetshenziswa kwe-PRP ku-orthopedics, lesi siqondiso sakhiwe ngokusekelwe ebufakazini bamanje.
ukulungiswa kwamathambo
Ukuphulukiswa kokuphuka kanye nokulungiswa kwezicubu zethambo ikakhulukazi kuhlanganisa izigaba ezimbili:
Isigaba sokuqala yisigaba sokuqala se-anabolic, esibonakala ngokuqashwa nokuhlukaniswa kwama-stem cells ukuze akhe amathambo nemithambo yegazi ekhansela, kanye nokwakheka koqwanga.
Isigaba sesibili yisigaba se-catabolic, esibonakala ngokufakwa kabusha kwe-cartilage ngenkathi futhi sisebenza njengesifanekiso sokwakhiwa kwethambo elisha ukuze lithathe indawo yoqwanga.Ngemuva kwalokho, izicubu ze-callus ziyahlungwa futhi ithambo elisanda kwakhiwa lilungiswa kabusha libe yi-cortical bone in situ.
Inqubo yokuphulukisa iyonke iwumphumela webhayoloji wamangqamuzana ahlotshaniswayo kanye nokusayina ngaphakathi kwezicubu ezivuselelayo.Esikhathini sokuqala sokulimala kwe-fracture, izicubu zendawo zikhiqiza izinto eziphilayo, ezisebenza njengezithunywa zendawo kanye nesistimu ohlelweni lokuphulukisa amathambo, futhi zibe nomthelela wokukhuthaza ukuphulukiswa kokuphuka.Ukungajwayelekile kwalezi zinto zebhayoloji kungaholela ekwelapheni kwamathambo okungavamile.
Isici sokukhula se-PRP
Umphumela wokulungisa amathambo we-platelet concentrate ungase ubhekwe ngenxa yezici zokukhula kwe-osteogenic eziqukethe.Ngemuva kokuthi ama-platelet kuma-platelet agxilile asebenze nge-calcium kanye/noma i-prothrombin, i-platelet alpha granules ikhulula izici ezihlukahlukene zokukhula nge-exocytosis, njenge-vascular endothelial growth factor (VEGF), i-platelet-derived growth factor (PDGF), eguqula ukukhula kwe-β. (TGF-β), i-insulin-like growth factor (IGF), i-epidermal growth factor (EGF), njll., lezi zici zonke zinemiphumela ye-osteogenic.
ukukhula kwe-vascular endothelial factor
Ingakwazi ukusekela futhi iqondise ukwakheka kokuqala kwemithambo yegazi nezinye izakhiwo ngokulawula ukufuduka, ukwanda nokuhlukaniswa kwamangqamuzana e-vascular endothelial.Ngesikhathi esifanayo, kungashukumisa ukuhlukaniswa kwama-osteoblasts futhi kuyisici esiyinhloko sokukhula ohlelweni lokulungiswa kwamathambo.
i-platelet derived growth factor
Ama-platelet ahlanganiswe emikhawulweni yokuphuka akhiqizwa ngobuningi futhi abonakaliswa kakhulu ngokuqhubekayo kuyo yonke inqubo yokuphulukisa.Bangakwazi ukulawula ukufuduka nokwanda kwama-stem cells, futhi bakhuthaze ukwanda nokuhlukaniswa kwama-osteoblasts.
ukuguqula ukukhula factor-beta
Ingaheha i-chemotaxis kanye ne-mitosis ye-fibroblasts nama-osteoblasts, ilawule ukukhula kwamangqamuzana nokwanda kwama-osteoblasts, ifake i-bone matrix synthesis, ilungise kabusha i-matrix yangaphandle, futhi ikhuthaze ukuphulukiswa kwamathambo.Ukuncipha kwe-TGF-β kungase kuhlotshaniswe nenyunyana yamathambo ebambezelekile noma ukungenzi lutho.
i-hormone yokukhula
(i-hormone yokukhula, i-GH)/i-insulin-like growth factor-1 (IGF-1) ihlotshaniswa nokubambezeleka kwenyunyana yamathambo noma ukungezwani, futhi babamba iqhaza ekwandeni kwamaseli we-mesenchymal stem, amaseli e-periosteal, ama-chondrocytes, ama-osteoblasts, nama-osteoclasts kanye nokuhlukaniswa. , lawula ukwakheka kwe-matrix yamathambo, ivuselele ama-osteoblasts nama-chondrocyte ukuze ikhiphe isici sokukhula kwe-vascular endothelial, futhi ikhuthaze i-angiogenesis.
Imiphumela yokulwa nokuvuvukala kwe-PRP
Ama-leukocyte kuma-platelet agxilile enza i-nuclear factor kB (i-nuclear factor kappa B, i-NF-kB) isayine ukuze iqhubeke nokukhulisa impendulo yokuvuvukala ngaphansi kwesenzo se-fibroblasts nama-osteoblasts.I-TNF-α, njenge-cytokine eyinhloko yempendulo yokuvuvukala, ingakhuthaza ukukhululwa kwe-TGF-β.I-TGF-β inomsebenzi we-immunostimulatory esigabeni sokuqala sokuvuvukala noma ekugxilweni okuphansi, futhi ingaqoqa amangqamuzana okuvuvukala;ekugxilweni okuphezulu, kungavimbela ukukhula nokusebenza kwamangqamuzana avuthayo afana ne-T, B lymphocytes, nama-macrophages, futhi avimbele amaseli e-cytotoxic T.Vikela umzimba ekuhlaselweni kwamasosha omzimba futhi uvimbele impendulo yokuvuvukala.
Umphumela we-Anti-infective we-PRP
Umphumela we-anti-infective we-platelet concentrate usekelwe ikakhulukazi kuma-platelet namangqamuzana egazi amhlophe aqukethe.Ama-platelet kuma-platelet agxilile akhiqiza ama-peptide e-antibacterial, angabhubhisa ulwelwesi lwamangqamuzana e-bacterial, avimbele ukuhlanganiswa kwe-RNA ye-microbial, ukuhlanganiswa kwamaprotheni noma ukugoqa amaprotheni, avule ubuthi bebhaktheriya, enze kusebenze uhlelo lwe-bacterial autolysis, bese kuba nemiphumela elwa namagciwane.Ama-leukocyte angakwazi ukuxhumanisa ukungatheleleki kwamaselula, enze ama-neutrophils asebenze, futhi afake ama-microorganisms e-pathogenic ngokusebenzisa ama-cytokines ahlukahlukene namaprotheni e-biological.Ucwaningo luye lwabonisa ukuthi ama-platelet agxilile aqukethe inani elikhulu lamangqamuzana amhlophe egazi anganciphisa ngempumelelo i-staphylococcus aureus.Ukuhlolwa kwe-antibacterial in vitro kubonise ukuthi i-PPR yayinemiphumela yokulwa namagciwane ku-Staphylococcus aureus, i-Escherichia coli, i-Streptococcus agalactiae, ne-Shigella, kodwa ayizange ibe nomthelela ku-Pseudomonas aeruginosa, i-Klebsiella pneumoniae, ne-Serratia.Igazi lonke lalingenawo umphumela wokulwa namagciwane kumagciwane ashiwo ngenhla.
Ekuphetheni
1. Ukuhlanganisa ama-platelet agxilile kungasheshisa ukuphulukiswa kokuphuka futhi kunciphise ukuhlala esibhedlela.
2. Kungasheshisa ukuphulukiswa kokungakhethi futhi kufinyeze ukuhlala esibhedlela.
3. Ezigulini eziphukile, ezingezona inyunyana, namathambo, ukusetshenziswa kwe-platelet concentrate ngeke kwandise izehlakalo ezingezinhle, njengokutheleleka, ububomvu bendawo, nokuvuvukala.
4. Nge-atrophic nonunion engashintshi futhi ezinzile, umjovo wasendaweni we-platelet concentrate ungase unciphise amathuba okusebenza kabusha.
5. Ama-platelet agxilile angase akhuthaze ukulungiswa kokubhema, ukuphuka kwesifo sikashukela, okungezona inyunyana, nokukhubazeka kwamathambo.
6. Ekwelapheni ukuphuka, okungezona inyunyana, nokukhubazeka kwamathambo kuhlanganiswe nokutheleleka, ukugxila kweplatelet ecebile i-leukocyte kungase kube ngcono kune-leukocyte-poor platelet concentrate.
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Isikhathi sokuthumela: Mar-15-2023
