Hoʻohana nui ʻia ka platelet-rich plasma (PRP) i kēia manawa ma nā ʻano lapaʻau like ʻole.I nā makahiki i hala iho nei, ua ʻoi aku ka nui o ka nānā ʻana o ka PRP i nā orthopedics, a ʻo kāna noi ʻana i nā ʻano like ʻole e like me ka hoʻolaʻa hou ʻana o ka ʻiʻo, ka hoʻōla ʻana i ka ʻeha, ka hoʻoponopono ʻana i ka ʻili, ka ʻoki plastik a me ka nani.Ma ka pukana o kēia lā, e kālailai mākou i ka biology o PRP, kona ʻano hana, a me ka hoʻokaʻawale ʻana o PRP no ka hoʻomaopopo pono ʻana i ka mea hiki a pono ʻole ke hana me PRP.
Ka Moolelo o PRP
Ua ʻike ʻia ʻo PRP he platelet-rich plasma (PRP), platelet-rich growth factor (GFS) a me platelet-rich fibrin (PRF) matrix.Ua hoʻomaka ka manaʻo a me ka wehewehe ʻana o PRP ma ke kahua o ka hematology.Ua hoʻokumu nā Hematologists i ka huaʻōlelo PRP i ka makahiki 1970, ka mea nui e mālama i nā maʻi me ka thrombocytopenia ma o ka unuhi ʻana i nā platelets a me ka hoʻohui ʻana i nā transfusions.
He ʻumi mau makahiki ma hope mai, hoʻomaka ka PRP e hoʻohana i ka hana maxillofacial e like me PRF.Loaʻa iā Fibrin nā waiwai adhesive a me ka homeostatic, a he mau mea anti-inflammatory ka PRP e hoʻoulu ai i ka hoʻonui ʻana o nā cell.Ma hope iho, hoʻomaka ka PRP e hoʻohana nui ʻia i ka musculoskeletal kahua o nā ʻeha haʻuki a loaʻa i nā hopena therapeutic maikaʻi.No ka mea, ʻo nā mea hoʻomaʻamaʻa lapaʻau ka nui o nā mea haʻuki ʻoihana, ua huki nui ʻia i ka media a ua hoʻohana nui ʻia i ke kahua o ka lāʻau lapaʻau.Ma hope mai, ua hoʻokiʻekiʻe ʻia ʻo PRP i nā orthopedic, ʻokiʻoki, ʻoki pediatric, gynecology, urology, plastic and cosmetic surgery and ophthalmology.
ʻAiʻi Platelet
Loaʻa nā pūnaewele koko ʻulaʻula, nā keʻokeʻo keʻokeʻo a me nā platelets, nā mea a pau i loaʻa mai kahi puʻupuʻu pluripotent maʻamau e hiki ke hoʻokaʻawale i nā laina laina like ʻole.Loaʻa i kēia mau laina kelepona nā cell precursor e hiki ke māhele a oʻo.Loaʻa ʻia nā platelets mai loko mai o ka iwi iwi a ʻo ia nā pūnaewele ʻano diski nucleated o nā ʻano nui like ʻole, me ke anawaena awelika ma kahi o 2 μm, a ʻo ia ka liʻiliʻi liʻiliʻi o nā ʻāpana koko.ʻO ka helu platelet ma ke kahe koko maʻamau mai 150,000 a 400,000 no ka microliter.Aia i loko o nā platelets kekahi mau granules huna koʻikoʻi, aia ʻekolu mau mea nui: nā granules dense, o-granules, a me nā lysosomes.Loaʻa i kēlā me kēia platelet ma kahi o 50-80 mau ʻāpana.
Ka Wehewehe o PRP
I ka hopena, ʻo ka PRP kahi huahana olaola, ʻo ia ka plasma concentrated me kahi kiʻekiʻe platelet kiʻekiʻe ma mua o ke koko peripheral.ʻAʻole i loaʻa wale i ka PRP nā pae kiʻekiʻe o nā platelets, akā loaʻa pū kekahi i nā mea coagulation a pau, me kahi ʻano o nā kumu ulu, chemokines, cytokines a me nā protein plasma.
Lawe ʻia ʻo PRP mai ke koko peripheral i huki ʻia e nā ʻano hana hoʻomākaukau keʻena hana.Ma hope o ka hoʻomākaukau ʻana, e like me nā gradients density like ʻole, hoʻokaʻawale ʻia nā ʻāpana koko ʻulaʻula, PRP, a me PPP i loko o nā ʻāpana koko.I ka PRP, ma kahi o ka nui o nā platelets, pono nō hoʻi e noʻonoʻo inā loaʻa nā leukocytes a inā ua hoʻāla ʻia.Ma muli o kēia mau hiʻohiʻona, ua hoʻoholo ʻia nā ʻano PRP like ʻole no nā kūlana pathological like ʻole.
Loaʻa i kekahi mau mea pāʻoihana i kēia manawa e hiki ke maʻalahi i ka hoʻomākaukau ʻana o PRP.Hoʻopuka pinepine kēia mau mea PRP i 2-5 paʻi kiʻekiʻe PRP platelet concentrations.ʻOiai e manaʻo paha kekahi ʻoi aku ka kiʻekiʻe o ka platelet concentration a ʻoi aku ka kiʻekiʻe o ka nui o ka ulu ʻana, ʻoi aku ka maikaʻi o ka hopena therapeutic, ʻaʻole i hoʻokumu ʻia, a ʻo 3-5 mau manawa i manaʻo ʻia he kūpono.
Loaʻa i nā mea pāʻoihana ka maikaʻi o ka maʻamau a maʻalahi, akā loaʻa nā palena o kā lākou mau mea hana.ʻAʻole hiki i kekahi ke wehe maikaʻi i nā haumia kikoʻī, a ʻaʻole kiʻekiʻe ka hoʻomākaukau ʻana o PRP.ʻO ke kumu, ʻaʻole hiki ke hoʻomākaukau pono ʻia nā mea ʻoihana a pau.ʻO kēia ka pilikia nui me nā mea hana maʻamau.I kēia manawa, hiki i ka ʻenehana hoʻomākaukau keʻena hoʻomākaukau kū hoʻokahi wale nō ke uhi i nā pono a pau o ka maʻi, nona nā koi kiʻekiʻe ma ka ʻenehana ʻenehana.
ʻO ka hoʻokaʻawale ʻana o PRP
I ka makahiki 2006, ua hāpai ʻo Everts et al i ka manaʻo o ka PRP waiwai leukocyte.No laila, hiki ke hoʻokaʻawale ʻia ka PRP i ʻelua ʻano e like me ka nui o nā leukocytes i loko: PRP me nā leukocytes ʻilihune a me ka PRP me nā leukocytes waiwai.
1) Platelet-rich plasma i loaʻa ka kiʻekiʻe o nā leukocytes, i kapa ʻia ʻo L-PRP (Leukocyte Platelet-Rich Plasma, loaʻa kahi liʻiliʻi o nā ʻulaʻula ʻulaʻula), hoʻohana nui ʻia no nā ʻeha refractory, ka wāwae diabetic, gout me ka ho'ōla ʻole. nā ʻeha, ka hoʻoponopono ʻana i ka iwi, ka nonunion, ka ʻeha o ka iwi a me nā lāʻau lapaʻau ʻē aʻe.
2) ʻO ka plasma waiwai nui Platelet me ka ʻole a me nā haʻahaʻa haʻahaʻa o nā leukocytes i kapa ʻia ʻo P-PRP (Pure Platelet-Rich Plasma, ʻaʻohe ʻulaʻula ʻulaʻula), hoʻohana nui ʻia no nā ʻeha haʻuki a me nā maʻi degenerative, me nā ʻeha meniscus, ligament a me nā ʻeha tendon. , kuʻekuʻe tennis, Arthritis kuli, degeneration cartilage, lumbar disc herniation a me nā maʻi ʻē aʻe.
3) Ma hope o ka hana ʻana o ka PRP wai e ka thrombin a i ʻole calcium, hiki ke hana ʻia kahi gel-like PRP a i ʻole PRF.(Hoʻomākaukau mua ʻia e Dohan et al. ma Farani)
Ma 2009, Dohan Ehrenfest et al.manaʻo ʻia he 4 hoʻohālikelike e pili ana i ka hiki ʻana a i ʻole ka ʻole o nā ʻāpana cellular (e like me nā leukocytes) a me ka hoʻolālā fibrin:
1) PRP maʻemaʻe a i ʻole leukocyte-poor PRP: ʻAʻohe leukocytes o ka PRP i hoʻomākaukau ʻia, a haʻahaʻa ka ʻike o ka fibrin ma hope o ka hoʻōla ʻana.
2) ʻO ke koko keʻokeʻo a me ka PRP: loaʻa nā keʻokeʻo keʻokeʻo keʻokeʻo, a haʻahaʻa ka ʻike o ka fibrin ma hope o ka hoʻāla ʻana.
3) PRF maʻemaʻe a i ʻole leukocyte-poor PRF: ʻaʻohe leukocytes i ka hoʻomākaukau ʻana a he fibrin kiʻekiʻe.Hele mai kēia mau huahana ma ke ʻano o nā gel i hoʻāla ʻia a ʻaʻole hiki ke hoʻohana ʻia no ka injection.
4) Leukocyte-waiwai fibrin a me PRF: loaʻa nā leukocytes a me ka fibrin kiʻekiʻe.
Ma 2016, Magalon et al.ua hoʻolālā i ka hoʻohālikelike DEPA (ke kaʻina, ka pono, ka maʻemaʻe, ka hoʻōla ʻana), e kālele ana i ka helu platelet PRP, ka maʻemaʻe o ka huahana, a me ka hoʻoulu ʻana o ka platelet.
1. Ka nui o ka platelet injection: E helu ʻia ma ka hoʻonui ʻana i ka ʻike platelet me ka nui platelet.E like me ka mea i hoʻopaʻa ʻia (i nā piliona a i ʻole miliona o nā platelets), hiki ke hoʻokaʻawale ʻia i (a) kiʻekiʻe loa: >5 biliona;(b) ka nui kiʻekiʻe: mai 3 biliona a 5 biliona;(c) ka nui waena: mai 1 biliona a 3 biliona;(d) haʻahaʻa haʻahaʻa: emi iho ma mua o 1 biliona.
2. Pono ka hoʻomākaukau: ka pakeneka o nā platelets i hōʻiliʻili ʻia mai ke koko.(a) ʻO ka pono o ka mea hana kiʻekiʻe: platelet recovery rate>90%;(b) ka pono o ka mīkini ma waena: ka helu hoʻihoʻi platelet ma waena o 70-90%;(c) haʻahaʻa haʻahaʻa haʻahaʻa haʻahaʻa: ka hoʻihoʻi ʻana ma waena o 30-70%;(d) He haʻahaʻa loa ka pono o nā mea hana: ʻoi aku ka liʻiliʻi o ka hoʻihoʻi ma mua o 30%.
3. PRP maʻemaʻe: E pili ana i ka pili o nā platelets, nā keʻokeʻo keʻokeʻo a me nā ʻulaʻula ʻulaʻula ma PRP.Hōʻike mākou he (a) PRP maʻemaʻe loa: >90% platelets pili i nā erythrocytes a me nā leukocytes i PRP;(b) PRP maʻemaʻe: 70-90% platelets;(c) heterogeneous PRP: % platelets Ma waena o 30-70%;(d) PRP koko holoʻokoʻa: ʻo ka pākēneka o nā platelets i PRP he emi ma mua o 30%.
4. Ke kaʻina hana: inā e hoʻāla i nā platelets me nā kumu coagulation exogenous, e like me ka thrombin autologous a i ʻole calcium chloride.
(Hoʻopuka hou ʻia ka ʻike o kēia ʻatikala.)
Ka manawa hoʻouna: Mei-16-2022