Platelet-rich plasma (PRP) bụ nke a na-ejikarị eme ihe ugbu a na ngalaba ahụike dị iche iche.N'ime afọ ndị na-adịbeghị anya, ntinye nke PRP na orthopedics na-adọrọ mmasị karị, na ntinye ya na mpaghara dị iche iche dị ka mmeghari anụ ahụ, ọgwụgwọ ọnya, nrụzi nchara, ịwa ahụ plastik na ịma mma na-abawanye ụba.Na mbipụta nke taa, anyị ga-enyocha usoro ndu PRP, usoro ya, na nhazi nke PRP iji ghọta nke ọma ihe nwere ike na-ekwesịghị ime na PRP.
Akụkọ ihe mere eme nke PRP
A na-akpọkwa PRP dị ka plasma-ọgaranya platelet (PRP), ihe na-eto eto-ọgaranya platelet (GFS) na matrix platelet-rich fibrin (PRF).Echiche na nkọwa nke PRP malitere na ngalaba hematology.Ndị ọkà mmụta ọbara na-ahụ maka ọbara chepụtara okwu ahụ bụ PRP na 1970, karịsịa iji gwọọ ndị ọrịa nwere thrombocytopenia site n'iwepụta platelet na ịgbakwụnye mmịnye ọbara.
Afọ iri ka e mesịrị, a malitere iji PRP mee ihe na ịwa ahụ maxillofacial dị ka PRF.Fibrin nwere nrapado na homeostatic Njirimara, na PRP nwere mgbochi mkpali Njirimara na-akpali cell proliferating.Mgbe nke ahụ gasịrị, a malitere iji PRP mee ihe n'ọtụtụ ebe na mpaghara musculoskeletal nke mmerụ egwuregwu ma nweta mmetụta ọgwụgwọ dị mma.N'ihi na ebumnuche ọgwụgwọ ahụ bụ ndị ọkachamara na-eme egwuregwu, ọ dọtara mmasị dị ukwuu na mgbasa ozi ma jiri ya mee ihe n'ọtụtụ ebe na ngalaba ọgwụ egwuregwu.N'ikpeazụ, a ji nwayọọ nwayọọ kwalite PRP na ọkpụkpụ ọkpụkpụ, ịwa ahụ, ịwa ahụ ụmụaka, gynecology, urology, plastic na ịchọ mma ịwa ahụ na ophthalmology.
Platelet Biology
Mkpụrụ ndụ ọbara dị n'akụkụ gụnyere mkpụrụ ndụ ọbara uhie, mkpụrụ ndụ ọbara ọcha na platelet, ha niile sitere na cell stem pluripotent nkịtị nke nwere ike ịwapụta n'usoro mkpụrụ ndụ dị iche iche.Ahịrị sel ndị a nwere sel precursor nke nwere ike kewaa na tozuo oke.A na-enweta platelet site na ụmị ọkpụkpụ ma bụrụ sel ndị nwere ụdị diski nucleic nke nwere nha dị iche iche, na nkezi dayameta nke ihe dịka 2 μm, ma bụrụ mkpụrụ ndụ ọbara kacha nta.Ọnụọgụ platelet n'ọbara na-ekesa nkịtị sitere na 150,000 ruo 400,000 kwa microliter.Platelet nwere ọtụtụ granules nzuzo dị oke mkpa, nke enwere isi atọ: granules siri ike, o-granules, na lysosomes.Nke ọ bụla platelet nwere ihe dị ka irighiri ihe 50-80.
Nkọwa nke PRP
N'ikpeazụ, PRP bụ ngwaahịa sitere n'okike, nke bụ plasma gbadoro anya nke nwere mkpokọta platelet dị elu karịa nke dị n'ọbara.Ọ bụghị naanị PRP nwere ọkwa platelet dị elu, kamakwa ọ nwere ihe niile na-akpata coagulation, gụnyere usoro ihe na-eto eto, chemokines, cytokines na protein plasma.
A na-ewepụta PRP n'ọbara dị n'akụkụ site na ụzọ nkwadebe ụlọ nyocha dị iche iche.Mgbe nkwadebe gasịrị, dị ka gradients njupụta dị iche iche, mkpụrụ ndụ ọbara uhie, PRP, na PPP na-ekewa n'ime ọbara n'usoro.Na PRP, na mgbakwunye na mkpokọta platelet dị elu, ọ dịkwa mkpa ịtụle ma ọ nwere leukocytes na ma ọ na-arụ ọrụ.Dabere na akụkụ ndị a, a na-ekpebi ụdị PRP dị iche iche kwesịrị ekwesị maka ọnọdụ pathological dị iche iche.
Ọtụtụ ngwaọrụ azụmahịa dị ugbu a nke nwere ike ime ka nkwadebe nke PRP dị mfe.Ngwa PRP ndị a na-emepụta mkpokọta platelet PRP okpukpu 2-5 dị elu.Ọ bụ ezie na mmadụ nwere ike iche na ọnụ ọgụgụ platelet dị elu ma na-abawanye ụba nke ihe na-eto eto, otú ahụ ka ọgwụgwọ ọgwụgwọ kwesịrị ịdị mma, nke a eguzobebeghị, na ugboro 3-5 a na-ewerekarị ntinye uche dị mma.
Ngwaọrụ azụmaahịa nwere uru nke ịbụ ahaziri ahazi yana dị mfe, mana enwere oke nke ngwaọrụ ha.Ụfọdụ enweghị ike iwepụ kpọmkwem adịghị ọcha nke ọma, na ụfọdụ nkwadebe PRP adịghị elu na itinye uche.N'ụzọ bụ isi, ngwá ọrụ azụmahịa niile enweghị ike ịkwado n'otu n'otu na nke ọma.Nke a bụ nsogbu kachasị na akụrụngwa ahaziri ahazi.Ka ọ dị ugbu a, naanị teknụzụ nkwadebe ụlọ nyocha n'otu n'otu nwere ike ikpuchi mkpa ndị ọrịa niile, nke nwere nnukwu ihe achọrọ na teknụzụ ụlọ nyocha.
Nhazi nke PRP
Na 2006, Everts et al tụpụtara echiche nke leukocyte-ọgaranya PRP.Ya mere, enwere ike kewaa PRP ụzọ abụọ dịka ọnụọgụ leukocytes dị: PRP nwere leukocytes dara ogbenye na PRP nwere leukocytes bara ụba.
1) Platelet-ọgaranya plasma nwere nnukwu leukocytes, nke a na-akpọ L-PRP (Leukocyte Platelet-Rich Plasma, nke nwere obere mkpụrụ ndụ ọbara uhie), a na-ejikarị eme ihe maka ọnya mgbagha, ụkwụ na-arịa ọrịa shuga, gout na-adịghị agwọ ọrịa. ọnyá, nrụzi ọkpụkpụ, enweghị njikọ, ụfụ ụmị ọkpụkpụ na ọgwụgwọ ndị ọzọ.
2) Platelet-ọgaranya plasma na-enweghị ma ọ bụ nke nwere obere leukocytes dị ala ka a na-akpọ P-PRP (Pure Platelet-Rich Plasma, na-enweghị mkpụrụ ndụ ọbara uhie), nke a na-ejikarị eme ihe maka mmerụ egwuregwu na ọrịa degenerative, gụnyere meniscus mmerụ, ligament na tendon. , Tennis elbow, ikpere ogbu na nkwonkwo, cartilage degeneration, lumbar diski herniation na ọrịa ndị ọzọ.
3) Mgbe thrombin ma ọ bụ calcium na-arụ ọrụ PRP mmiri mmiri, enwere ike ịmepụta gel-dị ka PRP ma ọ bụ PRF.(Nke mbụ Dohan et al. na France kwadoro)
Na 2009, Dohan Ehrenfest et al.Nhazi 4 tụrụ aro dabere na ọnụnọ ma ọ bụ enweghị akụrụngwa cellular (dịka leukocytes) na usoro fibrin:
1) PRP dị ọcha ma ọ bụ leukocyte-ogbenye PRP: PRP a kwadebere enweghị leukocytes, na ọdịnaya nke fibrin mgbe arụ ọrụ dị ala.
2) Mkpụrụ ndụ ọbara ọcha na PRP: nwere mkpụrụ ndụ ọbara ọcha, na ọdịnaya fibrin mgbe arụ ọrụ dị ala.
3) PRF dị ọcha ma ọ bụ leukocyte-ogbenye PRF: nkwadebe enweghị leukocytes ma nwee fibrin dị elu.Ngwaahịa ndị a na-abịa n'ụdị gels na-arụ ọrụ na enweghị ike iji ya mee ihe ntụtụ.
4) Leukocyte-ọgaranya fibrin na PRF: nwere leukocytes na fibrin dị elu.
Na 2016, Magalon et al.tụpụtara nhazi ọkwa DEPA (dose, arụmọrụ, ịdị ọcha, ịgbalite), na-elekwasị anya na ọnụ ọgụgụ platelet PRP, ịdị ọcha ngwaahịa, na ịgbalite platelet.
1. dose injection platelet: Gbakọọ site n'ịba ụba mkpokọta platelet site na olu platelet.Dika ogwu ogwu a gbanyere (n'ime ijeri ma obu nde platelet), enwere ike kewaa ya na (a) oke ogwu:>ijeri ise;(b) oke dose: site na ijeri 3 ruo ijeri 5;(c) ọkara dose: site na ijeri 1 ruo ijeri 3;(d) obere dose: ihe na-erughị 1 ijeri.
2. Nkwadebe arụmọrụ: pasent nke platelet anakọtara n'ọbara.(a) Ngwá ọrụ dị elu: ọnụego mgbake platelet>90%;(b) arụmọrụ ngwaọrụ ọkara: ọnụego mgbake platelet n'etiti 70-90%;(c) arụmọrụ ngwaọrụ dị ala: ọnụego mgbake n'etiti 30-70%;(d) Ngwá ọrụ akụrụngwa dị oke ala: ọnụego mgbake erughị 30%.
3. PRP ịdị ọcha: Ọ na-emetụta njikọ nke platelet, mkpụrụ ndụ ọbara ọcha na mkpụrụ ndụ ọbara uhie na PRP.Anyị na-akọwa ya dị ka (a) PRP dị ọcha:> 90% platelet metụtara erythrocytes na leukocytes na PRP;(b) PRP dị ọcha: 70-90% platelet;(c) PRP dị iche iche: % platelet N'etiti 30-70%;(d) Ọbara dum PRP: pasent nke platelet dị na PRP erughị 30%.
4. Usoro ịgbalite: ma ọ ga-arụ ọrụ platelet nwere ihe coagulation exogenous, dị ka autologous thrombin ma ọ bụ calcium chloride.
(A na-ebipụtaghachi ọdịnaya nke akụkọ a.)
Oge nzipu: Mee-16-2022