Kubaga mu kanwakoresha fibrine ikungahaye ku maraso yera na platine (L-PRF) mu kubaga kwa muganga, harimo guhindurwa, guhinduranya ingirabuzima fatizo, gutera amagufwa no kuyaterwa cyane.Yavuze ko L-PRF "ari nk'ibiyobyabwenge".Icyumweru kimwe nyuma yo kubagwa, urubuga rwo kubaga hakoreshejwe L-PRF rusa nkaho rwakize mu byumweru bitatu cyangwa bine, ibyo bikaba ari ibisanzwe. "Hughes yagize ati:" Byihutisha cyane uburyo bwo kuvura kaskade. "'
Platelet ikungahaye kuri fibrin (PRF)na plasma yabanjirije iyitwa plasma ikungahaye (PRP) ishyirwa mubikorwa byamaraso ya autologique, aribyo bicuruzwa byamaraso bikozwe mumaraso yabarwayi.Abaganga b’amavuriro bavana abarwayi amaraso kandi bagakoresha centrifuge kugirango bayitondere, batandukanya ibice bitandukanye byamaraso mubice bitandukanye bishobora gukoreshwa nabaganga b’amavuriro.Nubwo muri iki gihe hari uburyo butandukanye bwikoranabuhanga bushyira imbere ibice bitandukanye byamaraso, igitekerezo rusange cyubuvuzi bw amenyo ni kimwe - bakoresha amaraso yumurwayi kugirango bateze imbere gukira nyuma yo kubagwa umunwa.
Hughes yavuze ko gukira vuba ari imwe mu nyungu.Ubwo yaganiraga ku buryo bwihariye na L-PRF, yerekanye urukurikirane rw'inyungu ku barwayi n'abaganga b'amenyo: bigabanya kuva amaraso mu mikorere no kugabanya umuriro.Itezimbere ifunga ryibanze ryo kubaga flap kugirango re yegere.L-PRF ikungahaye ku maraso yera, bityo bikagabanya ibyago byo kwandura nyuma yo kubagwa.Kuberako ikozwe mumaraso yumurwayi, ikuraho ibyago byo allergie cyangwa kwangwa.Hanyuma, Hughes yavuze ko byoroshye gukora.
Hughes yagize ati: '' Mu myaka 30 namaze nkora ivuriro, nta bindi biyobyabwenge, ibikoresho, cyangwa ikoranabuhanga rishobora kugera kuri ibyo bintu byose nka L-PRF. " abavuzi b'amenyo bakunze guhura nibibazo mugihe bongereye PRP / PRF mubikorwa byabo.Ibibazo byihariye byo kongera ikoreshwa ryamaraso ya autologique harimo gucunga isoko ryibikoresho bikura, kumva impinduka zitandukanye nuburyo bwo kuzikoresha, no gusobanura imikoreshereze yazo mugukoresha amenyo.
PRP na PRF: Itandukaniro ryingenzi Abaganga b'amenyo rusange bagomba gusobanukirwa
PRP na PRF ntabwo ari ibicuruzwa bimwe, nubwo abimenyereza n'abashakashatsi bahinduranya gukoresha aya magambo yombi ku gisekuru kizaza cya biomateriali yo kuvugurura amagufwa no kuvuka igihe "na" Platelet ikungahaye kuri fibrine mu kuvura amenyo mashya: imiterere y'ibinyabuzima n'ibimenyetso by’amavuriro ". Miron yagize. ko PRP yakoreshejwe bwa mbere mu kubaga umunwa mu 1997. Bivuga kuri platine ikungahaye kuri platine ivanze na Anticoagulant. PRF yatangijwe nk'ibisekuru bya kabiri byibanze mu 2001, nta Anticoagulant.
Miron yagize ati: '' Ugereranije na PRP, amakuru aturuka mu nzego nyinshi z'ubuvuzi yerekana neza umusaruro mwiza kuri PRF, kubera ko coagulation ari ikintu gikomeye mu gikorwa cyo gukira ibikomere. "Yavuze ko ibyiza byo gukoresha PRP na PRF ari uko bishobora guteza imbere tissue kuvuka bushya ku giciro gito ugereranije. "Icyakora, kuvuga ko PRP" burigihe "ikoresha Anticoagulant byateje impaka hagati ya Arun K. Garg, DMD, wavumbuye PRP.
Garg ati: "Mu minsi ya mbere yo gukoresha PRP, rimwe na rimwe tureka Anticoagulant mugihe dukeneye gukoresha ibi bikoresho"."Mu gihe kirekire cyo gukora, twongeyeho Anticoagulant kugira ngo tubungabunge ibintu bikura bikomoka kuri platine kugeza igihe tuzaba twiteguye gukoresha ibi bikoresho, hanyuma tuzabyara igihe cyo kubikoresha."Hughes akoresha cyane cyane PRF mu myitozo ye, yongeraho ko zimwe mu mpamvu zituma dukenera kunoza PRP ari ukubera ko ibikoresho bya mbere bya PRP bihenze, kandi ikoranabuhanga riragoye kandi ritwara igihe - PRP isaba kuzunguruka kabiri muri centrifuge hiyongereyeho ya trombine, mugihe PRF ikeneye kuzunguruka rimwe gusa bidakenewe kongerwaho.Hughes yagize ati: '' PRP yabanje gukoreshwa cyane mu manza nini zo kubaga umunwa cyangwa plastiki mu bitaro. "PRP byagaragaye ko bidakwiriye gukoreshwa mu mavuriro asanzwe amenyo.
Kuva mubitekerezo kugeza mubikorwa: Amaraso yibanze, PRF, na PRP mubitaro by amenyo yubuvuzi byegeranijwe kandi bigakorwa muburyo busa.Basobanura ko amaraso akurwa mu barwayi agashyirwa mu icupa rito.Noneho uzengurutsa vial muri centrifuge kumuvuduko wateganijwe nigihe uzatandukanya PRF namaraso muriki gikorwa.PRF yabonetse ni gel yumuhondo nka membrane, ubusanzwe ikusanyirizwa mubice byiza.Kussek yagize ati: "Izi ngingo zishobora guhuzwa n’ibikoresho byo gutera amagufwa, bigahuzwa n’ibikoresho byo gutera amagufwa, cyangwa bigashyirwa hirya no hino cyangwa hejuru y’amenyo y’amenyo kugira ngo bitange biofilm itera gukura kw'amagufwa kandi biteza imbere ubuzima bw'abarwayi.PRF irashobora kandi gukoreshwa nkibikoresho byonyine byo guhindurwa kubagwa igihe.Byongeye kandi, ibi bikoresho bifasha cyane mu gusana imyenge mu gihe cyo kwaguka kwa sinus, kwirinda indwara, no kunoza ivuriro. ''
Kusek yakomeje agira ati: '' Ubusanzwe gukoresha PRP bikubiyemo kubihuza na PRF hamwe n'amagufwa kugira ngo bibe igufwa 'ryiziritse' ryoroshye guhuza no gukorera mu cyuho cyo mu kanwa mu gihe cyo guhindurwa. ", Ibikoresho bya PRP birashobora no guterwa muri Ahantu haterwa kugirango hongerwe ituze kandi utere mumitsi ikikije kugirango utezimbere gukira. '' "" Mubikorwa, bikoreshwa muguhuza amagufwa bavanga PRP nibikoresho byo gutera amagufa hanyuma ukabishyira, hanyuma ugashyira membrane ya PRF hejuru, hanyuma ugashyira membrane ya polytetrafluoroethylene. kuri yo, "Rogge ati. Ndacyakoresha PRF nk'umwambaro nyuma yo gukuramo amenyo - harimo amenyo y'ubwenge - kugira ngo mfashe kugabanya sock yumye no guteza imbere gukira. Mvugishije ukuri, ntabwo nigeze mbona sock yumye kuva nshyira mu bikorwa PRF. Kurandura sock yumye ni ntabwo inyungu yonyine Rogge abona.
'' Ntabwo nabonye gukira byihuse no gukura kw'amagufwa gusa, ahubwo nabonye no kugabanuka k'ububabare nyuma yo kubagwa bivugwa mugihe ukoresheje PRP na PRF. '' '' Niba PRP / PRF idakoreshejwe, umurwayi azakira?"Watts ati. Ariko niba ushobora kuborohereza kandi byihuse kugirango bagere ku gisubizo cya nyuma, hamwe n'ibibazo bike, kuki utabikora?"
Igiciro cyo kongeramo PRP / PRF kiratandukanye mubikorwa rusange by amenyo, ahanini biterwa niterambere ryiterambere ryamaraso ya autologique.Ibicuruzwa byabyaye inganda zingana na miriyari y'amadorari, hamwe nababikora batandukanye bakora ibintu byoroshye (rimwe na rimwe nyirubwite) bya centrifuges n'amacupa mato.Werts yagize ati: '' Centrifuges ifite imiterere itandukanye yihuta yatangijwe ku isoko, kandi impinduka muri centrifugation zirashobora kugira ingaruka ku mibereho n’imikorere ya selile muri zo. " Werts yavuze ko usibye ishoramari rya centrifuge n'amahugurwa ya phlebotomy, Werts yavuze ko andi mafaranga akoreshwa mu gukoresha PRP / PRF mu bikorwa, nk'imiyoboro ikusanyirizwamo vacuum ifunze, Winged infusion set hamwe na tebes, "ari bike".
Werts yagize ati: '' Gukoresha ibibyimba bishobora kwinjizwa mu kubaga transplant birashobora kugura amadorari 50 kugeza ku madolari 100 $. , ariko ubwishingizi ntibukunze kwishyura aya mafaranga. Nkunze kwishyuza kubagwa hanyuma nkabiha impano kumurwayi. ''
Paulisick, Zechman, na Kusek bagereranya ko igiciro cyambere cyo kongeramo centrifuges na compressor ya PRF membrane mu myitozo yabo kiri hagati y’amadolari 2000 kugeza $ 4000, hamwe n’ikiguzi cyiyongereyeho ni ibikoresho byo gukusanya amaraso, ubusanzwe bitwara amadorari atarenga 10 kuri buri gasanduku.Kubera amarushanwa yinganda numubare munini wa centrifuges iboneka kumasoko, abaganga b amenyo bagomba kubona ibikoresho kubiciro bitandukanye.Ubushakashatsi bwerekanye ko mugihe cyose protocole ihamye, ntihashobora kubaho itandukaniro rigaragara mubwiza bwa PRF yakozwe hakoreshejwe centrifuges zitandukanye.
Miron yagize ati: '' Itsinda ryacu ry’ubushakashatsi riherutse gushyira ahagaragara isuzuma rifatika aho twasanze PRF yarateje imbere cyane ibyavuye mu mavuriro mu gusana ingirabuzima fatizo ndetse no koroshya ingirabuzima fatizo. "Nubwo bimeze bityo ariko, twanzuye ko hakiri ubushakashatsi buke kugira ngo tugaragaze uruhare ya PRF mu gutera amagufwa (induction yamagufa). Kubwibyo rero, abaganga b’amavuriro bagomba kumenyeshwa ko PRF ifite imbaraga zo kuvugurura ingirabuzimafatizo zoroshye kuruta ingirabuzimafatizo zikomeye. ''
Ubushakashatsi bwinshi bwa siyansi busa nkaho bushyigikira ibyo Miron avuga.Hariho ibimenyetso byerekana ko PRP / PRF igira uruhare mugikorwa cyo gukira, nubwo urwego rwiterambere rutaba rufite imibare.Nubwo hari ibimenyetso byinshi bya Anecdotal, abashakashatsi bemeza ko hakenewe ibimenyetso bifatika.Kuva PRF yakoreshwa bwa mbere mu kubaga umunwa mu 2001, habaye impinduka nyinshi - L-PRF, A-PRF (fibrine ikungahaye cyane ya fibrin), na i-PRF (inshinge ya platine ikungahaye kuri fibrin).Nkuko Werts yabivuze, "birahagije kugutera umutwe no guharanira kubyiga no kubibuka. ''
Ati: '' Muri rusange, ibyo byose bishobora guturuka ku gitekerezo cya mbere cya PRP / PRF. " kimwe - byose biteza imbere gukira. '' Hughes yarabyemeye kandi yerekana ko L-PRF, A-PRF, na i-PRF byose ari "bito" bya PRF.Ubwo bwoko ntibusaba ibikoresho byihariye, ahubwo bisaba guhinduka. kuri gahunda ya centrifugal (igihe n'imbaraga zo kuzunguruka). "
Ihinduka rya mbere rya PRF ni L-PRF, ikurikiwe na A-PRF.Ubwoko bwa gatatu, i-PRF, nuburyo bwamazi, inshinge za PRF zitanga ubundi buryo bwa PRP.Hughes yagize ati: '' Ni ngombwa kumva ko ubusanzwe PRF ifata imiterere y'ibihuru, '' Niba ukeneye gutera PRF, ugomba gusa guhindura igihe cya centrifugation na RPM kugirango ube muburyo bwamazi - iyi ni i- PRF. " ni umugereka mwiza cyane wo guhuza amagufwa ya granulaire cyangwa manini, afasha gutuza no gutunganya ibihingwa. "Ati:" Nabonye ko kuyikoresha muri ubu bushobozi byageze ku musaruro mwiza. "'
Niba amoko atandukanye, amagambo ahinnye, n'amazina yo kwita amazina yitiranya inzobere mu nganda, ni gute abaganga b'amenyo basanzwe bakwiye gusobanura igitekerezo cy'amaraso ya autologique yibanda ku barwayi?
Ibiri muri iyi ngingo byongeye gusubirwamo, kandi ntidutanga ingwate iyo ari yo yose cyangwa yerekana ko ari ukuri, kwiringirwa cyangwa kuzuza ibikubiye muri iyi ngingo, kandi ntabwo dushinzwe ibitekerezo by'iyi ngingo, nyamuneka ubyumve.）
Igihe cyo kohereza: Nyakanga-24-2023