Ikoreshwa ryaPlatelet ikungahaye kuri plasma (PRP)mubice bitandukanye nuburyo bwo guhitamo PRP ikungahaye mungirangingo zamaraso yera (L-PRP) na PRP Abakene mumaraso yera (P-PRP)
Ivumburwa rya vuba ryibimenyetso byinshi byujuje ubuziranenge bishyigikira ikoreshwa rya LR-PRP mu kuvura Epicondylitis yanduye na LP-PRP mu kuvura ivi Amagufwa.Ibimenyetso byujuje ubuziranenge bishyigikira ikoreshwa rya LR-PRP yo gutera inshinge za patellar tendinose no gutera PRP kuri Plantar fasciitis hamwe nububabare bwabaterankunga muguhindura patellar tendon transplantation BTB ACL kwiyubaka.Nta bimenyetso bihagije byerekana buri gihe PRP ya rotator cuff tendinose, ikibuno Articular bone osteoarthritis cyangwa umugongo muremure.Ibimenyetso biriho byerekana ko PRP idafite imbaraga zo kuvura indwara ya Achilles tendon, gukomeretsa imitsi, kuvunika gukabije cyangwa amagufwa adahuje ubumwe, kongera imbaraga zo kubaga rotate cuff yo gusana, gusana imitsi ya Achilles, no kwiyubaka kwa ACL.
Plasitike ikungahaye kuri plasma (PRP) ni plasma ya autologique ya plasma yumuntu yongerera imbaraga za platel mukwinjiza amaraso menshi yumurwayi.Plateletes muri α Ibice byayo (TGF- β 1. PDGF, bFGF, VEGF, EGF, IGF-1) ikubiyemo ibintu byinshi bikura bikura hamwe nabunzi, byibanda kumurongo wa centrifugation kugirango urekure urugero rwinshi rwibintu bikura na cytokine. ahakomeretse no kuzamura inzira yo gukira bisanzwe.
Umubare usanzwe wa platelet ni 150000 kugeza 350000 / μ L. Iterambere ryamagufwa hamwe nudukoko tworoheje twagaragaye, hamwe na platine yibanze igera kuri 1000000 / μ L. Yerekana ubwiyongere bwikubye gatatu kugeza kuri butanu mubintu bikura.Ubusanzwe imyiteguro ya PRP igabanijwemo PRP ikungahaye kuri selile yera (LR-PRP), bisobanurwa ko kwibumbira hamwe kwa neutrophil hejuru y'ibanze, na PRP ikennye mu maraso yera (LP-PRP), bisobanurwa nk'uturemangingo tw'amaraso yera (neutrophil) munsi y'ibanze .
Kuvura ibikomere bya Tendon
Gukoresha PRP mu kuvura ibikomere cyangwa indwara ya tendon byabaye ingingo y’ubushakashatsi bwinshi, kandi cytokine nyinshi iboneka muri PRP igira uruhare mu kwerekana inzira zibaho mugihe cyo gukira kw’umuriro, ikwirakwizwa ry’utugingo, ndetse no guhindura imyenda nyuma.PRP irashobora kandi guteza imbere imiyoboro y'amaraso mishya, ishobora kongera amaraso nimirire ikenerwa kugirango ingirabuzimafatizo zangirika, ndetse no kuzana ingirabuzimafatizo nshya no kuvana imyanda mu ngingo zangiritse.Ubu buryo bwibikorwa bushobora kuba bufitanye isano cyane na tendinose idakira, aho imiterere yibinyabuzima idafasha gukira ingirangingo.Isubiramo rifatika hamwe na meta-isesengura ryanzuye ko gutera PRP bishobora kuvura neza tendinose yibimenyetso.
Epicondylitis
PRP yasuzumwe nk'uburyo bushobora kuvurwa ku barwayi barwaye Epicondylitis itagaragara neza muri physiotherapie.Mu bushakashatsi bunini nk'ubwo, Mishra n'abandi.Mu bushakashatsi buteganijwe bwa Cohort, hasuzumwe abarwayi 230 batitabye ubuyobozi bwa Conservateur bwa Epicondylitis yanduye byibuze amezi 3.Umurwayi yavuwe na LR-PRP, kandi mu byumweru 24, inshinge ya LR-PRP yajyanye no gutera imbere cyane mububabare ugereranije nitsinda rishinzwe kugenzura (71.5% vs 56.1%, P = 0.019), ndetse no kugabanuka gukabije kwa ijanisha ry'abarwayi bavuga ko inkokora zisigaye (29.1% vs 54.0%, P = 0.009).Mugihe cibyumweru 24, abarwayi bavuwe na LR-PRP bagaragaje iterambere ryingenzi kandi ry’imibare ugereranije n’inshinge zatewe no gutera inshinge zaho.
Ubushakashatsi bwibanze bwerekanye ko LR-PRP ishobora kandi gutanga ubufasha burambye ku bimenyetso bya Epicondylitis yanduye ugereranije no gutera inshinge za Corticosteroid, bityo ikagira ingaruka zirambye zo kuvura.PRP isa nkuburyo bwiza bwo kuvura Epicondylitis yo hanze.Ibimenyetso byujuje ubuziranenge byerekana igihe gito kandi kirekire.Ibimenyetso byiza biboneka byerekana neza ko LR-PRP igomba kuba uburyo bwa mbere bwo kuvura.
Indwara ya Patellar
Ubushakashatsi bugenzurwa busanzwe bushigikira ikoreshwa rya LR-PRP mu kuvura indwara zidakira zidakira.Draco n'abandi.Hasuzumwe abarwayi 23 barwaye patellar tendinose bananiwe kuyobora imiyoborere myiza.Abarwayi bahawe amahirwe yo kwakira inshinge ziyobowe na ultrasound cyangwa inshinge za LR-PRP, hanyuma bakurikiranwa ibyumweru 26.Binyuze mu gupima VISA-P, itsinda rivura PRP ryerekanye ko ryateye imbere cyane mu bimenyetso mu byumweru 12 (P = 0.02), ariko itandukaniro ntabwo ryagaragaye cyane mu byumweru 26 (P = 0.66), byerekana ko inyungu za PRP ku ndwara ya patellar tendon birashobora kuba iterambere mubimenyetso byambere.Vitrano n'abandi.Inyungu zo gutera inshinge PRP mu kuvura indwara zidakira za patellar tendon ugereranije no kwibanda ku kuvura indwara zidasanzwe (ECSWT).Nubwo nta tandukaniro rikomeye ryagaragaye hagati yitsinda mugihe cyamezi 2 yakurikiranwe, itsinda rya PRP ryerekanye iterambere ryibarurishamibare mumezi 6 na 12 yo gukurikirana, rirenga ECSWT nkuko byapimwe na VISA-P na VAS, no gupima Blazina amanota manini mumezi 12 yo gukurikirana (yose P <0.05).
Iri suzuma risuzuma ubuvanganzo bw’ubuvuzi buriho ku ikoreshwa rya plasma ikungahaye kuri platine (PRP), harimo na PRP (LR PRP) ikungahaye kuri leukocyte ikennye na PRP (LP PRP), hagamijwe gutegura ibyifuzo bishingiye ku bimenyetso by’indwara zinyuranye z’imitsi.
Ivumburwa rya vuba ryibimenyetso byinshi byujuje ubuziranenge bishyigikira ikoreshwa rya LR-PRP mu kuvura Epicondylitis yanduye na LP-PRP mu kuvura ivi Amagufwa.Ibimenyetso byujuje ubuziranenge bishyigikira ikoreshwa rya LR-PRP yo gutera inshinge za patellar tendinose no gutera PRP kuri Plantar fasciitis hamwe nububabare bwabaterankunga muguhindura patellar tendon transplantation BTB ACL kwiyubaka.Nta bimenyetso bihagije byerekana buri gihe PRP ya rotator cuff tendinose, ikibuno Articular bone osteoarthritis cyangwa umugongo muremure.Ibimenyetso biriho byerekana ko PRP idafite imbaraga zo kuvura indwara ya Achilles tendon, gukomeretsa imitsi, kuvunika gukabije cyangwa amagufwa adahuje ubumwe, kongera imbaraga zo kubaga rotate cuff yo gusana, gusana imitsi ya Achilles, no kwiyubaka kwa ACL.
Menyekanisha
Plasitike ikungahaye kuri plasma (PRP) ni plasma ya autologique ya plasma yumuntu yongerera imbaraga za platel mukwinjiza amaraso menshi yumurwayi.Plateletes muri α Ibice byayo (TGF- β 1. PDGF, bFGF, VEGF, EGF, IGF-1) ikubiyemo ibintu byinshi bikura bikura hamwe nabunzi, byibanda kumurongo wa centrifugation kugirango urekure urugero rwinshi rwibintu bikura na cytokine. ahakomeretse no kuzamura inzira yo gukira bisanzwe.Umubare usanzwe wa platelet ni 150000 kugeza 350000 / μ L. Iterambere ryamagufwa hamwe nudukoko tworoheje twagaragaye, hamwe na platine yibanze igera kuri 1000000 / μ L. Yerekana ubwiyongere bwikubye gatatu kugeza kuri butanu mubintu bikura.
Ubusanzwe imyiteguro ya PRP igabanijwemo imyiteguro ya PRP ikungahaye ku ngirabuzimafatizo z'amaraso yera (LR-PRP), bisobanurwa ko ari neutrophil yibanze hejuru y'ibanze, naho imyiteguro ya PRP ikennye mu maraso yera (LP-PRP), bisobanurwa ko ari selile yera (neutrophil). munsi y'ibanze.
Gutegura no guhimba
Nta bwumvikane rusange muburyo bwiza bwa PRP bwo guhuza ibice bigize amaraso, kandi kuri ubu hariho isoko ryinshi ryubucuruzi PRP ku isoko.Kubwibyo, ukurikije sisitemu zitandukanye zubucuruzi, hariho itandukaniro muri protokole ya PRP hamwe nibiranga imyiteguro, biha buri sisitemu ya PRP ibiranga byihariye.Sisitemu yubucuruzi isanzwe itandukanye muburyo bwo gufata platine, uburyo bwo gutandukana (intambwe imwe cyangwa intambwe ebyiri centrifugation), umuvuduko wa centrifugation, nubwoko bwo gukusanya imiyoboro ya sisitemu nigikorwa.Ubusanzwe, mbere ya centrifugation, amaraso yose arakusanywa akavangwa nibintu birwanya anticoagulant kugirango atandukane selile yamaraso itukura (RBCs) na plasma ikennye ya plasma (PPP) hamwe na "erythrocyte sedimentation brown layer layer" irimo platine yibanze hamwe na selile yera.Uburyo butandukanye bukoreshwa mugutandukanya platine, zishobora guterwa mumubiri wumurwayi cyangwa "gukora" wongeyeho calcium chloride cyangwa trombine, biganisha kuri platine no kurekura ibintu bikura.Ibintu bibiri byihariye by’abarwayi, harimo ubuyobozi bw’ibiyobyabwenge nuburyo bwo gutegura sisitemu yubucuruzi, bigira ingaruka kumiterere yihariye ya PRP, kimwe niyi mpinduka mubigize imiterere ya PRP mugusobanura imikorere yubuvuzi bwa PRP.
Ubu icyo dusobanukiwe nuko PRP yiyongereyeho selile yamaraso yera, aribyo PRP ikungahaye kuri selile yera (neutrophile), ifitanye isano ningaruka ziterwa no gutwika.Ubwiyongere bw'uturemangingo tw'amaraso yera (neutrophile) muri LR-PRP bifitanye isano no kwiyongera kwa cytokine ya catabolike, nka interleukin-1 β Fact Tumor Necrosis Factor α Na metalloproteinase, ishobora kurwanya cytokine ya anabolike iri muri platine.Ingaruka zishingiye ku mavuriro n'ingaruka za selile ziterwa na PRP zitandukanye, harimo n'uturemangingo tw'amaraso yera, ziracyasobanurwa.Iri suzuma rigamije gusuzuma ibimenyetso byiza biboneka kubimenyetso bitandukanye byubuvuzi byerekana PRP zitandukanye.
Indwara ya Achilles
Ibigeragezo byinshi byamateka byananiwe kwerekana itandukaniro mubisubizo byubuvuzi hagati ya PRP na placebo yonyine mukuvura Achilles tendinitis.Ikigeragezo giherutse kugenzurwa cyagereranije urukurikirane rw'inshinge enye za LP-PRP hamwe n'inshinge ya platbo hamwe na gahunda yo gusubiza mu buzima busanzwe centrifugal.Ugereranije nitsinda rya placebo, itsinda ryo kuvura PRP ryerekanye iterambere ryinshi mububabare, imikorere, n amanota yibikorwa kumwanya wose mugihe cyamezi 6 yo gukurikirana.Ubushakashatsi bwagaragaje kandi ko inshinge nini nini (50 mL) ya 0.5% ya Bupivacaine (10 mL), methylprednisolone (20 mg) na saline physiologique (40 mL) yagize iterambere risa, ariko iyo usuzumye ubwo buvuzi, hagomba kwitabwaho reba ibyago byiyongera byo guturika kwa tendon nyuma yo guterwa steroid.
Rotator Cuff Tendinose
Hariho ubushakashatsi buke bwo murwego rwo hejuru ku gutera inshinge PRP muburyo budasanzwe bwo kubaga indwara ya rotator cuff tendon.Ubushakashatsi buke bwashyizwe ahagaragara bwagereranije ibyavuye mu mavuriro yo gutera inshinge za PRP hamwe na placebo na Corticosteroid, kandi nta bushakashatsi bwigeze busuzuma inshinge PRP mu buryo bwonyine.Casey Buren n'abandi.Byagaragaye ko nta tandukaniro riri mu manota yavuye mu mavuriro ugereranije no gutera saline physiologique munsi yigitugu.Nyamara, igeragezwa ryemewe ryagaragaje ko inshinge ebyiri za LR-PRP buri byumweru bine byongereye ububabare ugereranije ninshinge za placebo.Shams n'abandi.Iterambere rigereranywa ry’inshinge PRP na Corticosteroid inshinge hagati ya Xi'an Ontario RC indangagaciro (WORI), icyerekezo cy’ubumuga bwo ku rutugu (SPDI) n’ububabare bwa VAS ku rutugu hamwe n’ikizamini cya Neer.
Kugeza ubu, ubushakashatsi bwerekanye ko gutera PRP munsi yigitugu bifite iterambere ryinshi mubisubizo byatangajwe by’abarwayi bafite rotate cuff tendon.Ubundi bushakashatsi busaba gukurikiranwa igihe kirekire, harimo no gusuzuma inshinge za PRP mu buryo bworoshye.Izi inshinge za PRP zerekanwe ko zifite umutekano kandi zishobora kuba ubundi buryo bwo gutera inshinge za Corticosteroid muri rotator cuff tendinose.
Fasciitis
Ikigeragezo cyinshi cyagenzuwe cyasuzumwe inshinge ya PRP ya fasitite idakira.Ubushobozi bwa PRP nkubuvuzi bwaho bwo gutera inshinge bugabanya impungenge zijyanye no gutera inshinge za Corticosteroid, nka atrophy yimyenda yimyambarire cyangwa guturika kwa fassiya.Meta-analyse ebyiri ziherutse gusuzuma isuzuma riri hagati yo guterwa PRP no gutera inshinge za Corticosteroid, maze zanzura ko gutera PRP ari uburyo bushoboka bwo gutera inshinge za Corticosteroid mubijyanye no gukora neza.Ubushakashatsi bumwe bwerekanye ko PRP isumba.
Kubaga hamwe na PRP
Gusana Urutugu
Ubushakashatsi butandukanye bwo mu rwego rwo hejuru bwasuzumye ikoreshwa rya PRP muri Arthroscopy yo gusana amarira ya rotator.Ubushakashatsi bwinshi bwize cyane cyane ikoreshwa rya platine ikungahaye kuri fibrin matrix yo kwitegura kuzamura (PRFM), mugihe ubundi bushakashatsi bwinjije PRP muburyo bwo gusana.Hariho itandukaniro rikomeye muri PRP cyangwa PRFM.Ibisubizo byerekeranye n’abarwayi byabonetse, nka kaminuza ya Californiya, Los Angeles (UCLA), Ishyirahamwe ry’abanyamerika n’ibitugu (ASES), amanota ahoraho ibitugu, amanota yoroshye y’ibitugu (SST), n’amanota y’ububabare bwa VAS, ndetse n’ubuvuzi bufite intego amakuru nka rotator cuff imbaraga nigitugu ROM yakusanyirijwe gupima itandukaniro mubisubizo byimikorere.Inyigisho nyinshi zabantu ku giti cyabo zerekanye itandukaniro rito mu ngamba zibi bisubizo muri PRP ugereranije no gusana umuntu ku giti cye [nk'amakariso ya Arthroscopy rotator cuff yo gusana.Byongeye kandi, isesengura rinini rya meta hamwe nisuzuma rikomeye ryerekanye ko Arthroscopy yo gusana ibitugu [PRP] nta nyungu nini ifite mu kongera amabere.Nyamara, amakuru make yerekana ko afite ingaruka mukugabanya ububabare bwa perioperative, bikaba bishoboka ko biterwa na anti-inflammatory ya PRP.
Isesengura ryitsinda ryerekanye ko hagati y amarira mato hamwe no kuvura Arthroscopy inshuro ebyiri zo gusana, gutera inshinge PRP bishobora kugabanya igipimo cyo gutanyagura, bityo bikagera kubisubizo byiza.Qiao n'abandi.Byagaragaye ko PRP ifite akamaro mukugabanya umuvuduko wo kongera gutanyagura amarira aringaniye kandi manini ya rotate cuff ugereranije no kubaga wenyine.
Igeragezwa ryamavuriro ryemewe hamwe nini-meta-isesengura ryerekana ko nta bimenyetso bifatika byo gukoresha PRP na PRFM nk'imbaraga zo gusana rotate cuff.Isesengura rito ryitsinda ryerekana ko gusana imirongo ibiri bishobora kugira inyungu zo kuvura amarira mato cyangwa aringaniye.PRP irashobora kandi gufasha guhita igabanya ububabare nyuma yo kubagwa.
Achilles Tendon Gusana
Ubushakashatsi bwibanze bwerekanye ko PRP igira ingaruka nziza mugutezimbere gukira kwa Achilles tendon.Ariko, ibimenyetso bivuguruzanya bibangamira ihinduka rya PRP nkumuti mwiza wokuvura gukabije kwa Achilles tendon abantu.Kurugero, mubushakashatsi bumwe, imiterere n'imikorere yabarwayi barwaye Achilles tendon yaturika bavuwe hamwe na PRP nta na kimwe.Ibinyuranye, Zou n'abandi.Mu bushakashatsi buteganijwe buteganijwe, hashyizweho abarwayi 36 babazwe cyane Achilles tendon yamenetse kandi batatewe inshinge za LR-PRP.Abarwayi bo mu itsinda rya PRP bari bafite imitsi myiza ya isokinetic mumezi 3, kandi bafite amanota menshi ya SF-36 na Leppilahti mumezi 6 na 12 (bose P <0.05).Mubyongeyeho, imigeri ihuriweho hamwe mumatsinda ya PRP nayo yateye imbere cyane mugihe cyose mumezi 6, 12, na 24 (P <0.001).Nubwo hakenewe ibigeragezo byinshi byujuje ubuziranenge, gutera inshinge PRP nkigikorwa cyo kubaga uburyo bukomeye bwo gusana Achilles tendon isa nkaho ari ingirakamaro.
Kubaga Imbere yo Kubaga Ligament
Intsinzi yo kubaga imbere (ACL) kubagwa ntabwo ishingiye gusa kubintu bya tekiniki (nko gushyira imiyoboro ya tunnel no gutunganya ibihingwa), ahubwo biterwa no gukiza ibinyabuzima bya ACL.Ubushakashatsi ku mikoreshereze ya PRP mu kubaga ACL yo kongera kubaka bwibanda ku buryo butatu bw’ibinyabuzima: (1) guhuza amagufwa y’amagufwa hagati y’igitereko hamwe na tibial tibial na femorale, (2) gukura kw'igice cyahurijwe hamwe, na ( 3) gukiza no kugabanya ububabare ahasarurwa.
Nubwo ubushakashatsi bwinshi bwibanze ku gushyira mu bikorwa inshinge za PRP mu kubaga ACL mu myaka itanu ishize, habaye ubushakashatsi bubiri bwo mu rwego rwo hejuru.Ubushakashatsi bwibanze bwerekanye ko ibimenyetso bivanze bishyigikira guhuza ingirabuzimafatizo ya Osteoligamous ikuze ikoresheje inshinge za PRP, ariko ibimenyetso bimwe byagaragaye ko bishyigikira ububabare kurubuga rwabaterankunga.Kubyerekeranye no gukoresha PRP yongerewe imbaraga kugirango tunonosore ibihuza amagufwa ya tunnel, amakuru aheruka kwerekana ko PRP nta nyungu ivura ifite mugukwirakwiza tunel cyangwa guhuza amagufwa yubukorikori.
Igeragezwa rya kliniki iheruka kwerekana ibisubizo bitanga umusaruro mukibanza cyabaterankunga ububabare no gukira ukoresheje PRP.Sajas n'abandi.Twihweje ububabare bw'ivi ry'imbere nyuma yo kwiyubaka kwa ACL amagufwa ya patella amagufwa (BTB), byagaragaye ko ugereranije nitsinda rishinzwe kugenzura, ububabare bw'ivi bw'imbere bwagabanutse mu gihe cy'amezi 2 yakurikiranwe.
Harakenewe ubushakashatsi bwinshi kugirango hamenyekane ingaruka za PRP muguhuza ACL graft, gukura, hamwe nububabare bwabaterankunga.Ariko, aho bigeze, ubushakashatsi bwerekanye ko PRP nta ngaruka zikomeye z’ubuvuzi zigira ku guhuza ibihingwa cyangwa gukura, ariko ubushakashatsi buke bwerekanye ibisubizo byiza mu kugabanya ububabare mu gice cy’abaterankunga ba patellar tendon.
Osteoarthritis
Abantu bashishikajwe cyane nubushobozi bwa PRP intra-articular inshinge mugutavura kubaga ivi Articular bone osteoarthritis.Shen n'abandi.Hakozwe meta-isesengura ryibizamini 14 byateganijwe (RCTs) harimo abarwayi 1423 kugirango bagereranye PRP nubugenzuzi butandukanye (harimo na placebo, aside hyaluronic, inshinge za Corticosteroid, imiti yo mu kanwa no kuvura Homeopathie).Isesengura rya Meta ryerekanye ko mu gihe cyo gukurikirana amezi 3, 6 na 12, amanota ya Osteoarthritis (WOMAC) yo muri kaminuza ya Western Ontario na kaminuza ya McMaster yazamutse cyane (= 0.02, 0.04, <0.001).Itsinda rito ryasesenguye imikorere ya PRP rishingiye ku buremere bwa osteoarthritis yo mu ivi ryerekanye ko PRP ikora neza ku barwayi bafite OA yoroheje kandi yoroheje.Umwanditsi yizera ko mu rwego rwo kugabanya ububabare n’ibisubizo byatanzwe n’umurwayi, inshinge zo mu nda ya PRP zikora neza kurusha izindi nshinge zindi mu kuvura ivi osteoarthritis.
Riboh n'abandi.yakoze meta-gusesengura kugirango agereranye uruhare rwa LP-PRP na LR-PRP mu kuvura ivi Osteoarthritis, asanga ugereranije na HA cyangwa umwanya wawo, inshinge za LP-PRP zishobora kuzamura amanota ya WOMAC.Ferrado n'abandi.yize inshinge ya LR-PRP, cyangwa asanga nta tandukanyirizo rishingiye ku mibare ugereranije no guterwa HA, bikomeza byerekana ko LP-PRP ishobora kuba amahitamo ya mbere yo kuvura ibimenyetso bya Osteoarthritis.Ishingiro ryibinyabuzima rishobora kuba muburyo bugereranije bwo gutwika hamwe nabunzi barwanya inflammatory biboneka muri LR-PRP na LP-PRP.Imbere ya LR-PRP, umuhuza wumuriro TNF- α 、 IL-6, IFN- ϒ Na IL-1 β Yiyongereye ku buryo bugaragara, mu gihe gutera inshinge LP-PRP byongera IL-4 na IL-10, birwanya kurwanya abunzi.Byagaragaye ko IL-10 ifasha cyane cyane kuvura hip osteoarthritis, kandi irashobora no kubuza umuhuza utwika TNF- α 、 IL-6 na IL-1 β Kurekura no guhagarika inzira yaka umuriro muguhindura ibikorwa bya kirimbuzi kB.Usibye ingaruka mbi zayo kuri chondrocytes, LR-PRP irashobora kandi kudashobora gufasha kuvura ibimenyetso bya Osteoarthritis kubera ingaruka zayo kuri selile synovial.Braun n'abandi.Byagaragaye ko kuvura uturemangingo twa synovial hamwe na LR-PRP cyangwa selile yumutuku bishobora gutuma habaho umusaruro mwinshi wumuhuza wica no gupfa.
Gutera inshinge zo mu nda ya LP-PRP ni uburyo bwo kuvura bwizewe, kandi hari ibimenyetso byo mu rwego rwa 1 byerekana ko bishobora kugabanya ibimenyetso by’ububabare no kongera imikorere y’abarwayi basuzumwe n’ivi Articular bone osteoarthritis.Ingano nini kandi ndende yo gukurikirana irakenewe kugirango tumenye neza igihe kirekire.
Hip Osteoarthritis
Ibigeragezo bine byonyine byagereranijwe ugereranije inshinge PRP na aside hyaluronic (HA) yo kuvura ikibuno osteoarthritis.Ibipimo byerekana ibisubizo ni amanota ya VAS, amanota ya WOMAC, hamwe na Harris ikibuno hamwe (HHS).
Batalya n'abandi.habonetse iterambere ryinshi mumanota ya VAS na HHS kumezi 1, 3, 6, na 12.Iterambere ryinshi ryabaye mu mezi 3, kandi ingaruka zagiye zigabanuka nyuma yaho [72].Amanota kumezi 12 aracyateye imbere cyane ugereranije n amanota y'ibanze (P <0.0005);Ariko, nta tandukanyirizo ryibarurishamibare ryagaragaye mubisubizo hagati yitsinda rya PRP na HA.
Di Sante n'abandi.yabonye ko amanota VAS yitsinda rya PRP yazamutse cyane mubyumweru 4, ariko agaruka kumurongo wibyumweru 16.Nta tandukaniro rikomeye ryagize amanota ya VAS hagati yitsinda rya HA mu byumweru 4, ariko habaye iterambere ryinshi mubyumweru 16.Dalari n'abandi.Twasuzumye ingaruka za PRP ku guterwa HA, ariko tunagereranya guhuza urushinge rwa HA na PRP kubibazo byombi.Itsinda rya PRP wasangaga rifite amanota make ya VAS mu matsinda uko ari atatu ku manota yose yo gukurikirana (amezi 2, amezi 6, n'amezi 12).PRP nayo yari ifite amanota meza ya WOMAC mumezi 2 na 6, ariko ntabwo yari mumezi 12.Doria n'abandi.Hakozwe igeragezwa rya kabiri-rihumye ryakozwe kugira ngo rigereranye abarwayi bahawe inshinge eshatu zikurikirana buri cyumweru za PRP ninshuro eshatu zikurikirana za HA.Ubu bushakashatsi bwabonye iterambere mu manota ya HHS, WOMAC, na VAS mu matsinda ya HA na PRP mu mezi 6 na 12 yo gukurikirana.Ariko, igihe cyose ingingo, nta tandukaniro rikomeye ryari hagati yaya matsinda yombi.Nta bushakashatsi bwerekanye ko gutera inshinge imbere ya PRP mu kibuno bigira ingaruka mbi, kandi bose bemeje ko PRP ifite umutekano.
Nubwo amakuru ari make, inshinge zo mu nda zatewe na PRP mu kuvura ikibuno Articular bone osteoarthritis byagaragaye ko ifite umutekano, kandi ifite akamaro kanini mu kugabanya ububabare no kunoza imikorere, nkuko byapimwe n’ibisubizo byatanzwe n’abarwayi.Ubushakashatsi bwinshi bwerekanye ko PRP ishobora kubanza kugabanya ububabare ugereranije na HA;Ariko, nkuko PRP na HA bifite imikorere isa cyane mumezi 12, inyungu zose zambere zisa nkintege nke mugihe.Kubera ko ubushakashatsi buke mu mavuriro bwasuzumye ishyirwa mu bikorwa rya PRP mu kibuno OA, hakenewe ibimenyetso byinshi byo mu rwego rwo hejuru kugira ngo hamenyekane niba PRP ishobora gukoreshwa nk'ubuyobozi bw’ubuyobozi bwa Konservateur kugira ngo itinde imikorere ya hip Articular bone osteoarthritis.
Amaguru
Ibigeragezo bibiri byonyine byujuje ubuziranenge byujuje ibisabwa kugirango dushyire mu bikorwa byasuzumye ikoreshwa rya PRP mu maguru akomeye.Roden n'abandi.Igeragezwa ry’amavuriro ryahumishijwe kabiri ryakozwe ku barwayi bafite amaguru akomeye muri ED, ugereranije inshinge za ultrasound zatewe no gutera anesthetic ya LR-PRP hamwe na saline hamwe n’inshinge za anesthetic.Basanze nta tandukanyirizo rishingiye ku mibare ryerekana amanota ya VAS cyangwa igipimo cyo hasi cyibikorwa (LEFS) hagati yaya matsinda yombi.
Laval n'abandi.ku buryo butemewe, abakinnyi 16 b'indobanure basuzumwe bafite amaguru maremare kugira ngo bahabwe ubuvuzi bwa LP-PRP buyobowe na ultrasound mu gihe cyo kuvura bwa mbere, kandi batewe inshinge nyinshi muri gahunda yo gusubiza mu buzima busanzwe cyangwa gahunda itandukanye yo gusubiza mu buzima busanzwe nyuma y'iminsi 7.Abarwayi bose bahawe protocole imwe yo kuvura no gusubiza mu buzima busanzwe.Ubushakashatsi bwerekanye ko itsinda rya LP-PRP ryasubukuye amarushanwa mugihe gito (iminsi 40.8 niminsi 59,6, P <0.006).
PRP isa nkaho idakora neza kubirenge bikaze.Nubwo ibimenyetso bike byerekana ko inshinge LP-PRP ishobora kugira ingaruka kumaguru maremare y'abakinnyi bakomeye.
Gukomeretsa imitsi
Gukoresha PRP mu kuvura imvune zerekanye ibimenyetso bidasobanutse byamavuriro.Kimwe no gukiza imitsi, intambwe zo gukira imitsi zirimo igisubizo cyambere cyo gutwika, hakurikiraho gukwirakwira kwingirabuzimafatizo, gutandukanya, no kuvugurura ingirangingo.Hamid n'abandi.Ubushakashatsi bumwe buhumyi bwakorewe ku barwayi 28 bafite ikibazo cyo mu cyiciro cya 2 hamstring, ugereranije inshinge za LR-PRP na gahunda yo gusubiza mu buzima busanzwe no gusubiza mu buzima busanzwe bonyine.Itsinda ryakira LR-PRP ryashoboye gukira amarushanwa byihuse (igihe cyo kugereranya muminsi, 26.7 na 42.5, P = 0.02), ariko ntirwigeze rugera kumiterere.Mubyongeyeho, ingaruka zikomeye zo mumatsinda yo kuvura zishobora kwitiranya ibisubizo.Muburyo bubiri-buhumyi Ikigereranyo cyagenzuwe, Reurink nibindi.Twasuzumye abarwayi 80 tugereranya inshinge za PRP ninshinge ya saline saline.Abarwayi bose bahawe ubuvuzi busanzwe.Umurwayi yakurikiranwe amezi 6 kandi nta tandukaniro rikomeye ryerekeranye nigihe cyo gukira cyangwa igipimo cy’imvune.Inzira nziza ya PRP yo kunoza imitsi muburyo bujyanye nubuvuzi iracyoroshye kandi ubushakashatsi bugomba gukorwa.
Gucunga ibice hamwe nubumwe
Nubwo hari ibimenyetso bifatika byemeza ikoreshwa rya PRP mu kunoza amagufwa, nta bwumvikane bw’amavuriro bwo gushyigikira ikoreshwa rya PRP mu rwego rwo guteza imbere gukira amagufwa.Ubushakashatsi buherutse gukorwa kuri PRP no kuvura kuvunika gukabije byagaragaje RCT eshatu zitagaragaje inyungu zijyanye n’ibisubizo byakozwe, mu gihe ubushakashatsi bubiri bwerekanye ibyavuye mu mavuriro.Ibyinshi mubigeragezo muri iri suzuma (6/8) byize ku mikorere ya PRP ifatanije n’ibindi binyabuzima (nka Mesenchymal stem selile na / cyangwa amagufwa) kugirango biteze imbere gukira kuvunika.
Ihame ryakazi rya plasma ikungahaye kuri platine (PRP) nugutanga ibintu bikura hamwe na cytokine bikubiye muri platine hamwe numubiri urenze urugero.Mubuvuzi bwa musculoskeletal, PRP nuburyo bwiza bwo kuvura bufite ibimenyetso byumutekano bigaragara.Nyamara, ibimenyetso byerekana ko ikora neza bivanze kandi biterwa cyane nibigize nibimenyetso byihariye.Ibigeragezo byinshi byujuje ubuziranenge kandi binini byamavuriro mugihe kizaza nibyingenzi kugirango duhindure ibitekerezo byacu kuri PRP.
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