Plasma ikungahaye kuri plasma (PRP) kuri ubu ikoreshwa cyane mubuvuzi butandukanye.Mu myaka yashize, ikoreshwa rya PRP muri orthopedie ryarushijeho kwitabwaho, kandi ikoreshwa mubikorwa bitandukanye nko kuvugurura ingirangingo, gukira ibikomere, gusana inkovu, kubaga plastique n'ubwiza byabaye byinshi cyane.Mu nomero yuyu munsi, tuzasesengura ibinyabuzima bya PRP, uburyo bwibikorwa, hamwe nu byiciro bya PRP kugirango twumve neza ibishobora gukorwa nibidakwiye gukorwa na PRP.
Amateka ya PRP
PRP izwi kandi nka plasma ikungahaye kuri platine (PRP), ibintu bikura bikungahaye kuri platine (GFS) na matrike ikungahaye kuri fibrine (PRF).Igitekerezo no gusobanura PRP byatangiriye mubijyanye na hematologiya.Abahanga mu kuvura indwara z’imiti bahimbye ijambo PRP mu myaka ya za 70, cyane cyane mu kuvura abarwayi bafite trombocytopenia bakuramo platine bakongeraho no guterwa.
Nyuma yimyaka icumi, PRP yatangiye gukoreshwa mububiko bwa maxillofacial nka PRF.Fibrin ifite imiti ifata hamwe na homeostatike, kandi PRP ifite imiti igabanya ubukana itera ikwirakwizwa ry'uturemangingo.Nyuma, PRP yatangiye gukoreshwa cyane murwego rwimitsi ya siporo yimvune ya siporo kandi igera ku ngaruka nziza zo kuvura.Kubera ko intego yo kuvura ahanini ari abakinnyi babigize umwuga, yakunze kwitabwaho cyane mubitangazamakuru kandi yagiye ikoreshwa cyane mubuvuzi bwa siporo.Nyuma yaho, PRP yazamuwe buhoro buhoro mu bijyanye n’amagufwa, kubaga, kubaga abana, kubagore, urologiya, kubaga plastique no kwisiga hamwe n’amaso.
Ibinyabuzima bya platine
Utugingo ngengabuzima twa periferique turimo uturemangingo tw'amaraso atukura, selile yera na platine, byose bikomoka kuri selile pluripotent stem selile ishobora gutandukana mumirongo itandukanye.Iyi mirongo ya selile irimo selile prursor ishobora kugabana no gukura.Plateletes ikomoka kumagufa kandi ni selile zifite disikuru zifite ubunini butandukanye, hamwe na diameter ya metero zigera kuri 2 mm, kandi ni selile nkeya.Platelet ibara mumaraso asanzwe azenguruka kuva 150.000 kugeza 400.000 kuri microliter.Amashanyarazi arimo granules nyinshi zingenzi, murizo harimo eshatu zingenzi: granules yuzuye, o-granules, na lysosomes.Buri platine ifite ibice 50-80.
Ibisobanuro bya PRP
Mu gusoza, PRP nigicuruzwa cyibinyabuzima, ni plasma yibanze hamwe na platine yibanze cyane kuruta iyo mumaraso ya peripheri.PRP ntabwo ikubiyemo gusa urwego rwo hejuru rwa platine, ariko kandi ikubiyemo ibintu byose bya coagulation, harimo urukurikirane rw'ibintu bikura, chemokine, cytokine na proteyine za plasma.
PRP ikurwa mumaraso ya peripheri ikururwa nuburyo butandukanye bwo gutegura laboratoire.Nyuma yo kwitegura, ukurikije gradients zitandukanye, selile yamaraso itukura, PRP, na PPP mubice bigize amaraso bitandukanijwe bikurikiranye.Muri PRP, usibye kuba mwinshi wa platine, birakenewe kandi gusuzuma niba irimo leukocytes kandi niba ikora.Ukurikije izi ngingo, ubwoko bwa PRP butandukanye bukwiranye nuburyo butandukanye bw’indwara.
Ibikoresho byinshi byubucuruzi birahari kuri ubu bishobora koroshya gutegura PRP.Ibi bikoresho bya PRP mubisanzwe bitanga inshuro 2-5 hejuru ya PRP platelet yibanze.Nubwo umuntu ashobora gutekereza ko uko platine yibanda cyane hamwe nubwinshi bwikura ryikura, ningaruka nziza yo kuvura igomba kuba nziza, ibi ntabwo byashizweho, kandi inshuro 3-5 kwibanda mubisanzwe bikwiye.
Ibikoresho byubucuruzi bifite ibyiza byo kuba bisanzwe kandi byoroshye, ariko bifite aho bigarukira.Bamwe ntibashobora gukuraho umwanda wihariye, kandi imyiteguro ya PRP ntabwo iri murwego rwo kwibanda.Ahanini, ibikoresho byose byubucuruzi ntibishobora gutegurwa kugiti cyawe kandi neza.Iki nikibazo kinini hamwe nibikoresho bisanzwe.Kugeza ubu, gusa tekinoroji yo gutegura laboratoire yihariye irashobora gukenera abarwayi bose bakeneye, ifite ibisabwa cyane mubuhanga bwa laboratoire.
Ibyiciro bya PRP
Muri 2006, Everts et al yatanze igitekerezo cya PRP ikungahaye kuri leukocyte.Kubwibyo, PRP irashobora kugabanywa muburyo bubiri ukurikije umubare wa leukocytes urimo: PRP ifite leukocytes mbi na PRP hamwe na leukocytes ikungahaye.
1. ibikomere, gusana amagufwa, kudahuza, gutwika amagufwa hamwe nubundi buvuzi.
2) plasma ikungahaye kuri platine idafite cyangwa ifite ubukana buke bwa leukocytes yitwa P-PRP (Plasma-Plasma ikungahaye, idafite selile itukura), ikoreshwa cyane cyane mu gukomeretsa siporo n'indwara zangirika, harimo ibikomere bya menisque, ligamente ndetse no gukomeretsa imitsi. , inkokora ya tennis, ivi Arthritis, kwangirika kwa karitsiye, disiki ya disiki nizindi ndwara.
3) Nyuma yamazi PRP ikora na trombine cyangwa calcium, hashobora kubaho geli nka PRP cyangwa PRF.(Bwa mbere byateguwe na Dohan n'abandi mu Bufaransa)
Muri 2009, Dohan Ehrenfest n'abandi.yatanze ibyiciro 4 bishingiye kubihari cyangwa bidahari bigize selile (nka leukocytes) n'imiterere ya fibrin:
1) PRP itanduye cyangwa leukocyte-ikennye PRP: PRP yateguwe ntigira leukocytes, kandi nibirimo fibrin nyuma yo gukora ni bike.
2) Amaraso yera na PRP: arimo selile yera, kandi ibirimo fibrin nyuma yo gukora ni bike.
3) PRF itanduye cyangwa leukocyte-ikennye PRF: imyiteguro ntabwo irimo leukocytes kandi ifite fibrine yuzuye.Ibicuruzwa biza muburyo bwa geles ikora kandi ntibishobora gukoreshwa mugutera inshinge.
4) Fibrin ikungahaye kuri Leukocyte na PRF: irimo leukocytes na fibrine yuzuye.
Muri 2016, Magalon n'abandi.yatanze icyifuzo cya DEPA (ikigereranyo, imikorere, ubuziranenge, gukora), yibanda kubibara bya PRP, ubuziranenge bwibicuruzwa, no gukora platine.
1. Igipimo cyo gutera inshinge: Kubara mugwiza ubunini bwa platel nubunini bwa platine.Ukurikije igipimo cyatewe (muri miliyari cyangwa miriyoni za platine), irashobora kugabanywamo (a) ikinini kinini:> miliyari 5;(b) igipimo kinini: kuva kuri miliyari 3 kugeza kuri miliyari 5;(c) ikigereranyo giciriritse: kuva kuri miliyari 1 kugeza kuri miliyari 3;(d) igipimo gito: munsi ya miliyari 1.
2. Uburyo bwiza bwo kwitegura: ijanisha rya platine yakusanyirijwe mumaraso.(a) Gukoresha ibikoresho bihanitse: igipimo cyo kugarura platelet> 90%;(b) ibikoresho biciriritse bikora neza: igipimo cyo kugarura platine hagati ya 70-90%;(c) ibikoresho bike bikora neza: igipimo cyo gukira hagati ya 30-70%;(d) Ibikoresho bikora neza ni bike cyane: igipimo cyo gukira kiri munsi ya 30%.
3. PRP isukuye: Ifitanye isano ugereranije na platine, selile yera na selile zitukura muri PRP.Turabisobanura nka (a) PRP yera cyane:> 90% platine ugereranije na erythrocytes na leukocytes muri PRP;(b) PRP yuzuye: platine 70-90%;(c) PRP itandukanye:% platine hagati ya 30-70%;(d) Amaraso yose PRP: ijanisha rya platine muri PRP ntiri munsi ya 30%.
4. Igikorwa cyo gukora: niba ugomba gukora platine hamwe nibintu bya coagulation exogenous, nka autologique trombin cyangwa calcium chloride.
(Ibiri muri iyi ngingo birasubirwamo.)
Igihe cyoherejwe: Gicurasi-16-2022