Platelet Rich Plasma (PRP)
PRP ya ja hankali saboda ya ƙunshi nau'ikan abubuwan girma, kuma ana amfani dashi sosai a cikin aikin tiyata na maxillofacial, orthopedics, tiyata filastik, ilimin ido da sauran fannoni.A cikin 2006, Uebel et al.da farko yayi kokarin pretreat follicular raka'a da za a dasa tare da PRP kuma lura cewa idan aka kwatanta da yankin kula da fatar kan mutum, da PRP da aka yi dashen gashi yankin tsira 18.7 follicular raka'a / cm2, yayin da kula da kungiyar tsira 16.4 follicular raka'a./cm2, yawan adadin ya karu da 15.1%.Sabili da haka, ana hasashen cewa abubuwan haɓakar da platelets ke fitarwa na iya yin aiki a kan sel mai tushe na kumburin gashin gashi, haɓaka bambance-bambancen ƙwayoyin ƙwayoyin cuta da haɓaka samuwar sabbin hanyoyin jini.
A cikin 2011, Takikawa et al.amfani da saline na al'ada, PRP, heparin-protamine microparticles hade tare da PRP (PRP & D / P MPs) zuwa allurar subcutaneous na AGA marasa lafiya don saita sarrafawa.Sakamakon ya nuna cewa yanki na yanki na gashi a cikin ƙungiyar PRP da PRP & D / P MPs ya karu sosai, ƙwayoyin collagen da fibroblasts a cikin gashin gashi sun yadu a ƙarƙashin microscope, da jini a kusa da su. gashin gashi ya yawaita.
PRP yana da wadata a cikin abubuwan ci gaban platelet.Wadannan mahimman sunadaran suna tsara ƙaurawar salula, haɗe-haɗe, haɓakawa, da bambance-bambance, suna haɓaka haɓakar matrix extracellular, kuma yawancin abubuwan haɓaka suna haɓaka haɓakar gashi: abubuwan haɓakawa a cikin PRP suna hulɗa tare da gashin gashi.Haɗin ƙwanƙwasa ƙwanƙwasa yana haifar da yaduwar gashin gashi, yana haifar da raka'a na follicular, kuma yana inganta farfadowar gashi.Bugu da ƙari, zai iya kunna aikin kascade na ƙasa kuma yana inganta angiogenesis.
Matsayin PRP na yanzu a cikin Maganin AGA
Har yanzu babu wata yarjejeniya kan hanyar shirye-shirye da abubuwan haɓaka platelet na PRP;tsarin kulawa ya bambanta da adadin jiyya, lokacin tazara, lokacin ja da baya, hanyar allura, da ko ana amfani da magungunan hade.
Mapar et al.sun hada da 17 maza marasa lafiya tare da mataki IV zuwa VI (Hamilton-Norwood staging method), kuma sakamakon ya nuna babu bambanci tsakanin PRP da placebo injections, amma binciken kawai an gudanar da allura 2, kuma adadin jiyya ya yi kadan.Sakamako a bude suke don tambaya.;
Gkini et al sun gano cewa marasa lafiya da ƙananan matakan sun nuna mafi girma ga maganin PRP;Qu et al ya tabbatar da wannan ra'ayi, wanda ya haɗa da maza 51 da 42 mata marasa lafiya tare da mataki II-V a cikin maza da I a cikin mata ~ Stage III (tsari shine Hamilton-Norwood da Ludwig staging method), sakamakon ya nuna cewa PRP magani yana da. bambance-bambance masu mahimmanci a cikin marasa lafiya tare da matakai daban-daban na maza da mata, amma tasiri na ƙananan matakai da matsayi mafi girma ya fi kyau, don haka masu bincike sun ba da shawarar II, Stage III maza marasa lafiya da mataki na mata marasa lafiya tare da PRP.
Factor Ingantacciyar Haɓakawa
Bambance-bambance a cikin hanyoyin shirye-shiryen PRP a cikin kowane binciken ya haifar da nau'ikan wadatuwar PRP daban-daban a cikin kowane binciken, yawancin waɗanda aka tattara su tsakanin sau 2 zuwa 6.Balaguron Platelet yana fitar da adadin abubuwan haɓaka mai yawa, yana daidaita ƙaura ta tantanin halitta, haɗewa, haɓakawa da bambance-bambance, yana haɓaka haɓakar ƙwayar gashi, jijiyar nama, kuma yana haɓaka tarin matrix extracellular.A lokaci guda, ana ɗaukar tsarin microneedling da ƙarancin kuzarin laser a matsayin Yana haifar da lalacewar nama mai sarrafawa kuma yana haɓaka tsarin lalata platelet na halitta, wanda ke ƙayyade ingancin samfurin PRP ya dogara da ayyukan ilimin halitta.Saboda haka, yana da mahimmanci don bincika ingantaccen taro na PRP.Wasu nazarin sun yi imanin cewa PRP tare da ninki na haɓakawa na sau 1-3 ya fi tasiri fiye da girman haɓaka, amma Ayatollahi et al.An yi amfani da PRP tare da haɓakar haɓakawa na sau 1.6 don magani, kuma sakamakon ya nuna cewa maganin marasa lafiya na AGA ba shi da amfani, kuma sun yi imanin cewa PRP Ƙaddamar da hankali ya kamata ya zama 4 ~ 7 sau.
Yawan Jiyya, Lokacin Tazarar da Lokacin Jawowa
Nazarin Mapar et al.da Puig et al.duka biyu sun sami sakamako mara kyau.Yawan jiyya na PRP a cikin waɗannan ka'idojin binciken guda biyu shine sau 1 da 2, bi da bi, waɗanda suka kasance ƙasa da sauran karatun (mafi yawa sau 3-6).Picard et al.sun gano cewa tasirin PRP ya kai kololuwar bayan jiyya na 3 zuwa 5, don haka sun yi imanin cewa fiye da jiyya 3 na iya zama dole don inganta alamun asarar gashi.
Binciken Gupta da Carviel ya gano cewa yawancin binciken da ake ciki yana da tazarar jiyya na wata 1, kuma saboda ƙayyadaddun adadin karatu, sakamakon jiyya tare da allurar PRP na wata-wata ba a kwatanta shi da sauran mitoci na allura, kamar allurar PRP na mako-mako.
Wani bincike da Hausauer da Jones [20] suka yi ya nuna cewa, batutuwan da aka yi musu alluran wata-wata sun sami ingantuwar adadin gashi idan aka kwatanta da yawan alluran kowane wata 3 (P<0.001);Schiavone et al.[21] ya kammala cewa, Dole ne a sake maimaita magani 10 zuwa watanni 12 bayan ƙarshen aikin jiyya;Al'ummai et al.ya biyo baya har tsawon shekaru 2, mafi tsayin lokaci a cikin duk binciken, kuma ya gano cewa wasu marasa lafiya sun sake dawowa a cikin watanni 12 (4/20 lokuta), kuma a cikin marasa lafiya 16 Alamun sun fi bayyana a cikin watanni.
A cikin binciken Sclafani, an gano cewa tasirin marasa lafiya ya ragu sosai watanni 4 bayan ƙarshen aikin jiyya.Picard et al.koma ga sakamakon kuma ya ba da shawarar magani mai dacewa: bayan tazara na al'ada na 3 jiyya na wata 1, magani ya kamata a yi kowane sau 3.Magani mai tsanani na wata-wata.Duk da haka, Sclafani bai bayyana adadin wadatar platelet na shirye-shiryen da aka yi amfani da su a cikin tsarin jiyya ba.A cikin wannan binciken, an shirya 8-9 ml na shirye-shiryen fibrin-arziƙin platelet daga 18 ml na jini na gefe (an ƙara PRP da aka cire a cikin bututun injin CaCl2, kuma an sanya manne fibrin a cikin manne fibrin. allura kafin samuwar). , Mun yi imanin cewa yawan haɓakar platelet a cikin wannan shiri na iya zama da nisa sosai, kuma ana buƙatar ƙarin shaida don tallafawa.
Hanyar allura
Yawancin hanyoyin allura sune alluran intradermal da allurar subcutaneous.Masu binciken sun tattauna tasirin hanyar gudanarwa akan tasirin magani.Gupta da Carviel sun ba da shawarar allurar subcutaneous.Wasu masu bincike suna amfani da allurar intradermal.Intradermal allurar na iya jinkirta shigar da PRP cikin jini, rage yawan adadin kuzari, tsawaita lokacin aikin gida, da haɓaka haɓakar dermis don haɓaka haɓakar gashi.kuma zurfin ba daya bane.Muna ba da shawarar cewa ya kamata a yi amfani da dabarar allurar Nappage sosai yayin yin alluran intradermal don kawar da tasirin bambance-bambancen allura, kuma muna ba da shawarar cewa marasa lafiya su yi gajeriyar gashin kansu don lura da alkiblar gashin, kuma su daidaita kusurwar allurar yadda ya dace daidai da ta. jagorar girma ta yadda titin allura zai iya kaiwa a kusa da gashin gashi, ta haka yana kara yawan PRP na gida a cikin gashin gashi.Waɗannan shawarwarin kan hanyoyin alluran don yin la'akari ne kawai, saboda babu wani binciken da ya kwatanta fa'idodi da rashin amfani da hanyoyin allura daban-daban.
Magungunan Haɗuwa
Jha et al.PRP da aka yi amfani da su tare da microneedling da 5% minoxidil hade far don nuna tasiri mai kyau a cikin duka dalilai na haƙiƙa da kuma kimanta kai na haƙuri.Har yanzu muna fuskantar ƙalubale wajen daidaita tsarin jiyya na PRP.Ko da yake yawancin nazarin suna amfani da hanyoyin ƙididdiga da ƙididdigewa don tantance haɓakar bayyanar cututtuka bayan jiyya, kamar ƙididdigan gashi mai ƙarewa, ƙididdige gashin vellus, adadin gashi, yawa, kauri, da dai sauransu, hanyoyin tantancewa sun bambanta sosai;Bugu da ƙari, shirye-shiryen PRP Babu daidaitattun daidaito dangane da hanya, ƙara kunnawa, lokacin centrifugation da sauri, ƙaddamarwar platelet, da dai sauransu;tsarin kulawa ya bambanta da adadin jiyya, lokacin tazara, lokacin ja da baya, hanyar allura, da ko haɗa magunguna;zaɓin samfurori a cikin binciken ba Stratification ta shekaru, jinsi, da digiri na alopecia ya kara daɗaɗɗen kimanta tasirin maganin PRP ba.A nan gaba, ana buƙatar ƙarin manyan-samfurin nazarin kamun kai don fayyace sigogin jiyya daban-daban, kuma za a iya inganta ingantaccen bincike na abubuwan kamar shekarun haƙuri, jinsi, da matakin asarar gashi a hankali.
(Ana sake buga abubuwan da ke cikin wannan labarin, kuma ba mu bayar da garantin bayyananne ko bayyananniyar garanti don daidaito, amintacce ko cikar abubuwan da ke cikin wannan labarin ba, kuma ba mu da alhakin ra'ayoyin wannan labarin, da fatan za a fahimta.)
Lokacin aikawa: Agusta-02-2022