Platelet Rich Plasma (PRP)
Epicondylitis na waje na humeral cuta ne na asibiti na yau da kullun wanda ke da zafi a gefen gwiwar gwiwar hannu.Yana da wayo kuma mai sauƙin sake dawowa, wanda zai iya haifar da ciwon gaba da ƙarfin wuyan hannu, kuma yana tasiri sosai ga rayuwar yau da kullum da aikin marasa lafiya.Akwai hanyoyi daban-daban na magani don epicondylitis na gefe na humerus, tare da tasiri daban-daban.Babu daidaitattun hanyar magani a halin yanzu.Platelet Rich plasma (PRP) yana da tasiri mai kyau akan gyaran kashi da tendon, kuma an yi amfani dashi sosai don magance humeral epicondylitis na waje.
Dangane da tsananin ƙimar amincewar zaɓe, an kasu kashi uku:
An yarda 100% cikakke (Level I)
90% ~ 99% an yarda da juna (Mataki na II)
70% ~ 89% sun yi gaba ɗaya (Mataki na III)
Manufar PRP da Abubuwan Bukatun Sinadaran Aikace-aikace
(1) Ra'ayi: PRP wani nau'in plasma ne.Matsalolin platelet ɗin sa ya fi na asali.Ya ƙunshi babban adadin abubuwan haɓaka da cytokines, waɗanda zasu iya inganta ingantaccen gyaran nama da warkarwa.
(2) Abubuwan bukatu don kayan aikin da aka shafa:
① Tsarin platelet na PRP a cikin maganin humeral epicondylitis na waje yana bada shawarar zama (1000 ~ 1500) × 109 / L (sau 3-5 na ƙaddamarwa na asali);
② Fi son amfani da PRP mai wadatar farin jini;
③ Ba a ba da shawarar kunna PRP mai kunnawa ba.
(Ƙarfin da aka ba da shawarar: Mataki na I; matakin shaidar adabi: A1)
Ingancin Kula da Fasahar Shiryewar PRP
(1) Bukatun cancantar ma'aikata: Shirye-shiryen da amfani da PRP yakamata ma'aikatan kiwon lafiya su gudanar da su tare da cancantar likitoci masu lasisi, ma'aikatan jinya masu lasisi da sauran ma'aikatan kiwon lafiya masu dacewa, kuma yakamata a aiwatar da su bayan horon aikin tiyata mai tsauri da horon shirye-shiryen PRP.
(2) Kayan aiki: Za a shirya PRP ta amfani da tsarin shirye-shiryen na'urorin kiwon lafiya na Class III da aka yarda.
(3) Yanayin aiki: Maganin PRP wani aiki ne mai ban tsoro, kuma ana ba da shawarar yin shiri da amfani da shi a cikin ɗakin kulawa na musamman ko ɗakin aiki wanda ya dace da buƙatun kula da hankali.
(Ƙarfin da aka ba da shawarar: Mataki na I; matakin shaidar adabi: Level E)
Alamomi da Contraindications na PRP
(1) Alamu:
① Maganin PRP ba shi da buƙatu masu mahimmanci don nau'in aikin jama'a, kuma ana iya la'akari da za a gudanar da shi a cikin marasa lafiya da buƙatu masu yawa (kamar taron wasanni) da ƙananan buƙata (kamar ma'aikatan ofis, ma'aikatan iyali, da dai sauransu. );
② Masu ciki da masu shayarwa na iya amfani da PRP a hankali lokacin da maganin jiki ba shi da tasiri;
③ Ya kamata a yi la'akari da PRP lokacin da maganin rashin aiki na humeral epicondylitis ba shi da tasiri fiye da watanni 3;
④ Bayan maganin PRP yana da tasiri, marasa lafiya da sake dawowa zasu iya yin la'akari da sake amfani da shi;
⑤ Ana iya amfani da PRP watanni 3 bayan allurar steroid;
⑥ Ana iya amfani da PRP don magance cututtukan tendon extensor da tsagewar jijiya.
(2) Cikakken contraindications: ① thrombocytopenia;② M ƙari ko kamuwa da cuta.
(3) Matsalolin dangi: ① marasa lafiya tare da rashin daidaituwa na jini da kuma shan magungunan anticoagulant;② Anemia, haemoglobin <100 g/L.
(Ƙarfin da aka ba da shawarar: Level II; matakin shaidar adabi: A1)
Maganin allurar PRP
Lokacin amfani da allurar PRP don magance epicondylitis na gefe na humerus, ana ba da shawarar yin amfani da jagorar duban dan tayi.Ana ba da shawarar yin allurar 1 ~ 3 ml na PRP a kusa da wurin da aka ji rauni.Allura guda ɗaya ta isa, gabaɗaya baya wuce sau 3, kuma tazarar allurar shine makonni 2 ~ 4.
(Ƙarfin da aka ba da shawarar: Mataki na I; matakin shaidar adabi: A1)
Aikace-aikacen PRP a cikin Aiki
Yi amfani da PRP nan da nan bayan sharewa ko suturing rauni yayin tiyata;Siffofin da aka yi amfani da su sun haɗa da PRP ko haɗe tare da gel mai arziki na platelet (PRF);Ana iya allurar PRP a cikin haɗin gwiwa na kashin tendon, wurin mayar da hankali kan tendon a wurare da yawa, kuma ana iya amfani da PRF don cike yankin lahani na tendon da kuma rufe saman tendon.Matsakaicin adadin shine 1-5 ml.Ba a ba da shawarar yin allurar PRP a cikin rami na haɗin gwiwa ba.
(Ƙarfin da aka ba da shawarar: Level II; matakin shaidar adabi: Level E)
Abubuwan da suka danganci PRP
(1) Gudanar da ciwo: Bayan maganin PRP na waje na humeral epicondylitis, acetaminophen (paracetamol) da raunin opioids za a iya la'akari da su don rage zafi na marasa lafiya.
(2) Ma'auni don mummunan halayen: ciwo mai tsanani, hematoma, kamuwa da cuta, haɗin gwiwa da sauran yanayi bayan jiyya na PRP ya kamata a yi aiki da hankali sosai, kuma ya kamata a tsara shirye-shiryen jiyya masu tasiri bayan inganta dakin gwaje-gwaje da bincike na hoto da kimantawa.
(3) Sadarwar majinyacin likita da ilimin kiwon lafiya: Kafin da bayan jiyya na PRP, cikakken aiwatar da sadarwar likita da haƙuri da ilimin kiwon lafiya, kuma sanya hannu kan takardar yarda da sanarwa.
(4) Tsarin gyaran gyare-gyare: ba a buƙatar gyarawa bayan maganin allurar PRP, kuma ayyukan da ke haifar da ciwo ya kamata a kauce masa a cikin 48 hours bayan jiyya.Ana iya jujjuya gwiwar hannu da tsawaita sa'o'i 48 bayan haka.Bayan tiyata tare da PRP, ya kamata a ba da fifiko ga shirin gyaran aikin bayan tiyata.
(Ƙarfin da aka ba da shawarar: Mataki na I; matakin shaidar adabi: Level E)
Magana:Chin J Trauma, Agusta 2022, Vol.38, No. 8, Jarida na Raɗaɗi na Sinanci, Agusta 2022
(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: Nuwamba-28-2022