Aikace-aikacen naPlatelet Rich Plasma (PRP)a Filaye Daban-daban da Yadda Ake Zaɓan PRP Mawadata a cikin Farin Jini (L-PRP) da PRP Talakawa a cikin Farin Jini (P-PRP)
Binciken da aka yi kwanan nan na babban adadin shaida mai inganci yana goyan bayan yin amfani da allurar LR-PRP don maganin Epicondylitis na gefe da LP-PRP don maganin gwiwa na Articular kashi.Matsakaicin shaida mai inganci yana goyan bayan yin amfani da allurar LR-PRP don tendinosis na patellar da kuma allurar PRP don Plantar fasciitis da kuma zafin wurin mai ba da gudummawa a cikin dasawa na patellar BTB ACL sake ginawa.Babu isassun shaidar da za ta ba da shawarar PRP akai-akai don rotator cuff tendinosis, hip Articular kashi osteoarthritis ko babban idon ƙafa.Shaidu na yanzu sun nuna cewa PRP ba ta da inganci wajen magance cututtukan jijiya na Achilles, raunin tsoka, karaya mai tsanani ko haɗin kai, ingantaccen aikin gyaran rotator cuff, gyaran gyare-gyaren Achilles, da sake gina ACL.
Platelet Rich Plasma (PRP) shiri ne na plasma na ɗan adam mai sarrafa kansa wanda ke ƙara yawan ƙwayar platelet ta hanyar sanya adadin jinin mara lafiya mai yawa.Platelets a cikin α Particles (TGF- β 1. PDGF, bFGF, VEGF, EGF, IGF-1) sun ƙunshi adadin abubuwan haɓaka da yawa da masu shiga tsakani, waɗanda aka mayar da hankali ta hanyar tsarin centrifugation don saki suprabiological adadin waɗannan abubuwan girma da cytokines. zuwa wurin da aka ji rauni da haɓaka tsarin warkarwa na halitta.
Matsakaicin adadin platelet na yau da kullun shine 150000 zuwa 350000/ μ L. An nuna haɓakar warkarwa na kashi da taushi nama, tare da tattarawar platelet masu yawa har zuwa 1000000 / μ L. Yana wakiltar haɓakar ninki uku zuwa biyar a cikin abubuwan haɓaka.Shirye-shiryen PRP yawanci ana ƙara rarraba su zuwa PRP mai wadata a cikin farin jini (LR-PRP), wanda aka bayyana a matsayin maida hankali neutrophil sama da tushe, da PRP matalauta a cikin fararen jini (LP-PRP), wanda aka ayyana a matsayin farin jini (neutrophil) maida hankali a ƙasa tushe. .
Maganin Raunin Tendon
Yin amfani da PRP don maganin ciwon jijiyoyi ko cututtuka na jijiyoyi ya zama batun nazarin karatu da yawa, kuma yawancin cytokines da aka samu a cikin PRP suna shiga cikin hanyoyin siginar da ke faruwa a lokacin matakan warkarwa na kumburi, yaduwar kwayar halitta, da kuma sake gyara nama na baya.PRP kuma na iya inganta samuwar sabbin hanyoyin jini, wanda zai iya ƙara yawan samar da jini da abinci mai gina jiki da ake buƙata don sake farfado da ƙwayoyin da suka lalace, da kuma kawo sabbin ƙwayoyin cuta da cire tarkace daga nama mai lalacewa.Wadannan hanyoyin aiwatarwa na iya zama masu dacewa musamman ga tendinosis na yau da kullun, inda yanayin nazarin halittu ba su dace da warkar da nama ba.Wani bita na yau da kullun da meta-bincike ya kammala cewa allurar PRP na iya magance tendinosis na alama yadda ya kamata.
Lateral Epicondylitis
An ƙididdige PRP azaman zaɓi mai yuwuwar magani ga marasa lafiya tare da Epicondylitis na gefe waɗanda ba su da tasiri a cikin ilimin motsa jiki.A cikin mafi girma irin wannan binciken, Mishra et al.A cikin binciken Cohort mai zuwa, marasa lafiya 230 waɗanda ba su amsa kulawar Conservative na Epicondylitis na gefe na aƙalla watanni 3 an kimanta su.Mai haƙuri ya karɓi magani na LR-PRP, kuma a cikin makonni 24, allurar LR-PRP tana da alaƙa da haɓakar haɓakar zafi idan aka kwatanta da ƙungiyar kulawa (71.5% vs 56.1%, P = 0.019), kazalika da raguwa mai yawa a cikin kashi dari na marasa lafiya suna ba da rahoton raɗaɗin taushin gwiwar gwiwar hannu (29.1% vs 54.0%, P=0.009).A makonni 24, marasa lafiya da aka yi musu magani tare da LR-PRP sun nuna mahimmancin asibiti da haɓakar ƙididdiga idan aka kwatanta da allurar sarrafa aiki na maganin sa barci na gida.
Nazarin da suka gabata sun nuna cewa LR-PRP kuma na iya ba da taimako mai ɗorewa don alamun Epicondylitis na gefe idan aka kwatanta da allurar Corticosteroid, don haka yana da tasirin warkewa mai dorewa.PRP alama hanya ce mai tasiri don maganin Epicondylitis na waje.Babban shaida mai inganci yana nuna inganci na ɗan gajeren lokaci da na dogon lokaci.Mafi kyawun shaidar da aka samu yana nuna a fili cewa LR-PRP yakamata ya zama hanyar jiyya ta farko.
Patellar Tendinosis
Binciken da aka sarrafa bazuwar yana goyan bayan amfani da LR-PRP don kula da cututtukan jijiya mai ɗorewa.Draco et al.An kimanta marasa lafiya ashirin da uku tare da tendinosis na patellar waɗanda suka gaza gudanar da Conservative.An ba marasa lafiya ba da gangan don karɓar busassun busassun busassun busassun kowane mutum na duban dan tayi ko allura na LR-PRP, kuma an bi su don> makonni 26.Ta hanyar ma'auni na VISA-P, ƙungiyar kulawa ta PRP ta nuna gagarumin ci gaba a cikin alamun bayyanar cututtuka a cikin makonni 12 (P = 0.02), amma bambancin ba shi da mahimmanci a> 26 makonni (P = 0.66), yana nuna cewa amfanin PRP don cututtukan cututtuka na patellar. na iya zama haɓakawa a farkon bayyanar cututtuka.Vitrano et al.An kuma bayar da rahoton fa'idodin allurar PRP a cikin kula da cututtukan jijiya mai kau da kai idan aka kwatanta da mayar da hankali kan jiyya na girgiza girgizar kasa (ECSWT).Duk da cewa babu wani gagarumin bambanci tsakanin kungiyoyin a tsawon watanni 2, kungiyar PRP ta nuna ci gaban kididdiga a cikin watanni 6 da 12 na bin diddigin, wanda ya zarce ECSWT kamar yadda aka auna ta VISA-P da VAS, da kuma auna Blazina. sikelin ma'auni a watanni 12 na biyo baya (duk P <0.05).
Wannan bita yana kimanta wallafe-wallafen asibiti na yanzu game da yin amfani da plasma mai arzikin platelet (PRP), ciki har da leukocytes mai arziki PRP (LR PRP) da leukocyte matalauta PRP (LP PRP), don haɓaka shawarwarin tushen shaida don cututtuka daban-daban na musculoskeletal.
Binciken da aka yi kwanan nan na babban adadin shaida mai inganci yana goyan bayan yin amfani da allurar LR-PRP don maganin Epicondylitis na gefe da LP-PRP don maganin gwiwa na Articular kashi.Matsakaicin shaida mai inganci yana goyan bayan yin amfani da allurar LR-PRP don tendinosis na patellar da kuma allurar PRP don Plantar fasciitis da kuma zafin wurin mai ba da gudummawa a cikin dasawa na patellar BTB ACL sake ginawa.Babu isassun shaidar da za ta ba da shawarar PRP akai-akai don rotator cuff tendinosis, hip Articular kashi osteoarthritis ko babban idon ƙafa.Shaidu na yanzu sun nuna cewa PRP ba ta da inganci wajen magance cututtukan jijiya na Achilles, raunin tsoka, karaya mai tsanani ko haɗin kai, ingantaccen aikin gyaran rotator cuff, gyaran gyare-gyaren Achilles, da sake gina ACL.
Gabatarwa
Platelet Rich Plasma (PRP) shiri ne na plasma na ɗan adam mai sarrafa kansa wanda ke ƙara yawan ƙwayar platelet ta hanyar sanya adadin jinin mara lafiya mai yawa.Platelets a cikin α Particles (TGF- β 1. PDGF, bFGF, VEGF, EGF, IGF-1) sun ƙunshi adadin abubuwan haɓaka da yawa da masu shiga tsakani, waɗanda aka mayar da hankali ta hanyar tsarin centrifugation don saki suprabiological adadin waɗannan abubuwan girma da cytokines. zuwa wurin da aka ji rauni da haɓaka tsarin warkarwa na halitta.Matsakaicin adadin platelet na yau da kullun shine 150000 zuwa 350000/ μ L. An nuna haɓakar warkarwa na kashi da taushi nama, tare da tattarawar platelet masu yawa har zuwa 1000000 / μ L. Yana wakiltar haɓakar ninki uku zuwa biyar a cikin abubuwan haɓaka.
Shirye-shiryen PRP yawanci ana ƙara rarraba su zuwa shirye-shiryen PRP masu wadata a cikin farin jini (LR-PRP), wanda aka bayyana a matsayin ƙididdigar neutrophil sama da tushe, da shirye-shiryen PRP maras kyau a cikin farin jini (LP-PRP), wanda aka bayyana a matsayin adadin farin jini (neutrophil). kasa asali.
Shiri da Abun da ke ciki
Babu wata yarjejeniya ta gaba ɗaya akan mafi kyawun tsarin PRP don tattara abubuwan haɗin jini, kuma a halin yanzu akwai tsarin PRP na kasuwanci daban-daban a kasuwa.Saboda haka, bisa ga tsarin kasuwanci daban-daban, akwai bambance-bambance a cikin ka'idojin tattara PRP da halaye na shirye-shirye, suna ba kowane tsarin PRP halaye na musamman.Tsarin kasuwanci yawanci ya bambanta a cikin ingancin kama platelet, hanyar rabuwa (mataki ɗaya ko mataki biyu), saurin centrifugation, da nau'in tsarin tarin tarin bututu da aiki.Yawancin lokaci, kafin centrifugation, ana tattara dukan jini kuma a haɗe shi da abubuwan da ke hana jini jini don raba kwayoyin jinin jini (RBCs) daga plasta-malauci (PPP) da "erythrocyte sedimentation brown Layer" wanda ke dauke da platelets da fararen jini.Ana amfani da hanyoyi daban-daban don ware platelets, waɗanda za a iya yin allurar kai tsaye a cikin jikin majiyyaci ko kuma "a kunna" ta hanyar ƙara calcium chloride ko thrombin, wanda zai haifar da raguwar platelet da sakin abubuwan girma.Abubuwa guda biyu na ƙayyadaddun haƙuri, ciki har da gudanar da magunguna da hanyoyin shirye-shiryen tsarin kasuwanci, suna shafar ƙayyadaddun tsarin PRP, da kuma wannan canji a cikin abubuwan da aka tsara na PRP a cikin bayanin tasirin asibiti na PRP.
Fahimtarmu ta yanzu ita ce PRP tare da ƙara yawan adadin farin jini, wato PRP mai arziki a cikin farin jini (neutrophils), yana da alaƙa da tasirin kumburi.Ƙara yawan ƙwayar jinin jini (neutrophils) a cikin LR-PRP kuma yana da alaƙa da karuwa a cikin cytokines na catabolic, irin su interleukin-1 β, Tumor Necrosis Factor α da metalloproteinases, wanda zai iya haifar da cytokines anabolic da ke cikin platelets.Sakamakon asibiti da tasirin salula na waɗannan nau'ikan PRP daban-daban, gami da abun ciki na farin jini, har yanzu ana bayyana su.Wannan bita yana nufin kimanta mafi kyawun shaidar inganci da ake samu don alamun asibiti daban-daban na ƙirar PRP daban-daban.
Ciwon Achilles Tendon
Yawancin gwaje-gwaje na tarihi sun kasa nuna bambance-bambance a cikin sakamakon asibiti tsakanin PRP da placebo kadai a cikin maganin Achilles tendinitis.Gwajin da aka sarrafa bazuwar kwanan nan idan aka kwatanta jerin allurar LP-PRP guda huɗu tare da allurar placebo hade tare da shirin gyaran kaya na centrifugal.Idan aka kwatanta da ƙungiyar placebo, ƙungiyar kula da PRP ta nuna ci gaba mai mahimmanci a cikin ciwo, aiki, da ƙididdiga na aiki a kowane lokaci a duk tsawon lokacin 6-watanni.Har ila yau, binciken ya gano cewa allura mai girma guda ɗaya (50 ml) na 0.5% Bupivacaine (10 ml), methylprednisolone (20 MG) da saline na jiki (40 ml) sun sami ci gaba daidai, amma idan aka yi la'akari da wannan magani, ya kamata a kula da shi. ra'ayi na ƙara haɗarin fashewar tendon bayan allurar steroid.
Rotator Cuff Tendinosis
Akwai ƴan karatun manyan matakai akan allurar PRP a cikin maganin marasa aikin tiyata na cututtukan jijiya na rotator cuff.Wasu binciken da aka buga sun kwatanta sakamakon asibiti na allurar subcromial na PRP tare da placebo da Corticosteroid, kuma babu wani binciken da ya kimanta allurar kai tsaye na PRP a cikin tendon kanta.Casey Buren et al.An gano cewa babu bambanci a cikin sakamakon sakamakon asibiti idan aka kwatanta da allurar saline na ilimin lissafi a karkashin kololuwar kafada.Duk da haka, gwajin gwajin da aka bazu ya gano cewa allura biyu na LR-PRP kowane mako hudu sun inganta jin zafi idan aka kwatanta da allurar placebo.Shams et al.Kwatankwacin haɓakawa na PRP na subacromial da allurar Corticosteroid tsakanin Xi'an Ontario RC index (WORI), alamar raunin raunin kafada (SPDI) da VAS ciwon kafada da gwajin Neer an ruwaito.
Ya zuwa yanzu, bincike ya nuna cewa allurar PRP a ƙarƙashin ƙafar ƙafar kafada yana da gagarumin ci gaba a cikin sakamakon da aka ruwaito na marasa lafiya tare da cututtukan cututtuka na rotator cuff.Sauran karatun da ke buƙatar dogon bibiya, gami da kimanta allurar kai tsaye na PRP cikin tendons.Wadannan alluran PRP an nuna su lafiya kuma suna iya zama madadin allurar Corticosteroid a cikin tendinosis rotator cuff.
Plantar Fasciitis
Yawancin gwajin sarrafawa da bazuwar an kimanta allurar PRP don fasciitis na Plantar na yau da kullun.Yiwuwar PRP azaman maganin allura na gida yana rage damuwa da ke da alaƙa da allurar Corticosteroid, kamar atrophy na pads na fashion ko fashewar fascia.Nazarin meta-biyu na baya-bayan nan sun kimanta kwatancen tsakanin allurar PRP da allurar Corticosteroid, kuma sun kammala cewa allurar PRP hanya ce mai yuwuwa ga allurar Corticosteroid dangane da inganci.Wasu bincike sun tabbatar da fifikon PRP.
Tiyata hade da PRP
Gyaran Hannun Kafada
Yawancin karatun asibiti da yawa sun kimanta amfani da samfuran PRP a cikin gyaran Arthroscopy na rotator cuff hawaye.Yawancin karatu sun yi nazari na musamman game da amfani da shirye-shiryen matrix na fibrin na platelet don haɓakawa (PRFM), yayin da wasu nazarin sun yi allurar PRP kai tsaye zuwa wurin gyarawa.Akwai mahimmin iri-iri a cikin tsarin PRP ko PRFM.An samo sakamakon haƙuri na haƙuri, kamar Jami'ar California, Los Angeles (UCLA), yarjejeniyar Amurka (sst), da ci gaban kafada, da kuma maƙarƙashiya bayanai kamar ƙarfin rotator cuff da ROM na kafada an tattara su don auna bambance-bambance a cikin sakamakon aiki.Yawancin nazarin mutum ya nuna ɗan bambanci a cikin matakan waɗannan sakamakon a cikin PRP idan aka kwatanta da gyaran gyare-gyare na mutum [kamar pads don gyaran gyare-gyare na Arthroscopy rotator cuff.Bugu da ƙari, babban bincike-bincike da nazari na baya-bayan nan sun tabbatar da cewa gyaran gyare-gyare na Arthroscopy na kafada [PRP] ba shi da wani amfani mai mahimmanci a cikin ƙwayar nono.Duk da haka, ƙayyadaddun bayanai sun nuna cewa yana da wani tasiri a rage rage ciwo na perioperative, wanda zai yiwu saboda abubuwan da ke da kariya na PRP.
Binciken ƙananan ƙungiyoyi ya nuna cewa a tsakiyar da ƙananan hawaye da aka yi amfani da su tare da gyaran gyare-gyare na Arthroscopy sau biyu, allurar PRP na iya rage yawan raguwa, don haka samun sakamako mafi kyau.Qiao et al.An gano cewa PRP na da fa'ida wajen rage yawan sake tsage hawaye masu matsakaici da manyan rotator cuff idan aka kwatanta da tiyata kadai.
Gwajin gwaje-gwaje na asibiti da aka bazu da kuma ƙididdigar ƙididdiga masu girma suna nuna rashin shaida don amfani da PRP da PRFM a matsayin ƙarfafawa don gyaran gyare-gyare na rotator cuff.Wasu ƙididdiga na ƙungiyoyi suna nuna cewa gyaran layi biyu na iya samun wasu fa'idodi don magance ƙananan ko matsakaicin hawaye.PRP na iya taimakawa nan da nan don rage jin zafi bayan aiki.
Gyaran Tendon Achilles
Binciken da aka yi na farko ya nuna cewa PRP yana da tasiri mai ban sha'awa akan inganta warkaswar rupture na Achilles.Duk da haka, shaidun da suka saba wa juna suna hana jujjuyawar PRP a matsayin ingantacciyar magani mai mahimmanci don tsagawar jijiyoyin Achilles a cikin mutane.Alal misali, a cikin binciken daya, tsarin tsarin da sakamakon aiki na marasa lafiya tare da raunin jijiya na Achilles da aka yi tare da kuma ba tare da PRP ba.Sabanin haka, Zou et al.A cikin binciken da aka tsara bazuwar, an ɗauki majinyata 36 waɗanda aka yi wa gyaran gyare-gyare mai tsauri na Achilles tare da ba tare da allurar ciki ta LR-PRP ba.Marasa lafiya a cikin ƙungiyar PRP suna da tsokoki na isokinetic mafi kyau a cikin watanni 3, kuma suna da SF-36 da Leppilahti mafi girma a cikin watanni 6 da 12, bi da bi (duk P <0.05).Bugu da ƙari, haɗin gwiwa na haɗin gwiwa na motsi a cikin ƙungiyar PRP kuma ya inganta sosai a kowane lokaci a 6, 12, da 24 watanni (P <0.001).Ko da yake ana buƙatar ƙarin ingantattun gwaje-gwaje na asibiti, yin allurar PRP a matsayin haɓakar tiyata don m gyaran jijiyar Achilles ba ze da amfani.
Tiyatar Jiki na Gaban Cruciate
Nasarar aikin tiyata na gaba (ACL) ya dogara ba kawai akan abubuwan fasaha ba (kamar sanya rami na rami da gyaran gyare-gyare), amma har ma akan warkar da kwayoyin halitta na ACL grafts.Binciken da aka yi game da amfani da PRP a cikin aikin tiyata na ACL yana mayar da hankali kan matakai uku na nazarin halittu: (1) haɗakar da haɗin gwiwa tsakanin jijiyoyi da tibial da femoral tunnels, (2) maturation na haɗin gwiwa rabo na graft, da (2). 3) waraka da rage jin zafi a wurin girbi.
Kodayake karatun da yawa sun mayar da hankali kan aikace-aikacen allurar PRP a cikin aikin tiyata na ACL a cikin shekaru biyar da suka gabata, an yi karatun digiri biyu ne kawai.Nazarin da suka gabata sun nuna cewa shaidun da aka haɗu sun goyi bayan haɗakarwa na dasawa ko haɓakar ƙwayoyin Osteoligamous balagagge ta amfani da allurar PRP, amma an nuna wasu shaidu don tallafawa jin zafi a wurin mai bayarwa.Game da amfani da haɓakar PRP don inganta haɗin ramin ƙashi, bayanan kwanan nan sun nuna cewa PRP ba ta da fa'idodin asibiti a cikin faɗaɗa rami ko haɗin kashi na grafts.
Gwaje-gwaje na asibiti na baya-bayan nan sun nuna sakamako mai ban sha'awa na farko a cikin jin zafi da kuma warkarwa ta amfani da PRP.Sajas et al.Lura da ciwon gwiwa na baya bayan autologous ACL sake ginawa na kashi patella kashi (BTB), an gano cewa idan aka kwatanta da ƙungiyar kulawa, an rage ciwon gwiwa na baya a yayin bin 2-watanni.
Ana buƙatar ƙarin bincike don bincika sakamakon PRP akan haɗin haɗin gwiwar ACL, balaga, da zafin wurin mai bayarwa.Duk da haka, a wannan lokaci, nazarin ya nuna cewa PRP ba shi da wani tasiri mai mahimmanci na asibiti a kan haɗin gwiwa ko balagagge, amma ƙayyadaddun nazarin sun nuna sakamako mai kyau don rage ciwo a cikin yankin mai ba da gudummawar patellar.
Osteoarthritis
Mutane sun fi sha'awar tasirin PRP intra-articular allura a cikin maganin da ba a yi amfani da shi ba na gwiwa Articular kashi osteoarthritis.Shen et al.Meta-bincike na 14 bazuwar gwaji na asibiti (RCTs) ciki har da 1423 marasa lafiya da aka gudanar don kwatanta PRP tare da daban-daban controls (ciki har da placebo, hyaluronic acid, Corticosteroid allura, baka magani da Homeopathy magani).Meta bincike ya nuna cewa yayin bin 3, 6 da 12 watanni, ƙimar Osteoarthritis index (WOMAC) na Jami'ar Western Ontario da Jami'ar McMaster sun inganta sosai (= 0.02, 0.04, <0.001, bi da bi).Wani bincike na rukuni na tasirin PRP dangane da tsananin ciwon osteoarthritis na gwiwa ya nuna cewa PRP ya fi tasiri a cikin marasa lafiya tare da OA mai sauƙi zuwa matsakaici.Marubucin ya yi imanin cewa dangane da jin zafi da kuma sakamakon da aka ba da rahoton haƙuri, allurar PRP na intra articular ya fi tasiri fiye da sauran alluran allurai a cikin maganin osteoarthritis na gwiwa.
Riboh et al.sun gudanar da bincike-bincike don kwatanta rawar LP-PRP da LR-PRP a cikin maganin Osteoarthritis na gwiwa, kuma sun gano cewa idan aka kwatanta da HA ko placebo, allurar LP-PRP na iya inganta darajar WOMAC.Ferrado et al.yayi nazarin allurar LR-PRP, ko gano cewa babu wani bambanci na ƙididdiga idan aka kwatanta da allurar HA, ƙara tabbatar da cewa LP-PRP na iya zama zaɓi na farko don maganin cututtukan Osteoarthritis.Tushen nazarin halittu na iya kasancewa a cikin matakan dangi na kumburi da masu shiga tsakani na anti-mai kumburi da ke cikin LR-PRP da LP-PRP.A gaban LR-PRP, mai shiga tsakani mai kumburi TNF- α, IL-6, IFN- ϒ Da IL-1 β Ya karu sosai, yayin da allurar LP-PRP ta ƙara IL-4 da IL-10, waɗanda ke da anti-mai kumburi. masu shiga tsakani.An gano cewa IL-10 yana taimakawa musamman wajen maganin ciwon osteoarthritis na hip, kuma yana iya hana mai shiga tsakani mai kumburi TNF-a, IL-6 da IL-1 β Saki da kuma toshe hanyar kumburi ta hanyar kawar da ayyukan kB na nukiliya.Baya ga illar cutarwa akan chondrocytes, LR-PRP na iya kasa taimakawa wajen magance cututtukan Osteoarthritis saboda tasirin sa akan sel synovial.Braun et al.An gano cewa kula da ƙwayoyin synovial tare da LR-PRP ko jajayen jinin jini na iya haifar da gagarumin samar da mai shiga tsakani da kuma mutuwar kwayar halitta.
Intra articular allura na LP-PRP hanya ce mai aminci, kuma akwai shaidar Level 1 cewa zai iya rage alamun zafi da haɓaka aikin marasa lafiya da aka gano tare da gwiwa Articular kashi osteoarthritis.Ana buƙatar babban ma'auni da dogon nazari na bin diddigin don tantance ingancinsa na dogon lokaci.
Hip Osteoarthritis
Gwaje-gwaje na asibiti guda hudu ne kawai idan aka kwatanta allurar PRP da allurar hyaluronic acid (HA) don maganin ciwon osteoarthritis na hip.Ma'anar sakamakon shine maki ciwo na VAS, maki WOMAC, da Harris hip joint score (HHS).
Batliya et al.ya sami ci gaba mai mahimmanci a maki VAS da HHS a watanni 1, 3, 6, da 12.An sami babban ci gaba a cikin watanni 3, kuma tasirin ya ragu a hankali daga baya [72].Sakamakon a cikin watanni 12 har yanzu ya inganta sosai idan aka kwatanta da ma'auni na asali (P <0.0005);Koyaya, babu wani bambanci mai mahimmanci a cikin sakamako tsakanin ƙungiyoyin PRP da HA.
Di Sante et al.ya ga cewa ƙimar VAS na ƙungiyar PRP ta inganta sosai a cikin makonni 4, amma an dawo da shi zuwa tushe a makonni 16.Babu wani bambanci mai mahimmanci a cikin maki VAS tsakanin ƙungiyar HA a makonni 4, amma an sami ci gaba mai mahimmanci a makonni 16.Dalari et al.Mun kimanta tasirin PRP akan allurar HA, amma kuma idan aka kwatanta haɗin haɗin HA da PRP don lokuta biyu.An gano ƙungiyar PRP da mafi ƙarancin makin VAS a cikin dukkanin ƙungiyoyi uku a duk lokacin biyo baya (watanni 2, watanni 6, da watanni 12).PRP kuma tana da mafi kyawun maki WOMAC a watanni 2 da 6, amma ba a watanni 12 ba.Doria et al.An gudanar da gwajin gwajin makafi sau biyu don kwatanta marasa lafiya da suka karbi allurai guda uku na mako-mako na PRP da kuma allura guda uku na HA.Wannan binciken ya sami ci gaba a cikin maki HHS, WOMAC, da VAS a cikin ƙungiyoyin HA da PRP yayin bin 6 da 12 watanni.Duk da haka, a kowane lokaci, babu wani gagarumin bambanci tsakanin ƙungiyoyin biyu.Babu wani bincike da ya nuna cewa allurar intra-articular na PRP a cikin hip yana da mummunan tasiri, kuma duk sun kammala cewa PRP yana da lafiya.
Ko da yake bayanan sun iyakance, allurar intra-articular na PRP a cikin maganin hip Articular kashi osteoarthritis an tabbatar da cewa yana da lafiya, kuma yana da wasu tasiri wajen rage ciwo da inganta aiki, kamar yadda aka auna ta sakamakon sakamakon da aka ruwaito ta hanyar marasa lafiya.Yawancin karatu sun nuna cewa PRP na iya fara rage zafi idan aka kwatanta da HA;Koyaya, kamar yadda PRP da HA ke da inganci iri ɗaya a cikin watanni 12, duk wani fa'ida ta farko da alama tana raunana akan lokaci.Tun da wasu ƙananan nazarin asibiti sun kimanta aikace-aikacen PRP a cikin OA na hip, ana buƙatar ƙarin shaida mafi girma don sanin ko za a iya amfani da PRP a matsayin madadin gudanarwa na Conservative don jinkirta aikin hip Articular kashi osteoarthritis.
Tashin idon sawu
Gwaje-gwaje na asibiti guda biyu ne kawai waɗanda suka cika ka'idodin haɗakar da mu sun kimanta aikace-aikacen PRP a cikin ƙaƙƙarfan ƙaƙƙarfan ƙafar ƙafa.Roden et al.An gudanar da gwajin gwajin gwaji na asibiti mai makafi sau biyu a kan marasa lafiya da ke fama da matsananciyar ƙafar ƙafar ƙafa a cikin ED, kwatanta duban dan tayi jagorar allurar maganin sa barci na gida LR-PRP tare da saline da alluran anesthetic na gida.Ba su sami wani bambanci mai mahimmanci ba a cikin ƙimar ciwo na VAS ko ƙananan aikin aiki na hannu (LEFS) tsakanin ƙungiyoyin biyu.
Laval et al.bazuwar bazuwar ƴan wasa fitattu 16 da aka bincikar da su tare da tsattsauran ƙafar ƙafar ƙafa don karɓar maganin allurar LP-PRP ta hanyar duban dan tayi a matakin farko na jiyya, da maimaita injections na tsarin gyarawa na haɗin gwiwa ko wani shirin gyara na daban bayan kwanaki 7.Duk marasa lafiya sun sami ka'idar maganin gyaran gyare-gyare iri ɗaya da ka'idojin sake dawowa.Binciken ya gano cewa ƙungiyar LP-PRP ta sake komawa gasa a cikin ɗan gajeren lokaci (kwanaki 40.8 vs. 59.6 days, P<0.006).
PRP da alama ba ta da tasiri don raunin idon ƙafar ƙafa.Ko da yake ƙayyadaddun shaida sun nuna cewa allurar LP-PRP na iya shafar babban idon ƙwararrun 'yan wasa.
Raunin tsoka
Yin amfani da PRP don magance raunin tsoka ya nuna shaidar asibiti mara kyau.Hakazalika da warkar da jijiya, matakan warkar da tsoka sun haɗa da amsawar farko na kumburi, wanda ya biyo baya yaduwa tantanin halitta, bambance-bambance, da gyaran nama.Hamid et al.An gudanar da binciken bazuwar makafi guda ɗaya akan marasa lafiya na 28 tare da raunin hamstring na 2, kwatanta allurar LR-PRP tare da tsare-tsaren gyarawa da gyarawa kadai.Ƙungiyar da ke karɓar magani na LR-PRP ta sami damar murmurewa daga gasar cikin sauri (matsakaicin lokaci a cikin kwanaki, 26.7 vs. 42.5, P=0.02), amma ba su cimma ingantaccen tsarin ba.Bugu da ƙari, mahimmancin tasirin placebo a cikin rukunin jiyya na iya rikitar da waɗannan sakamakon.A cikin gwajin gwaji mai sarrafa makafi sau biyu, Reurink et al.Mun kimanta marasa lafiya 80 kuma mun kwatanta allurar PRP tare da allurar saline na placebo.Duk marasa lafiya sun sami daidaitaccen magani na gyarawa.An bi mai haƙuri don watanni 6 kuma babu wani bambanci mai mahimmanci dangane da lokacin dawowa ko sake raunin rauni.Madaidaicin tsarin PRP don inganta warkar da tsoka a cikin hanyoyin da suka dace na asibiti har yanzu yana da wuyar gaske kuma ya kamata a gudanar da bincike na gaba.
Gudanar da Karya da Ƙungiya
Ko da yake akwai dalilai masu ma'ana don tallafawa amfani da PRP don inganta warkar da kashi, babu wata yarjejeniya ta asibiti don tallafawa yin amfani da PRP na yau da kullum don inganta warkar da kashi.Wani bita na baya-bayan nan game da PRP da jiyya mai tsauri ya nuna alamun RCT guda uku waɗanda ba su nuna fa'idodi ba dangane da sakamakon aikin, yayin da binciken biyu ya nuna sakamako mafi girma na asibiti.Yawancin gwaje-gwajen da ke cikin wannan bita (6/8) sunyi nazarin tasirin PRP a hade tare da wasu kwayoyin halitta (irin su kwayoyin halitta na mesenchymal da / ko kashi kashi) don inganta waraka.
Ka'idar aiki na plasma mai arzikin platelet (PRP) ita ce samar da abubuwan haɓaka da cytokines waɗanda ke ƙunshe a cikin platelet tare da wuce gona da iri.A cikin maganin musculoskeletal, PRP wata hanya ce ta magani mai ban sha'awa tare da tabbataccen shaidar aminci.Duk da haka, shaidar ingancinsa yana gauraye kuma yana dogara sosai akan sinadaran da takamaiman alamomi.Ƙarin inganci da manyan gwaje-gwaje na asibiti a nan gaba suna da mahimmanci don tsara ra'ayinmu akan PRP.
(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: Yuli-24-2023