Platelet nplua nuj Plasma (PRP)
Sab nraud humeral epicondylitis yog ib yam kab mob uas tshwm sim los ntawm qhov mob ntawm sab nraud ntawm lub luj tshib.Nws yog insidious thiab yooj yim rau rov ua dua, uas tuaj yeem ua rau mob forearm thiab lub dab teg lub zog poob, thiab cuam tshuam rau lub neej niaj hnub thiab kev ua haujlwm ntawm cov neeg mob.Muaj ntau txoj kev kho mob rau lateral epicondylitis ntawm humerus, nrog rau cov teebmeem sib txawv.Tam sim no tsis muaj txoj kev kho tus qauv.Platelet nplua nuj plasma (PRP) muaj txiaj ntsig zoo rau kev kho pob txha thiab cov leeg, thiab tau siv dav los kho cov kab mob humeral epicondylitis.
Raws li kev siv zog ntawm kev tso cai pov npav, nws muab faib ua peb qib:
100% pom zoo tag nrho (Qib I)
90% ~ 99% yog kev pom zoo (Qib II)
70% ~ 89% yog kev sib koom ua ke (Qib III)
PRP Lub Tswv Yim thiab Daim Ntawv Thov Cov Khoom Siv Khoom Siv
(1) Lub tswv yim: PRP yog plasma derivative.Nws cov platelet concentration yog siab dua li lub hauv paus.Nws muaj ntau yam kev loj hlob thiab cytokines, uas tuaj yeem txhawb nqa cov ntaub so ntswg kho thiab kho.
(2) Cov khoom siv rau cov khoom siv:
① Cov platelet concentration ntawm PRP nyob rau hauv kev kho mob ntawm sab nraud humeral epicondylitis yog pom zoo kom yog (1000 ~ 1500) × 109 / L (3-5 zaug ntawm lub hauv paus concentration);
② Nyiam siv PRP nplua nuj hauv cov qe ntshav dawb;
③ Activator ua kom PRP tsis pom zoo.
(Kev pom zoo siv: Qib I; cov ntaub ntawv pov thawj qib: A1)
Kev Tswj Xyuas Zoo ntawm PRP Preparation Technology
(1) Kev tsim nyog rau cov neeg ua haujlwm: Kev npaj thiab siv PRP yuav tsum tau ua los ntawm cov neeg ua haujlwm kho mob nrog rau cov kws kho mob uas muaj ntawv tso cai, cov kws saib xyuas neeg mob thiab lwm tus neeg ua haujlwm kho mob, thiab yuav tsum tau ua tom qab kev cob qhia kev ua haujlwm aseptic nruj thiab kev npaj PRP.
(2) Cov Khoom Siv: PRP yuav tsum tau npaj los ntawm kev siv cov txheej txheem kev npaj ntawm cov khoom siv kho mob pom zoo Class III.
(3) Kev ua haujlwm ib puag ncig: PRP kev kho mob yog kev ua haujlwm tsis zoo, thiab nws qhov kev npaj thiab siv tau raug pom zoo kom ua nyob rau hauv chav kho mob tshwj xeeb lossis chav ua haujlwm uas ua tau raws li qhov yuav tsum tau muaj ntawm kev tswj xyuas qhov xav tau.
(Kev pom zoo siv: Qib I; cov ntaub ntawv pov thawj qib: Qib E)
Indications thiab contraindications ntawm PRP
(1) Cov lus qhia:
① PRP kev kho mob tsis muaj qhov yuav tsum tau ua kom pom tseeb rau hom kev ua haujlwm ntawm cov pej xeem, thiab nws tuaj yeem txiav txim siab ua rau cov neeg mob uas xav tau ntau (xws li cov neeg ua kis las) thiab cov neeg thov tsawg (xws li cov neeg ua haujlwm hauv chaw ua haujlwm, cov neeg ua haujlwm hauv tsev neeg, thiab lwm yam. );
② Cov neeg mob cev xeeb tub thiab lactating tuaj yeem siv PRP ceev faj thaum kho lub cev tsis zoo;
③ PRP yuav tsum raug txiav txim siab thaum qhov kev kho tsis zoo ntawm humeral epicondylitis tsis zoo rau ntau tshaj 3 lub hlis;
④ Tom qab kev kho PRP zoo, cov neeg mob rov qab tuaj yeem txiav txim siab siv nws dua;
⑤ PRP tuaj yeem siv tau 3 lub hlis tom qab txhaj tshuaj steroid;
⑥ PRP tuaj yeem siv los kho cov kab mob extensor tendon thiab ib nrab cov leeg tsim kua muag.
(2) Tsis muaj contraindications: ① thrombocytopenia;② Malignant qog los yog kab mob.
(3) Cov txheeb ze contraindications: ① cov neeg mob uas muaj ntshav coagulation thiab noj tshuaj anticoagulant;② Ntshav Qab Zib, hemoglobin <100 g / L.
(Kev pom zoo siv: Qib II; cov ntaub ntawv pov thawj qib: A1)
PRP Txhaj Tshuaj Kho Mob
Thaum PRP txhaj tshuaj yog siv los kho lateral epicondylitis ntawm humerus, nws raug nquahu kom siv cov kev taw qhia ultrasound.Nws raug nquahu kom txhaj 1 ~ 3 ml ntawm PRP ntawm thiab ib ncig ntawm qhov chaw raug mob.Kev txhaj tshuaj ib zaug yog txaus, feem ntau tsis pub ntau tshaj 3 zaug, thiab lub sijhawm txhaj tshuaj yog 2 ~ 4 lub lis piam.
(Kev pom zoo siv: Qib I; cov ntaub ntawv pov thawj qib: A1)
Kev siv PRP hauv Kev Ua Haujlwm
Siv PRP tam sim ntawd tom qab tshem tawm lossis suturing qhov txhab thaum phais;Cov ntawv siv ntau npaum li cas suav nrog PRP lossis ua ke nrog platelet nplua nuj gel (PRF);PRP tuaj yeem raug txhaj rau hauv cov leeg pob txha, qhov chaw ua haujlwm ntawm cov leeg ntawm ntau lub ntsiab lus, thiab PRF tuaj yeem siv los sau cov leeg nqaij thiab npog cov leeg nqaij.Cov koob tshuaj yog 1-5 ml.Nws tsis pom zoo kom txhaj PRP rau hauv qhov sib koom ua ke.
(Kev pom zoo siv: Qib II; cov ntaub ntawv pov thawj qib: Qib E)
PRP Cov teeb meem ntsig txog
(1) Kev tswj qhov mob: Tom qab PRP kev kho mob ntawm sab nraud humeral epicondylitis, acetaminophen (paracetamol) thiab cov tshuaj opioids tsis muaj zog tuaj yeem txiav txim siab txo qhov mob ntawm cov neeg mob.
(2) Kev tiv thaiv kev tsis zoo: mob hnyav, hematoma, kab mob, sib koom ua ke thiab lwm yam mob tom qab kev kho PRP yuav tsum tau ua haujlwm nrog, thiab cov phiaj xwm kho kom zoo yuav tsum tau tsim tom qab txhim kho kev kuaj xyuas thiab ntsuas thiab ntsuas.
(3) Tus kws kho mob kev sib txuas lus thiab kev kawm txog kev noj qab haus huv: Ua ntej thiab tom qab kev kho mob PRP, ua tiav kev sib txuas lus ntawm tus kws kho mob-tus neeg mob thiab kev kawm txog kev noj qab haus huv, thiab kos npe rau daim ntawv pom zoo.
(4) Txoj Kev Npaj Kho Mob: Tsis tas yuav kho kho tom qab kev txhaj tshuaj PRP, thiab kev ua ub no ua rau mob yuav tsum zam tsis pub dhau 48 teev tom qab kho.Lub luj tshib flexion thiab txuas ntxiv tuaj yeem ua tau 48 teev tom qab.Tom qab kev phais ua ke nrog PRP, kev kho mob tom qab phais yuav tsum tau muab qhov tseem ceeb rau.
(Kev pom zoo siv: Qib I; cov ntaub ntawv pov thawj qib: Qib E)
Cov ntaub ntawv:Chin J Trauma, Lub Yim Hli 2022, Vol.38, No.8, Chinese Journal of Trauma, Lub Yim Hli 2022
(Cov ntsiab lus ntawm tsab xov xwm no tau luam tawm dua, thiab peb tsis muab ib qho kev qhia lossis kev lees paub rau qhov raug, kev ntseeg tau lossis ua tiav ntawm cov ntsiab lus muaj nyob rau hauv tsab xov xwm no, thiab tsis muaj lub luag haujlwm rau cov kev xav ntawm tsab xov xwm no, thov nkag siab.)
Post lub sij hawm: Nov-28-2022