Platelet-nplua nuj plasma (PRP) yog tam sim no siv dav hauv ntau yam kev kho mob.Nyob rau hauv xyoo tas los no, daim ntawv thov ntawm PRP hauv orthopedics tau nyiam ntau thiab ntau dua, thiab nws daim ntawv thov nyob rau hauv ntau yam xws li cov ntaub so ntswg regeneration, kho qhov txhab, kho caws pliav, phais yas thiab kev zoo nkauj tau dhau los ua ntau thiab ntau dua.Hauv qhov teeb meem niaj hnub no, peb yuav txheeb xyuas cov kab mob ntawm PRP, nws cov txheej txheem ntawm kev ua, thiab kev faib tawm ntawm PRP kom nkag siab zoo dua qhov ua tau thiab tsis tsim nyog ua nrog PRP.
Keeb kwm ntawm PRP
PRP tseem hu ua platelet-nplua nuj plasma (PRP), platelet-nplua nuj loj hlob yam (GFS) thiab platelet-nplua nuj fibrin (PRF) matrix.Lub tswv yim thiab kev piav qhia ntawm PRP tau pib hauv thaj tsam ntawm hematology.Hematologists coined lub sij hawm PRP nyob rau hauv lub xyoo 1970s, feem ntau yog kho cov neeg mob nrog thrombocytopenia los ntawm extracting platelets thiab ntxiv cov ntshav.
Kaum xyoo tom qab, PRP tau pib siv hauv kev phais maxillofacial li PRF.Fibrin muaj cov nplaum nplaum thiab homeostatic, thiab PRP muaj cov khoom tiv thaiv kab mob uas txhawb nqa cell proliferation.Tom qab ntawd, PRP tau pib siv dav hauv thaj chaw musculoskeletal ntawm kev raug mob kis las thiab ua tiav cov txiaj ntsig zoo.Vim hais tias cov hom phiaj kev kho mob yog cov neeg ncaws pob tshwj xeeb, nws tau nyiam ntau yam hauv xov xwm thiab tau siv dav hauv kev ua kis las tshuaj.Tom qab ntawd, PRP tau maj mam nce hauv orthopedics, phais, phais menyuam yaus, gynecology, urology, phais yas thiab kho kom zoo nkauj thiab ophthalmology.
Platelet Biology
Cov qe ntshav peripheral suav nrog cov qe ntshav liab, cov qe ntshav dawb thiab cov platelets, txhua tus tau los ntawm cov kab mob pluripotent uas tuaj yeem sib txawv rau hauv cov kab mob sib txawv.Cov kab ntawm tes no muaj cov hlwb ua ntej uas tuaj yeem faib thiab paub tab.Platelets yog muab los ntawm cov pob txha pob txha thiab yog nucleated disc-zoo li cov hlwb ntawm ntau qhov sib txawv, nrog qhov nruab nrab txoj kab uas hla ntawm li 2 μm, thiab yog cov qe ntshav tsawg tshaj plaws.Platelet suav hauv cov ntshav ncig ib txwm muaj los ntawm 150,000 txog 400,000 ib microliter.Platelets muaj ob peb qhov tseem ceeb secretory granules, uas muaj peb lub ntsiab tseem ceeb: ntom granules, o-granules, thiab lysosomes.Txhua platelet muaj txog 50-80 hais.
Lub ntsiab lus ntawm PRP
Hauv kev xaus, PRP yog cov khoom siv roj ntsha, uas yog cov ntshav plasma uas muaj cov platelet concentration ntau dua li cov ntshav peripheral.PRP tsis tsuas yog muaj cov platelets siab xwb, tab sis kuj muaj tag nrho cov coagulation yam, nrog rau cov kab mob loj hlob, chemokines, cytokines thiab plasma proteins.
PRP yog muab rho tawm los ntawm cov ntshav peripheral kos los ntawm ntau txoj kev npaj hauv chav kuaj.Tom qab kev npaj, raws li qhov sib txawv ntawm qhov sib txawv, cov qe ntshav liab, PRP, thiab PPP nyob rau hauv cov ntshav cov khoom raug muab cais ua ntu zus.Hauv PRP, ntxiv rau qhov siab ntawm platelets, nws tseem yuav tsum tau txiav txim siab seb nws puas muaj leukocytes thiab seb nws puas tau qhib.Raws li cov yam ntxwv no, ntau hom PRP haum rau cov kab mob sib txawv tau txiav txim siab.
Ntau cov khoom lag luam tam sim no muaj uas tuaj yeem yooj yim rau kev npaj PRP.Cov khoom siv PRP no feem ntau tsim 2-5 quav ntau dua PRP platelet concentrations.Txawm hais tias ib tus yuav xav tias qhov siab dua cov platelet concentration thiab ntau dua qhov kev loj hlob, qhov kev kho mob zoo dua yuav tsum yog, qhov no tsis tau tsim, thiab 3-5 npaug ntawm qhov concentration feem ntau suav tias tsim nyog.
Cov khoom siv lag luam muaj qhov zoo ntawm kev ua qauv thiab yooj yim dua, tab sis muaj kev txwv ntawm lawv cov khoom siv.Qee qhov tsis tuaj yeem tshem tawm cov impurities tshwj xeeb zoo, thiab qee qhov kev npaj PRP tsis siab siab.Hauv paus, tag nrho cov khoom lag luam tsis tuaj yeem ua tus kheej thiab npaj kom raug.Qhov no yog qhov teeb meem loj tshaj plaws nrog cov khoom siv tau zoo.Tam sim no, tsuas yog cov cuab yeej ua haujlwm hauv chav kuaj xyuas tus kheej tau yooj yim tuaj yeem npog tag nrho cov neeg mob xav tau, uas muaj cov kev xav tau siab ntawm kev sim tshuab.
Kev faib tawm ntawm PRP
Hauv xyoo 2006, Everts thiab al tau npaj lub tswv yim ntawm leukocyte-nplua nuj PRP.Yog li, PRP tuaj yeem faib ua ob hom raws li cov leukocytes muaj: PRP nrog cov leukocytes tsis zoo thiab PRP nrog cov nplua nuj leukocytes.
1) Platelet-nplua nuj plasma uas muaj siab concentration ntawm leukocytes, hu ua L-PRP (Leukocyte Platelet-Rich Plasma, muaj ib tug me me ntawm cov qe ntshav liab), yog tsuas yog siv rau refractory qhov txhab, mob ntshav qab zib ko taw, gout nrog tsis zoo. qhov txhab, kho pob txha, nonunion, pob txha pob txha o thiab lwm yam kev kho mob.
2) Platelet-nplua nuj plasma yam tsis muaj lossis tsis tshua muaj cov leukocytes yog hu ua P-PRP (Pure Platelet-Rich Plasma, tsis muaj cov qe ntshav liab), feem ntau yog siv rau kev ua kis las thiab cov kab mob degenerative, suav nrog kev raug mob meniscus, ligament thiab tendon raug mob. , tennis luj tshib, hauv caug mob caj dab, pob txha mos degeneration, lumbar disc herniation thiab lwm yam kab mob.
3) Tom qab cov kua PRP tau qhib los ntawm thrombin lossis calcium, gel zoo li PRP lossis PRF tuaj yeem tsim.(Thawj npaj los ntawm Dohan li al. hauv Fabkis)
Xyoo 2009, Dohan Ehrenfest et al.npaj 4 kev faib tawm raws li qhov muaj lossis tsis muaj cov khoom ntawm tes (xws li leukocytes) thiab cov qauv fibrin:
1) Ntshiab PRP los yog leukocyte-poor PRP: PRP npaj tsis muaj leukocytes, thiab cov ntsiab lus ntawm fibrin tom qab ua kom qis.
2) Cov qe ntshav dawb thiab PRP: muaj cov qe ntshav dawb, thiab cov ntsiab lus ntawm fibrin tom qab ua kom qis.
3) Ntshiab PRF los yog leukocyte-poor PRF: qhov kev npaj tsis muaj leukocytes thiab muaj fiber ntau ntom ntom.Cov khoom no tuaj nyob rau hauv daim ntawv ntawm activated gels thiab tsis tuaj yeem siv rau kev txhaj tshuaj.
4) Leukocyte-nplua nuj fibrin thiab PRF: muaj leukocytes thiab high-density fibrin.
Nyob rau hauv 2016, Magalon et al.tau npaj DEPA kev faib tawm ( koob tshuaj, kev ua haujlwm zoo, purity, ua kom muaj zog), tsom rau PRP platelet suav, khoom purity, thiab platelet activation.
1. Platelet txhaj koob tshuaj: xam los ntawm kev muab platelet concentration los ntawm platelet ntim.Raws li cov koob txhaj tshuaj (hauv billions lossis lab tus platelets), nws tuaj yeem muab faib ua (a) koob tshuaj ntau heev:> 5 billion;(b) koob tshuaj siab: los ntawm 3 billion mus rau 5 billion;(c) nruab nrab koob: los ntawm 1 billion mus rau 3 billion;(d) koob tshuaj tsawg: tsawg dua 1 billion.
2. Kev npaj ua kom zoo: feem pua ntawm cov platelets sau los ntawm cov ntshav.(a) Cov cuab yeej ua haujlwm siab: platelet rov qab tus nqi> 90%;(b) nruab nrab cov cuab yeej siv tau zoo: platelet rov qab tus nqi ntawm 70-90%;(c) cov cuab yeej ua haujlwm qis: rov qab tus nqi ntawm 30-70%;(d) Cov cuab yeej siv tau qis heev: tus nqi rov qab yog tsawg dua 30%.
3. PRP purity: Nws muaj feem xyuam rau cov txheeb ze ntawm cov platelets, cov qe ntshav dawb thiab cov qe ntshav liab hauv PRP.Peb piav qhia nws li (a) PRP ntshiab heev:> 90% platelets txheeb ze rau erythrocytes thiab leukocytes hauv PRP;(b) PRP ntshiab: 70-90% platelets;(c) heterogeneous PRP: % platelets Ntawm 30-70%;(d) Tag nrho cov ntshav PRP: feem pua ntawm cov platelets hauv PRP tsawg dua 30%.
4. Cov txheej txheem ua kom muaj zog: seb puas yuav qhib platelets nrog exogenous coagulation yam, xws li autologous thrombin lossis calcium chloride.
(Cov ntsiab lus ntawm tsab xov xwm no yog luam tawm.)
Post lub sij hawm: May-16-2022