Tšebeliso eaPlatelet Rich Plasma (PRP)Libakeng tse fapaneng le Mokhoa oa ho Khetha PRP Rich in White Blood Cells (L-PRP) le PRP E futsanehileng ka har'a lisele tse tšoeu tsa mali (P-PRP)
Ho sibolloa ha morao tjena palo e kholo ea bopaki ba boleng bo phahameng bo tšehetsa tšebeliso ea ente ea LR-PRP bakeng sa phekolo ea lateral Epicondylitis le LP-PRP bakeng sa phekolo ea lengole Articular bone.Bopaki ba boleng bo bohareng bo tšehetsa tšebeliso ea ente ea LR-PRP bakeng sa patellar tendinosis le ente ea PRP bakeng sa Plantar fasciitis le bohloko ba sebaka sa bafani ka patellar tendon transplantation BTB ACL reconstruction.Ha ho na bopaki bo lekaneng ba ho khothaletsa kamehla PRP bakeng sa rotator cuff tendinosis, hip Articular bone osteoarthritis kapa high ankle sprain.Bopaki ba morao-rao bo bontša hore PRP ha e na matla a ho phekola lefu la tendon la Achilles, kotsi ea mesifa, ho robeha ho matla kapa ho se kopane ha masapo, ho ntlafatsa opereishene ea ho lokisa li-rotator, tokiso ea Achilles, le ho tsosolosoa ha ACL.
Platelet rich plasma (PRP) ke tokiso ea plasma ea motho e ikemetseng e eketsang khatello ea liplatelete ka ho kenya mali a mangata haholo a mokuli.Li-platelets ho α Particles tsa eona (TGF- β 1. PDGF, bFGF, VEGF, EGF, IGF-1) li na le palo e feteletseng ea lintlha tsa kholo le li-mediators, tse tsepamisitsoeng ka ts'ebetso ea centrifugation ho lokolla palo ea suprabiological ea lintlha tsena tsa kgolo le li-cytokines. sebakeng se lemetseng le ho ntlafatsa mokhoa oa tlhaho oa ho folisa.
Palo e tloaelehileng ea palo ea liplatelete ke 150000 ho 350000 / μ L. Ho ntlafatsoa ha pholiso ea masapo le lisele tse bonolo ho bontšitsoe, ka liplatelete tse tsepamisitsoeng tse fihlang ho 1000000 / μ L. E emela ho eketseha ka makhetlo a mararo ho isa ho a mahlano a lintlha tsa kholo.Litokisetso tsa PRP hangata li arotsoe ka PRP e ruileng ka lisele tse tšoeu tsa mali (LR-PRP), e hlalosoang e le mahloriso a neutrophil ka holimo ho motheo, le PRP e futsanehileng lisele tse tšoeu tsa mali (LP-PRP), e hlalosoang e le mahloriso a lisele tse tšoeu tsa mali (neutrophil) ka tlase ho motheo. .
Kalafo ea Likotsi Tsa Tendon
Tšebeliso ea PRP bakeng sa phekolo ea kotsi ea tendon kapa lefu la tendon e fetohile sehlooho sa liphuputso tse ngata, 'me li-cytokine tse ngata tse fumanoang ho PRP li ameha ho bonts'a litsela tse hlahang nakong ea pholiso ea ho ruruha, ho ata ha lisele, le ho tsosolosoa ha lisele tse latelang.PRP e ka boela ea khothalletsa ho thehoa ha methapo e mecha ea mali, e ka eketsang phepelo ea mali le phepo e nepahetseng bakeng sa ho tsosolosoa ha lisele tsa lisele tse senyehileng, hammoho le ho tlisa lisele tse ncha le ho tlosa litšila ho tloha lisele tse senyehileng.Mekhoa ena ea liketso e ka 'na ea e-ba ea bohlokoa ka ho khetheha ho tendinosis e sa foleng, moo maemo a likokoana-hloko a sa khoneng ho folisa lisele.Tlhahlobo ea morao-rao e hlophisitsoeng le tlhahlobo ea meta e fihletse qeto ea hore ho kenya PRP ho ka sebetsana ka katleho le tendinosis ea matšoao.
Epicondylitis ea morao-rao
PRP e 'nile ea hlahlojoa e le khetho ea phekolo bakeng sa bakuli ba nang le lateral Epicondylitis ba sa sebetseng ka physiotherapy.Thutong e kholo ka ho fetisisa e joalo, Mishra et al.Phuputsong e lebelloang ea Cohort, bakuli ba 230 ba sa kang ba arabela tsamaisong ea Conservative ea lateral Epicondylitis bonyane likhoeli tsa 3 ba ile ba hlahlojoa.Mokuli o ile a fumana phekolo ea LR-PRP, 'me libeke tsa 24, ente ea LR-PRP e ne e amahanngoa le ntlafatso e kholo ea bohloko ha e bapisoa le sehlopha sa taolo (71.5% vs 56.1%, P = 0.019), hammoho le ho fokotseha ho hoholo liperesente tsa bakuli ba tlalehang bolutu bo setseng ba setsoe (29.1% vs 54.0%, P=0.009).Libekeng tsa 24, bakuli ba tšoaroang ka LR-PRP ba bontšitse ntlafatso ea bohlokoa ea bongaka le ea lipalo-palo ha e bapisoa le liente tse sebetsang tsa taolo ea lithethefatsi tsa lehae.
Liphuputso tse fetileng li bontšitse hore LR-PRP e ka boela ea fana ka phomolo ea nako e telele bakeng sa matšoao a lateral Epicondylitis ha e bapisoa le ente ea Corticosteroid, kahoo e na le phello e tsitsitseng ea phekolo.PRP e bonahala e le mokhoa o atlehang oa phekolo ea Epicondylitis e ka ntle.Bopaki ba boleng bo phahameng bo bontša katleho ea nako e khutšoanyane le ea nako e telele.Bopaki bo molemo ka ho fetisisa bo teng bo bontša ka ho hlaka hore LR-PRP e lokela ho ba mokhoa oa pele oa phekolo.
Patellar Tendinosis
Lithuto tse laoloang ka nako e sa lekanyetsoang li tšehetsa tšebeliso ea LR-PRP bakeng sa phekolo ea lefu le sa foleng la refractory patellar tendon.Draco et al.Bakuli ba mashome a mabeli a metso e meraro ba nang le patellar tendinosis ba ileng ba hlōleha tsamaiso ea Conservative ba ile ba hlahlojoa.Bakuli ba ne ba abeloa ka mokhoa o sa reroang hore ba fumane linale tse omeletseng tse tataisoang ke ultrasound kapa ente ea LR-PRP, 'me ba lateloa bakeng sa> libeke tse 26.Ka tekanyo ea VISA-P, sehlopha sa phekolo ea PRP se bontšitse ntlafatso e kholo matšoao a libeke tsa 12 (P = 0.02), empa phapang e ne e se ea bohlokoa ho> libeke tsa 26 (P = 0.66), e bontšang hore melemo ea PRP bakeng sa lefu la patellar tendon e ka ba ntlafatso ea matšoao a pele.Vitrano et al.Melemo ea ente ea PRP ho alafa lefu le sa foleng le sa foleng la patellar tendon ha le bapisoa le ECSWT le tsepamisitsoeng maikutlo a extracorporeal shock wave therapy (ECSWT).Le hoja ho ne ho se na phapang e khōlō pakeng tsa lihlopha nakong ea ho latela khoeli ea 2, sehlopha sa PRP se bontšitse ntlafatso ea lipalo-palo ho 6 le likhoeli tsa 12 tsa ho latela, ho feta ECSWT e lekantsoeng ke VISA-P le VAS, le ho lekanya Blazina. lintlha tse lekaneng likhoeling tsa 12 tsa ho latela (tsohle P <0.05).
Tlhahlobo ena e hlahloba lingoliloeng tsa morao-rao tsa kliniki mabapi le tšebeliso ea plasma e nang le platelet-rich (PRP), ho akarelletsa le leukocyte rich PRP (LR PRP) le leukocyte poor PRP (LP PRP), e le ho hlahisa litlhahiso tse thehiloeng bopaking bakeng sa mafu a sa tšoaneng a mesifa le masapo.
Ho sibolloa ha morao tjena palo e kholo ea bopaki ba boleng bo phahameng bo tšehetsa tšebeliso ea ente ea LR-PRP bakeng sa phekolo ea lateral Epicondylitis le LP-PRP bakeng sa phekolo ea lengole Articular bone.Bopaki ba boleng bo bohareng bo tšehetsa tšebeliso ea ente ea LR-PRP bakeng sa patellar tendinosis le ente ea PRP bakeng sa Plantar fasciitis le bohloko ba sebaka sa bafani ka patellar tendon transplantation BTB ACL reconstruction.Ha ho na bopaki bo lekaneng ba ho khothaletsa kamehla PRP bakeng sa rotator cuff tendinosis, hip Articular bone osteoarthritis kapa high ankle sprain.Bopaki ba morao-rao bo bontša hore PRP ha e na matla a ho phekola lefu la tendon la Achilles, kotsi ea mesifa, ho robeha ho matla kapa ho se kopane ha masapo, ho ntlafatsa opereishene ea ho lokisa li-rotator, tokiso ea Achilles, le ho tsosolosoa ha ACL.
Tsebisa
Platelet rich plasma (PRP) ke tokiso ea plasma ea motho e ikemetseng e eketsang khatello ea liplatelete ka ho kenya mali a mangata haholo a mokuli.Li-platelets ho α Particles tsa eona (TGF- β 1. PDGF, bFGF, VEGF, EGF, IGF-1) li na le palo e feteletseng ea lintlha tsa kholo le li-mediators, tse tsepamisitsoeng ka ts'ebetso ea centrifugation ho lokolla palo ea suprabiological ea lintlha tsena tsa kgolo le li-cytokines. sebakeng se lemetseng le ho ntlafatsa mokhoa oa tlhaho oa ho folisa.Palo e tloaelehileng ea palo ea liplatelete ke 150000 ho 350000 / μ L. Ho ntlafatsoa ha pholiso ea masapo le lisele tse bonolo ho bontšitsoe, ka liplatelete tse tsepamisitsoeng tse fihlang ho 1000000 / μ L. E emela ho eketseha ka makhetlo a mararo ho isa ho a mahlano a lintlha tsa kholo.
Litokisetso tsa PRP hangata li arotsoe ka litokisetso tsa PRP tse ruileng ka lisele tse tšoeu tsa mali (LR-PRP), tse hlalosoang e le li-neutrophil concentrations ka holimo ho motheo, le litokisetso tsa PRP tse futsanehileng liseleng tse tšoeu tsa mali (LP-PRP), tse hlalosoang e le lisele tse tšoeu tsa mali (neutrophil) ka tlase ho motheo.
Tokisetso le Sebopeho
Ha ho na tumellano e akaretsang mabapi le tlhahiso e nepahetseng ea PRP bakeng sa mahloriso a karolo ea mali, 'me hona joale ho na le mekhoa e mengata e fapaneng ea khoebo ea PRP marakeng.Ka hona, ho ea ka mekhoa e fapaneng ea khoebo, ho na le liphapang tsa liprothokholo tsa pokello ea PRP le litšobotsi tsa ho itokisa, ho fa tsamaiso e 'ngoe le e' ngoe ea PRP litšobotsi tse ikhethang.Mekhoa ea khoebo e atisa ho fapana ka katleho ea ho tšoara liplatelete, mokhoa oa ho arohana (mohato o le mong kapa oa mehato e 'meli ea centrifugation), lebelo la centrifugation, le mofuta oa tsamaiso ea li-tube tsa pokello le ts'ebetso.Hangata, pele ho centrifugation, mali a feletseng a bokelloa 'me a kopantsoe le lintho tse thibelang mali ho arola lisele tse khubelu tsa mali (RBCs) ho tloha ho platelet-poor plasma (PPP) le "erythrocyte sedimentation brown layer" e nang le liplatelete tse teteaneng le lisele tse tšoeu tsa mali.Ho sebelisoa mekhoa e sa tšoaneng ho arola liplatelete, tse ka kenngoang ka ho toba 'meleng oa mokuli kapa tsa "activated" ka ho eketsa calcium chloride kapa thrombin, e leng se lebisang ho senyeha ha platelet le ho lokolloa ha lintho tse hōlang.Lintlha tse peli tse tobileng tsa mokuli, ho kenyeletsa tsamaiso ea lithethefatsi le mekhoa ea ho lokisetsa tsamaiso ea khoebo, e ama sebopeho se khethehileng sa PRP, hammoho le phetoho ena ea ho hlophisoa ha PRP ho hlalosa katleho ea kliniki ea PRP.
Kutloisiso ea rona ea hona joale ke hore PRP e nang le lisele tse tšoeu tsa mali tse eketsehileng, e leng PRP e nang le lisele tse tšoeu tsa mali (neutrophils), e amahanngoa le liphello tsa pro-inflammatory.Ho eketseha ha lisele tse tšoeu tsa mali (neutrophils) ho LR-PRP ho boetse ho amahanngoa le keketseho ea li-cytokine tsa catabolic, tse kang interleukin-1 β, Tumor Necrosis Factor α Le metalloproteinases, e ka 'nang ea hanyetsa li-cytokine tsa anabolic tse nang le liplatelete.Liphello tsa kliniki le liphello tsa lisele tsa mefuta ena e fapaneng ea PRP, ho kenyeletsa le lisele tse tšoeu tsa mali, li ntse li hlakisoa.Tlhahlobo ena e ikemiselitse ho lekola bopaki ba boleng bo holimo bo fumanehang bakeng sa matšoao a fapaneng a kliniki a mefuta e fapaneng ea PRP.
Lefu la Tendon Achilles
Liteko tse 'maloa tsa histori li hlōlehile ho bontša phapang pakeng tsa liphello tsa kliniki pakeng tsa PRP le placebo feela ha ho phekoloa Achilles tendinitis.Teko ea morao-rao e laoloang ka Randomized e bapisitse letoto la liente tse 'nè tsa LP-PRP le ente ea placebo e kopantsoeng le lenaneo la centrifugal load rehabilitation.Ha ho bapisoa le sehlopha sa placebo, sehlopha sa phekolo ea PRP se bontšitse ntlafatso e kholo ea bohloko, ts'ebetso, le lintlha tsa ts'ebetso ka linako tsohle ho pholletsa le nako ea ho latela likhoeli tsa 6.Phuputso e boetse e fumane hore ente e le 'ngoe e kholo ea molumo (50 mL) ea 0.5% Bupivacaine (10 mL), methylprednisolone (20 mg) le physiological saline (40 mL) e bile le ntlafatso e tšoanang, empa ha ho nahanoa ka phekolo ena, tlhokomelo e lokela ho nkoa. pono ea kotsi e eketsehileng ea ho phatloha ha tendon ka mor'a ente ea steroid.
Tendinosis ea Rotator Cuff
Ho na le lithuto tse 'maloa tse phahameng tsa ente ea PRP kalafo e sa buuoeng ea lefu la rotator cuff tendon.Liphuputso tse 'maloa tse hatisitsoeng li bapisitse liphello tsa kliniki tsa ente ea subacromial ea PRP le placebo le Corticosteroid,' me ha ho thuto e hlahlobileng ente e tobileng ea PRP ho tendon ka boeona.Casey Buren et al.Ho ile ha fumanoa hore ho ne ho se na phapang lipakeng tsa liphello tsa kliniki ha li bapisoa le ho kenya letsoai la 'mele tlas'a tlhōrō ea mahetla.Leha ho le joalo, teko e laoloang ka Randomized e fumane hore liente tse peli tsa LR-PRP libeke tse ling le tse ling tse 'nè li ntlafatsa bohloko ha li bapisoa le liente tsa placebo.Shams et al.Ntlafatso e bapisoang ea ente ea subacromial PRP le Corticosteroid pakeng tsa Xi'an Ontario RC index (WORI), index ea bokooa ba mahetla (SPDI) le VAS bohloko ba mahetla le tlhahlobo ea Neer e tlalehiloe.
Ho fihlela joale, lipatlisiso li bontšitse hore ho kenya PRP tlas'a tlhōrō ea mahetla ho na le ntlafatso e kholo liphellong tse tlalehiloeng tsa bakuli ba nang le lefu la rotator cuff tendon.Lithuto tse ling tse hlokang ho latela nako e telele, ho kenyelletsa le ho hlahloba ente e tobileng ea PRP ho li-tendon.Liente tsena tsa PRP li bontšitsoe hore li bolokehile 'me e ka' na ea e-ba mokhoa o mong oa liente tsa Corticosteroid ka rotator cuff tendinosis.
Plantar Fasciitis
Liteko tse 'maloa tse laoloang ka Randomized li ile tsa hlahloba ente ea PRP bakeng sa Plantar fasciitis e sa foleng.Bokhoni ba PRP e le phekolo ea ente ea sebakeng sa heno e kokobetsa matšoenyeho a amanang le ente ea Corticosteroid, e kang atrophy of fashion pads kapa ho phatloha ha plantar fascia.Litlhahlobo tse peli tsa morao-rao tsa meta li ile tsa lekola papiso lipakeng tsa ente ea PRP le ente ea Corticosteroid, 'me ea etsa qeto ea hore ente ea PRP ke mokhoa o mong o ka khonehang oa ente ea Corticosteroid mabapi le katleho.Liphuputso tse ling li bontšitse bophahamo ba PRP.
Opereishene e kopantsoeng le PRP
Ho Lokisa Mahetla a Mahetla
Lithuto tse 'maloa tsa boemo bo phahameng ba kliniki li ile tsa hlahloba tšebeliso ea lihlahisoa tsa PRP ho lokisoa ha Arthroscopy ea likhapha tsa rotator cuff.Liphuputso tse ngata li ithutile ka ho khetheha tšebeliso ea litokisetso tsa platelet rich fibrin matrix bakeng sa ntlafatso (PRFM), ha lithuto tse ling li kentse PRP ka ho toba sebakeng sa tokiso.Ho na le ho fapana ho hoholo hoa PRP kapa PRFM formulations.Liphetho tse shebaneng le bakuli li ile tsa fumanoa, joalo ka Univesithi ea California, Los Angeles (UCLA), American Shoulder and Elbow Association (ASES), Constant Shoulder Score, Simple Shoulder Test (SST), le lintlha tsa bohloko tsa VAS, hammoho le sepheo sa bongaka. lintlha tse kang matla a rotator cuff le ROM ea mahetla li ile tsa bokelloa ho lekanya phapang pakeng tsa liphello tse sebetsang.Liphuputso tse ngata ka bomong li bontšitse phapang e fokolang mehatong ea liphetho tsena ho PRP ha li bapisoa le tokiso ea motho ka mong [joalo ka liphaephe tsa ho lokisa li-cuff tsa Arthroscopy rotator.Ho phaella moo, tlhahlobo e kholo ea meta le tlhahlobo e matla ea morao-rao e pakile hore ho lokisoa ha Arthroscopy ea mahetla a mahetla [PRP] ha ho na molemo o moholo oa ho eketsa matsoele.Leha ho le joalo, boitsebiso bo fokolang bo bontša hore bo na le phello e itseng ho fokotsa bohloko ba perioperative, e leng mohlomong ka lebaka la thepa e khahlanong le ho ruruha ea PRP.
Tlhahlobo ea lihlopha tse nyenyane e bontšitse hore meokho e bohareng le e nyenyane e tšoaroang ka ho lokisoa ha mela e 'meli ea Arthroscopy, ente ea PRP e ka fokotsa sekhahla sa ho rusolla, kahoo ho fumana liphello tse molemo.Qiao et al.Ho ile ha fumanoa hore PRP e na le molemo oa ho fokotsa sekhahla sa ho taboha ha meokho e itekanetseng le e kholo ea rotator ha e bapisoa le ho buuoa feela.
Liteko tsa kliniki tse sa reroang le tlhahlobo e kholo ea meta e bonts'a ho hloka bopaki ba tšebeliso ea PRP le PRFM e le matlafatso bakeng sa tokiso ea rotator cuff.Liphuputso tse ling tsa lihlopha tse nyenyane li fana ka maikutlo a hore ho lokisa mela e 'meli ho ka ba le melemo ea ho phekola meokho e nyenyane kapa e itekanetseng.PRP e ka boela ea thusa ho kokobetsa hang-hang bohloko ba ka mor'a ho buuoa.
Ho lokisa Tendon ea Achilles
Liphuputso tsa preclinical li bontšitse hore PRP e na le phello e tšepisang ho khothalletsa pholiso ea ho phatloha ha tendon Achilles.Leha ho le joalo, bopaki bo hanyetsanang bo sitisa phetoho ea PRP e le phekolo e sebetsang ea adjuvant bakeng sa ho phatloha ho matla ha tendon ea Achilles ho batho.Ka mohlala, phuputsong e 'ngoe, liphello tsa moralo le tse sebetsang tsa bakuli ba nang le ho phatloha ha tendon Achilles ba tšoaroang le ntle le PRP ba ne ba tšoana.Ka lehlakoreng le leng, Zou et al.Phuputsong e sa lebelloang e laoloang ka mokhoa o sa reroang, bakuli ba 36 ba ile ba hiriloe ba ileng ba lokisoa ka mokhoa o matla oa ho phatloha ha tendon ea Achilles le ntle le ente ea intraoperative ea LR-PRP.Bakuli ba sehlopha sa PRP ba ne ba e-na le mesifa e ntle ea isokinetic likhoeling tsa 3, 'me ba e-na le lintlha tse phahameng tsa SF-36 le Leppilahti likhoeling tsa 6 le 12, ka ho latellana (kaofela P <0.05).Ho phaella moo, mokhoa oa ho tsamaea o kopantsoeng oa maqaqailana sehlopheng sa PRP le oona o ntlafetse haholo ka linako tsohle ho 6, 12, le likhoeli tsa 24 (P <0.001).Le hoja ho hlokahala liteko tse ling tsa boemo bo phahameng ba kliniki, ho kenya PRP e le ntlafatso ea ho buuoa bakeng sa tokiso e matla ea Achilles ha ho bonahale ho le molemo.
Opereishene ea Anterior Cruciate Ligament
Katleho ea opereishene ea anterior cruciate ligament (ACL) ha e itšetlehe feela ka lintlha tsa tekheniki (joalo ka ho beoa ha kotopo le ho lokisoa), empa hape le pholiso ea likokoana-hloko ea li-graft tsa ACL.Lipatlisiso mabapi le tšebeliso ea PRP ho opereishene ea ho tsosolosoa ha ACL e lebisa tlhokomelo mekhoeng e meraro ea likokoana-hloko: (1) ho kopanngoa ha li-ligamente tsa masapo pakeng tsa li-graft le li-tunnel tsa tibial le tsa botšehali, (2) ho hōla ha karolo e kopanetsoeng ea graft, le (2) 3) pholiso le ho fokotsa bohloko sebakeng sa kotulo.
Le hoja liphuputso tse ngata li tsepamisitse maikutlo ho sebelisoa ha ente ea PRP ho buuoa ka ACL lilemong tse hlano tse fetileng, ho bile le lithuto tse peli feela tsa boemo bo phahameng.Liphuputso tse fetileng li bontšitse hore bopaki bo tsoakiloeng bo tšehetsa ho kopanngoa ha li-transplant kapa graft mature Osteoligamous lisele tse sebelisang ente ea PRP, empa bopaki bo bong bo bontšitsoe ho tšehetsa bohloko sebakeng sa bafani.Mabapi le tšebeliso ea ntlafatso ea PRP ho ntlafatsa maqhama a graft bone tunnel, lintlha tsa morao-rao li bontša hore PRP ha e na melemo ea kliniki ka ho atolosa kotopo kapa ho kopanya masapo a li-grafts.
Liteko tsa morao-rao tsa meriana li bontšitse liphello tse tšepisang pele ho bohloko ba sebaka sa bafani le pholiso ho sebelisa PRP.Sajas et al.Ho shebella bohloko ba lengole la pele ka mor'a ho tsosolosoa ha ACL ea autologous ea bone patella bone (BTB), ho ile ha fumanoa hore ha ho bapisoa le sehlopha sa taolo, bohloko bo ka pele ba lengole bo fokotsehile nakong ea ho latela khoeli ea 2.
Ho hlokahala lipatlisiso tse eketsehileng ho batlisisa liphello tsa PRP ho kopanngoa ha ACL graft, maturation, le bohloko ba sebaka sa bafani.Leha ho le joalo, ntlheng ena, liphuputso li bontšitse hore PRP ha e na tšusumetso e kholo ea kliniki ho kopanngoa ha graft kapa ho hōla, empa lithuto tse fokolang li bontšitse liphello tse ntle ho fokotsa bohloko sebakeng sa bafani ba tendon ea patellar.
Osteoarthritis
Batho ba thahasella haholoanyane ka katleho ea PRP ente ea intra-articular kalafo e sa buuoeng ea lengole Articular bone osteoarthritis.Shen et al.Tlhahlobo ea meta ea liteko tsa kliniki tsa 14 (RCTs) tse kenyeletsang bakuli ba 1423 li ile tsa etsoa ho bapisa PRP le litsamaiso tse fapaneng (ho akarelletsa le placebo, hyaluronic acid, ente ea Corticosteroid, meriana ea molomo le phekolo ea Homeopathy).Tlhahlobo ea Meta e bontšitse hore nakong ea ho latela likhoeli tsa 3, 6 le 12, palo ea Osteoarthritis index (WOMAC) ea Western Ontario University le McMaster University e ntlafetse haholo (= 0.02, 0.04, <0.001, ka ho latellana).Tlhahlobo ea lihlopha tse nyenyane tsa katleho ea PRP e thehiloeng ho boima ba knee osteoarthritis e bontšitse hore PRP e sebetsa haholo ho bakuli ba nang le OA e bonolo ho isa ho e itekanetseng.Mongoli o lumela hore mabapi le ho fokotsa bohloko le liphello tse tlalehiloeng ke mokuli, ente ea intra articular PRP e sebetsa ho feta liente tse ling tse ling tsa ho phekola lefu la masapo a mangole.
Riboh et al.e ile ea etsa tlhahlobo ea meta ho bapisa karolo ea LP-PRP le LR-PRP ho phekola Osteoarthritis ea lengole, 'me ea fumana hore ha e bapisoa le HA kapa placebo, ente ea LP-PRP e ka ntlafatsa haholo palo ea WOMAC.Ferrado et al.o ithutile ente ea LR-PRP, kapa a fumana hore ho ne ho se na phapang ea lipalo ha e bapisoa le ente ea HA, e leng ho pakang ho eketsehileng hore LP-PRP e ka ba khetho ea pele bakeng sa phekolo ea matšoao a Osteoarthritis.Motheo oa eona oa tlhaho o ka ba maemong a amanang le ho ruruha le li-mediators tse khahlanong le ho ruruha tse teng ho LR-PRP le LP-PRP.Ka pel'a LR-PRP, mokena-lipakeng oa ho ruruha TNF- α, IL-6, IFN- ϒ Le IL-1 β E eketsehile haholo, ha ente ea LP-PRP e eketsa IL-4 le IL-10, e leng khahlanong le ho ruruha. batsereganyi.Ho fumanoa hore IL-10 e thusa ka ho khetheha ho phekola hip osteoarthritis, hape e ka thibela mokena-lipakeng oa ho ruruha TNF- α, IL-6 le IL-1 β Ho lokolla le ho thibela tsela ea ho ruruha ka ho fokotsa ts'ebetso ea nuclear factor kB.Ho phaella liphellong tsa eona tse kotsi ho li-chondrocyte, LR-PRP e ka boela ea sitoa ho thusa ho tšoara matšoao a Osteoarthritis ka lebaka la liphello tsa eona liseleng tsa synovial.Braun et al.Ho ile ha fumanoa hore ho phekola lisele tsa synovial ka LR-PRP kapa lisele tse khubelu tsa mali ho ka lebisa tlhahisong ea mokena-lipakeng oa bohlokoa oa ho ruruha le lefu la lisele.
Intra articular injection ea LP-PRP ke mokhoa o sireletsehileng oa phekolo, 'me ho na le bopaki ba Level 1 hore e ka fokotsa matšoao a bohloko le ho ntlafatsa mosebetsi oa bakuli ba fumanoeng ba e-na le knee Articular bone osteoarthritis.Lithuto tse kholoanyane le tse lateloang nako e telele lia hlokahala ho fumana katleho ea eona ea nako e telele.
Osteoarthritis ea Hip
Ke liteko tse 'nè feela tsa kliniki tse sa tloaelehang tse bapisoang le ente ea PRP le ente ea hyaluronic acid (HA) bakeng sa phekolo ea hip osteoarthritis.Lipontšo tsa sephetho ke lintlha tsa bohloko tsa VAS, lintlha tsa WOMAC, le lintlha tsa Harris hip joint (HHS).
Batalya et al.e fumane lintlafatso tse kholo ho lintlha tsa VAS le HHS ho 1, 3, 6, le likhoeli tsa 12.Ntlafatso ea tlhōrō e etsahetse likhoeling tsa 3, 'me phello e ile ea fokotseha butle-butle ka mor'a moo [72].Lintlha tsa likhoeli tsa 12 li ntse li ntlafala haholo ha li bapisoa le lintlha tsa motheo (P <0.0005);Leha ho le joalo, ho ne ho se na phapang e kholo ea lipalo-palo pakeng tsa lihlopha tsa PRP le HA.
Di Sante et al.o bone hore palo ea VAS ea sehlopha sa PRP e ntlafetse haholo libeke tsa 4, empa e ile ea khutlisetsoa ho ea pele libeke tsa 16.Ho ne ho se na phapang e kholo ho lintlha tsa VAS pakeng tsa sehlopha sa HA libeke tsa 4, empa ho bile le ntlafatso e kholo libeke tsa 16.Dalari et al.Re ile ra hlahloba phello ea PRP ho ente ea HA, empa hape re bapisa motsoako oa ente ea HA le PRP bakeng sa linyeoe tseo ka bobeli.Sehlopha sa PRP se fumanoe se e-na le palo e tlaase ka ho fetisisa ea VAS har'a lihlopha tsohle tse tharo ka nako eohle ea ho latela nako (likhoeli tsa 2, likhoeli tsa 6 le likhoeli tsa 12).PRP e boetse e na le lintlha tse betere tsa WOMAC likhoeling tse 2 le 6, empa eseng likhoeling tse 12.Doria et al.Teko ea tleliniki e sa boneng ka makhetlo a mabeli e ile ea etsoa ho bapisa bakuli ba fumaneng liente tse tharo tse latellanang tsa beke le beke tsa PRP le liente tse tharo tse latellanang tsa HA.Phuputso ena e fumane ntlafatso ho lintlha tsa HHS, WOMAC, le VAS lihlopheng tsa HA le PRP nakong ea 6 le likhoeli tsa 12 tsa ho latela.Leha ho le joalo, ka linako tsohle, ho ne ho se na phapang e khōlō pakeng tsa lihlopha tsena tse peli.Ha ho lipatlisiso tse bontšitseng hore ente ea intra-articular ea PRP ka lethekeng e na le liphello tse mpe, 'me bohle ba fihletse qeto ea hore PRP e sireletsehile.
Le hoja boitsebiso bo lekanyelitsoe, ente ea intra-articular ea PRP ha ho phekoloa hip Articular bone osteoarthritis e ipakile e sireletsehile, 'me e na le katleho e itseng ho fokotsa bohloko le ho ntlafatsa mosebetsi, joalokaha ho lekantsoe ke lintlha tsa liphello tse tlalehiloeng ke bakuli.Liphuputso tse ngata li bontšitse hore PRP e ka qala hantle ho fokotsa bohloko ha e bapisoa le HA;Leha ho le joalo, kaha PRP le HA li na le katleho e tšoanang haholo likhoeling tsa 12, molemo ofe kapa ofe oa pele o bonahala o fokola ha nako e ntse e ea.Kaha lithuto tse 'maloa tsa kliniki li hlahlobile tšebeliso ea PRP ka hip OA, ho hlokahala bopaki bo bongata bo phahameng ho fumana hore na PRP e ka sebelisoa e le mokhoa o mong oa tsamaiso ea Conservative ho lieha ho sebetsa ha hip Articular bone osteoarthritis.
Leqhoa la Leqhoa
Ke liteko tse peli feela tsa kliniki tse sa reroang tse ileng tsa kopana le litekanyetso tsa rona tsa ho kenyelletsa li ile tsa hlahloba tšebeliso ea PRP ka mokokotlo o matla oa maqaqailana.Roden le al.Teko ea tleliniki e laoloang ka mokhoa o sa reroang ea li-placebo tse sa boneng habeli li ile tsa etsoa ho bakuli ba nang le sekhahla se matla sa maqaqailana ho ED, ho bapisa ente e tataisoang ea ultrasound ea anesthetic ea lehae ea LR-PRP le ente ea saline le ea anesthetic ea lehae.Ha baa ka ba fumana phapang e kholo ea lipalo-palo ea bohloko ba VAS kapa tekanyo e tlaase ea maoto le maoto (LEFS) pakeng tsa lihlopha tse peli.
Laval le ba bang.ka nako e sa lekanyetsoang baatlelete ba phahameng ba 16 ba fumanoeng ba e-na le li-sprains tse phahameng tsa maqaqailana ho fumana phekolo ea ente ea LP-PRP e tataisoang ke ultrasound boemong ba pele ba phekolo, le liente tse pheta-phetoang tsa moralo o kopanetsoeng oa ho tsosolosa kapa moralo o fapaneng oa ho tsosolosa matsatsi a 7 hamorao.Bakuli bohle ba ile ba fumana protocol e tšoanang ea phekolo ea ho tsosolosa le mekhoa ea ho fokotseha.Phuputso e fumane hore sehlopha sa LP-PRP se ile sa tsosolosa tlhōlisano ka nako e khutšoanyane (matsatsi a 40.8 vs. 59.6 matsatsi, P <0.006).
PRP e bonahala e sa sebetse bakeng sa leqeba le matla la maqaqailana.Le hoja bopaki bo fokolang bo fana ka maikutlo a hore ente ea LP-PRP e ka ama leqaqailaneng le phahameng la baatlelete ba phahameng.
Kotsi ea Mesifa
Tšebeliso ea PRP bakeng sa ho phekola kotsi ea mesifa e bontšitse bopaki bo sa utloahaleng ba kliniki.Ho tšoana le pholiso ea tendon, mehato ea pholiso ea mesifa e kenyelletsa karabo ea pele ea ho ruruha, e lateloa ke ho ata ha lisele, ho arohana, le ho nchafatsa lisele.Hamid le ba bang.Phuputso e le 'ngoe e sa boneng e entsoeng ka mokhoa o sa tloaelehang e ile ea etsoa ho bakuli ba 28 ba nang le kotsi ea hamstring ea sehlopha sa 2, ho bapisa ente ea LR-PRP ka merero ea ho tsosolosa le ho tsosolosa feela.Sehlopha se fumanang phekolo ea LR-PRP se khonne ho hlaphoheloa tlhōlisanong ka potlako (karolelano ea nako ka matsatsi, 26.7 vs. 42.5, P = 0.02), empa ha ea ka ea finyella ntlafatso ea moralo.Ho phaella moo, liphello tse kholo tsa placebo sehlopheng sa phekolo li ka 'na tsa ferekanya liphello tsena.Tekong e laoloang e sa boneng habeli ea Randomized, Reurink et al.Re ile ra hlahloba bakuli ba 80 mme ra bapisa ente ea PRP le ente ea saline ea placebo.Bakuli bohle ba ile ba fumana phekolo e tloaelehileng ea ho tsosolosa.Mokuli o ile a lateloa ka likhoeli tsa 6 'me ho ne ho se na phapang e khōlō mabapi le nako ea ho hlaphoheloa kapa lebelo la ho lemala hape.Mokhoa o nepahetseng oa PRP oa ho ntlafatsa pholiso ea mesifa ka litsela tse amanang le bophelo bo botle e ntse e le thata 'me lipatlisiso tsa nakong e tlang li lokela ho etsoa.
Taolo ea Likheo le tse sa Kopanetsoeng
Le hoja ho na le bopaki bo utloahalang ba ho tšehetsa tšebeliso ea PRP ho ntlafatsa pholiso ea masapo, ha ho na tumellano ea kliniki ea ho tšehetsa tšebeliso e tloaelehileng ea PRP ho khothalletsa pholiso ea masapo.Tlhahlobo ea morao-rao ea PRP le phekolo e matla ea ho robeha e ile ea totobatsa li-RCT tse tharo tse sa kang tsa bontša melemo ho latela liphello tse sebetsang, ha lithuto tse peli li bontšitse liphello tse phahameng tsa kliniki.Boholo ba liteko tlhahlobisong ena (6/8) li ithutile katleho ea PRP hammoho le li-agent tse ling tsa likokoana-hloko (tse kang lisele tsa mesenchymal stem le / kapa li-grafts tsa masapo) ho khothalletsa pholiso ea fracture.
Molao-motheo o sebetsang oa plasma e nang le platelet-rich (PRP) ke ho fana ka lintlha tsa kholo le li-cytokine tse nang le li-platelet tse nang le bongata bo feteletseng ba 'mele.Meriana ea mesifa le masapo, PRP ke mokhoa o tšepisang oa phekolo o nang le bopaki bo hlakileng ba tšireletso.Leha ho le joalo, bopaki ba ho sebetsa ha eona bo kopane 'me bo itšetlehile haholo ka metsoako le lipontšo tse itseng.Liteko tse ling tsa boemo bo holimo le tse kholo nakong e tlang li bohlokoa bakeng sa ho theha pono ea rona ka PRP.
(Likahare tsa sengoloa sena li hatisitsoe hape, 'me ha re fane ka tiisetso efe kapa efe e hlakileng kapa e boletsoeng bakeng sa ho nepahala, ho ts'epahala kapa botlalo ba litaba tse teng sengolong sena,' me ha re ikarabelle bakeng sa maikutlo a sengoloa sena, ka kopo utloisisa.)
Nako ea poso: Jul-24-2023