Platelet-rich plasma (PRP) hajoale e sebelisoa haholo mafapheng a fapaneng a bongaka.Lilemong tsa morao tjena, ts'ebeliso ea PRP ho lingaka tsa masapo e 'nile ea khahla tlhokomelo e eketsehileng,' me ts'ebeliso ea eona likarolong tse fapaneng tse kang ho tsosolosoa ha lisele, ho folisa maqeba, ho lokisoa ha maqeba, ho buuoa ka polasetiki le botle bo se bo atile haholo.Khatisong ea kajeno, re tla sekaseka baeloji ea PRP, mokhoa oa eona oa ts'ebetso, le ho aroloa ha PRP ho utloisisa hantle hore na ke eng e ka etsoang le e sa lokelang ho etsoa ka PRP.
Nalane ea PRP
PRP e boetse e tsejoa e le platelet-rich plasma (PRP), platelet-rich growth factor (GFS) le platelet-rich fibrin (PRF) matrix.Khopolo le tlhaloso ea PRP e qalile tšimong ea hematology.Litsebi tsa mafu a mali li ile tsa qapa lentsoe PRP lilemong tsa bo-1970, haholo-holo ho phekola bakuli ba thrombocytopenia ka ho ntša liplatelete le ho eketsa tšelo ea mali.
Lilemo tse leshome hamorao, PRP e ile ea qala ho sebelisoa ho buuoa ka maxillofacial e le PRF.Fibrin e na le thepa ea ho khomarela le ea homeostatic, 'me PRP e na le lintho tse thibelang ho ruruha tse susumetsang ho ata ha lisele.Ka mor'a moo, PRP e ile ea qala ho sebelisoa haholo tšimong ea mesifa ea mesifa ea likotsi tsa lipapali 'me ea fumana liphello tse ntle tsa phekolo.Hobane sepheo sa phekolo ke haholo-holo baatlelete ba litsebi, e hohetse tlhokomelo e kholo mecheng ea litaba 'me e sebelisitsoe haholo lefapheng la meriana ea lipapali.Ka mor'a moo, PRP e ile ea khothalletsoa butle-butle ho lingaka tsa masapo, ho buuoa, ho buuoa ke bana, mafu a basali, urology, polasetiki le opereishene ea litlolo le ophthalmology.
Platelet Biology
Lisele tsa mali tsa peripheral li kenyelletsa lisele tse khubelu tsa mali, lisele tse tšoeu tsa mali le li-platelet, kaofela li tsoa seleng e tloaelehileng ea pluripotent stem e ka khethollang meloko e fapaneng ea lisele.Lisele tsena li na le lisele tse ka pele tse khonang ho arohana le ho hola.Liplatelete li tsoa mokong oa masapo 'me ke lisele tse nang le sebōpeho sa "disc" tsa boholo bo fapaneng, tse bophara ba hoo e ka bang 2 μm, 'me ke lisele tse nyenyane tsa mali tse teteaneng.Platelet e baloa ka mali a tloaelehileng a potolohang ho tloha ho 150,000 ho isa ho 400,000 ka microliter.Li-platelet li na le li-granules tse 'maloa tsa bohlokoa tsa lekunutu, tseo ho tsona ho nang le tse tharo tse kholo: li-granules tse teteaneng, li-o-granules le li-lysosomes.Platelet e 'ngoe le e' ngoe e na le likaroloana tse ka bang 50-80.
Tlhaloso ea PRP
Qetellong, PRP ke sehlahisoa sa likokoana-hloko, e leng plasma e tsitsitseng e nang le platelet e phahameng haholo ho feta mali a peripheral.PRP ha e na feela likarolo tse phahameng tsa liplatelete, empa hape e na le lintlha tsohle tsa coagulation, ho kenyelletsa le letoto la lintlha tsa ho hōla, li-chemokine, li-cytokine le liprotheine tsa plasma.
PRP e ntšoa maling a peripheral a nkiloeng ka mekhoa e fapaneng ea ho lokisa laboratoring.Ka mor'a ho itokisa, ho ea ka li-gradients tse sa tšoaneng, lisele tse khubelu tsa mali, PRP, le PPP likarolong tsa mali li aroloa ka tatellano.Ho PRP, ho phaella ho palo e phahameng ea liplatelete, ho boetse hoa hlokahala ho nahana hore na e na le leukocyte le hore na e sebetsa.Ho ipapisitsoe le lintlha tsena, ho khethoa mefuta e fapaneng ea PRP e loketseng maemo a fapaneng a pathological.
Lisebelisoa tse 'maloa tsa khoebo li fumaneha hona joale tse ka nolofatsang ho lokisoa ha PRP.Lisebelisoa tsena tsa PRP hangata li hlahisa 2-5 fold high PRP platelet concentrations.Le hoja motho a ka nahana hore palo e phahameng ea platelet le palo e phahameng ea kholo ea kholo, phello ea phekolo e lokela ho ba molemo, sena ha se e-s'o thehoe, 'me makhetlo a 3-5 ka kakaretso ho nkoa a loketse.
Lisebelisoa tsa khoebo li na le monyetla oa ho ba tse tloaelehileng le tse bonolo, empa li na le mefokolo ea lisebelisoa tsa tsona tse fapaneng.Ba bang ha ba khone ho tlosa litšila tse itseng hantle, 'me litokisetso tse ling tsa PRP ha li phahame haholo.Ha e le hantle, lisebelisoa tsohle tsa khoebo li ke ke tsa lokisoa ka bomong le ka nepo.Ena ke bothata bo boholo ka thepa e tloaelehileng.Hajoale, ke theknoloji e nepahetseng feela ea boitokisetso ba laboratori e ikemetseng e ka koahelang litlhoko tsohle tsa mokuli, tse nang le litlhoko tse phahameng tsa theknoloji ea laboratori.
Sehlopha sa PRP
Ka 2006, Everts et al o ile a etsa tlhahiso ea khopolo ea PRP e nang le leukocyte e ruileng.Ka hona, PRP e ka aroloa hoo e batlang e le mefuta e 'meli ho ea ka palo ea li-leukocyte tse nang le: PRP e nang le li-leukocyte tse futsanehileng le PRP e nang le li-leukocyte tse ruileng.
1) Plasma e nang le liplatelete e nang le li-leukocyte tse ngata, tse bitsoang L-PRP (Leukocyte Platelet-Rich Plasma, e nang le lisele tse khubelu tsa mali), e sebelisoa haholo-holo bakeng sa maqeba a refractory, leoto la lefu la tsoekere, gout le ho se fole. maqeba, ho lokisoa ha masapo, ho se kopane, ho ruruha ha moko oa masapo le phekolo e meng ea bongaka.
2) Plasma e nang le li-platelet e ngata ntle le kapa e nang le likhahla tse tlaase tsa leukocyte e bitsoa P-PRP (Pure Platelet-Rich Plasma, ntle le lisele tse khubelu tsa mali), haholo-holo e sebelisetsoang likotsi tsa lipapali le mafu a senyehang, ho akarelletsa le likotsi tsa meniscus, ligament le tendon. , setsoe sa tennis, ramatiki ea lengole, ho senyeha ha lefufuru, lumbar disc herniation le mafu a mang.
3) Ka mor'a hore metsi a PRP a sebelisoe ke thrombin kapa calcium, PRP kapa PRF e kang gel e ka thehoa.(E lokiselitsoe pele ke Dohan et al. Fora)
Ka 2009, Dohan Ehrenfest et al.Likarolo tse 4 tse reriloeng ho latela boteng kapa ho ba sieo ha likarolo tsa cellular (joalo ka leukocyte) le sebopeho sa fibrin:
1) PRP e hloekileng kapa PRP e futsanehileng ea leukocyte: PRP e lokiselitsoeng ha e na leukocyte, 'me litaba tsa fibrin ka mor'a ho sebetsa li tlaase.
2) Lisele tse tšoeu tsa mali le PRP: li na le lisele tse tšoeu tsa mali, 'me litaba tsa fibrin ka mor'a hore li sebelisoe li tlaase.
3) PRF e hloekileng kapa PRF e futsanehileng ea leukocyte: ho itokisa ha ho na leukocyte ebile ho na le fibrin e phahameng haholo.Lihlahisoa tsena li tla ka sebōpeho sa li-gel tse sebetsang 'me li ke ke tsa sebelisoa bakeng sa ente.
4) Leukocyte-rich fibrin le PRF: e nang le leukocyte le fibrin e phahameng haholo.
Ka 2016, Magalon et al.e hlahisitse karolo ea DEPA (tekanyetso, katleho, bohloeki, ts'ebetso), e shebaneng le palo ea liplatelete tsa PRP, bohloeki ba sehlahisoa, le ts'ebetso ea platelet.
1. Tekanyetso ea ente ea platelet: Bala ka ho atisa mahloriso a platelet ka molumo oa platelet.Ho ea ka tekanyo e entsoeng (ka limilione tse likete kapa limilione tsa liplatelete), e ka aroloa ka (a) tekanyo e phahameng haholo:> 5 limilione tse likete;(b) tekanyo e phahameng: ho tloha ho limilione tse likete tse 3 ho ea ho tse limilione tse likete tse 5;(c) tekanyo e mahareng: ho tloha ho 1 bilione ho ea ho 3 bilione;(d) tekanyo e tlase: e ka tlase ho 1 bilione.
2. Bokhoni ba ho itokisa: peresente ea liplatelete tse bokeletsoeng maling.(a) Tšebeliso e phahameng ea lisebelisoa: tekanyo ea ho hlaphoheloa ha platelet> 90%;(b) katleho ea lisebelisoa tse mahareng: sekhahla sa ho hlaphoheloa ha platelet lipakeng tsa 70-90%;(c) ts'ebetso e tlase ea lisebelisoa: sekhahla sa ho hlaphoheloa pakeng tsa 30-70%;(d) Ts'ebetso ea lisebelisoa e tlase haholo: sekhahla sa ho hlaphoheloa se ka tlase ho 30%.
3. Bohloeki ba PRP: E amana le sebopeho se lekanyelitsoeng sa liplatelete, lisele tse tšoeu tsa mali le lisele tse khubelu tsa mali ho PRP.Re e hlalosa e le (a) PRP e hloekileng haholo:> 90% liplatelete tse amanang le erythrocyte le leukocyte ho PRP;(b) PRP e hloekileng: 70-90% platelets;(c) PRP e fapaneng: % platelets Pakeng tsa 30-70%;(d) PRP ea mali a feletseng: peresente ea liplatelete ho PRP e ka tlaase ho 30%.
4. Ts'ebetso ea ts'ebetso: hore na ho kenya liplatelete tse nang le lintlha tse sa tloaelehang tsa coagulation, joalo ka autologous thrombin kapa calcium chloride.
(Litaba tsa sengoloa sena li hlahisitsoe hape.)
Nako ea poso: May-16-2022