I-Primary atrophic rhinitis (1Ry AR) yisifo sekhala esingamahlalakhona esibonakala ngokulahleka kokusebenza kwe-mucociliary clearance, ukuba khona kwezimfihlo ezinamathelayo kanye neziqweqwe ezomile, okuholela ephunga elibi elivamile, ngokuvamile ezinhlangothini zombili.Inani elikhulu lezindlela zokwelapha zizanyiwe, kodwa akukabikho ukuvumelana ngokwelashwa okuphumelelayo kwesikhathi eside okuphumelelayo.Inhloso yalolu cwaningo ukuhlola ukubaluleka kwe-plasma ecebile nge-platelet njengesivuseleli sebhayoloji sokugqugquzela ukuphulukiswa kwe-atrophic rhinitis eyinhloko.
Umbhali uhlanganise isamba samacala angama-78 atholakala emtholampilo ane-atrophic rhinitis eyinhloko.Iqembu A (amacala) kanye neziguli ezine-platelet empofu zenze i-endoscopy yamakhala, uhlu lwemibuzo lwe-Sino Nasal Outcome Test-25, isivivinyo sesikhathi se-saccharin ukuze kuhlolwe izinga lokukhishwa kwe-mucosal ciliary, kanye ne-plasma ku-biopsy specimen Iqembu B (ukulawula) inyanga engu-1 nezinyanga ezingu-6 ngaphambi kokufakwa kwesicelo. i-plasma ecebile ye-platelet.
Izimpawu ezivame kakhulu ezitholwa yizo zonke iziguli kuQembu A ngaphambi kokujova i-plasma ecebile yeplatelet zazihlanganisa utwayi lwamakhala, olwabonisa ukuthuthukiswa kwe-endoscopic nokuncipha kwezigameko, ngamacala angama-36 (92.30%);uphansi, 31 (79.48%);Ukuvaleka kwamakhala, ama-30 (76.92%);Ukulahlekelwa iphunga, 17 (43.58%);Futhi i-epistaxis, 7 (17.94%) kuya kutwayi lwamakhala, 9 (23.07%);Izinyawo, 13 (33.33%);Ukucinana kwamakhale, 14 (35.89%);Ukulahlekelwa iphunga, 13 (33.33%);Futhi i-epistaxis, engu-3 (7.69%), ngemva kwezinyanga ezingu-6, lokhu kubonakala ekwehleni kwesikolo se-Sino Nasal Outcome Test-25, esinesilinganiso esingu-40 ngaphambi kwe-plasma ecebile ye-platelet futhi yehla yaya ku-9 ngemva kwezinyanga ezingu-6.Ngokufanayo, isikhathi sokuvunyelwa kwe-mucociliary safinyezwa kakhulu ngemva kokujova i-plasma ecebile yeplatelet;Isilinganiso sokuqala sokuhlolwa kwesikhathi sokuthutha i-saccharin kwakuyimizuzwana engu-1980, futhi sehla safinyelela kumasekhondi angu-920 ezinyangeni ezingu-6 ngemva kokujova i-plasma ecebile yeplatelet.
Ukusetshenziswa kwe-plasma ecebile ye-platelet njenge-ejenti yebhayoloji kungase kube indlela entsha ehlasela kancane engalungisa ngempumelelo ukungondleki kwezicubu ngocwaningo olwengeziwe.
Kunezindlela ezine eziyinhloko zokwelapha i-atrophic rhinitis: ukunciphisa imbobo yamakhala ngezinto ezihlukahlukene kanye nokufakelwa, ukukhuthaza ukuvuselelwa kwe-mucosal evamile usebenzisa ukuhlinzwa kwe-Yang yakudala noma okushintshiwe, ukugcoba ulwelwesi lwamakhala, noma ukuthuthukisa imithambo yegazi yamakhala.I-Cavity.Ziningi ezinye izindlela zokwelapha ezizanyiwe, okuhlanganisa ukuchelela emakhaleni kanye nokushaywa kwamanzi, i-glucose glycerol nasal drops, upharafini owuketshezi, i-estradiol emafutheni amakinati, isixazululo se-anti ozaena, ama-antibiotics, insimbi, i-zinc, amaprotheni, izithako zamavithamini, ama-vasodilator, ama-prostheses, imigomo, i-placenta extracts. noma i-acetylcholine, ene-pilocarpine noma ngaphandle kwayo.Nokho, ukusebenza kwalezi zindlela kuyehluka.Emsebenzini wokwelapha, ukugeza umgodi wamakhala ngesifutho samakhala kuyindlela evame ukusetshenziswa kakhulu ekwelapheni izimpawu ze-atrophic rhinitis, njengoba kungamanzisa ulwelwesi lwamakhala futhi kuvimbele ukuqubuka.
Phakathi kwalezi zindlela ezingenhla, ukuhlinzwa kuka-Yang okuthuthukisiwe kuye kwafakazelwa ukuthi kuyindlela ephumelelayo nehlala isikhathi eside yokwelapha i-atrophic rhinitis.Nokho, umphumela wokuphefumula komlomo ovulekile kungabangela ukungakhululeki okukhulu ezigulini.Izinto zokuthambisa nezithasiselo ziboniswe zinemiphumela elinganiselwe neyesikhashana.Ngakho-ke, ezinye izindlela zokugqugquzela ukuvuselelwa kwe-mucosal yamakhala noma i-angiogenesis ziye zafundwa.
I-PRPyakhiwe ukugxila kwe-plasma okwedlula ukugcwala kweplatelet egazini lonke.I-PRP ithuthukisa izici ezithinta ukukhula kwezicubu, ukuhlukaniswa, nokuphulukiswa kwezibazi, njenge-platelet derived growth factor, ukuguqula ukukhula kwe-fibroblast, factor growth factor, endothelial growth factor, and insulin-like growth factor.Ngakho-ke, i-PRP iye yafakazelwa ukuthi inemiphumela emihle eyamukelekayo ezifundweni ezihlukahlukene zomtholampilo, ezikhuthaza ngokuphumelelayo ukuphulukiswa kwesilonda nokuvuselelwa kwezicubu, kuhlanganise nomkhakha we-otolaryngology.Ngokuqondile, kuye kwabikwa ukuthi i-PRP iphumelela ekuthuthukiseni ukuvuselelwa kwe-membrane ye-tympanic, izintambo zezwi kanye nezinzwa zobuso, kanye nokuphulukiswa ngemva kokuhlinzwa kwe-myringoplasty noma i-endoscopic sinus.Ngaphezu kwalokho, ucwaningo lokuhlola lwenziwa eminyakeni embalwa edlule ukuze kwelaphe i-atrophic rhinitis ngomjovo wengxube ye-PRP lipid.Ngaphezu kwalokho, i-PRP isebenzisa igazi le-autologous futhi ayinakho ukusabela okweqile noma ukwaliwa komzimba.Ingalungiswa kalula phakathi kwemizuzu embalwa ngokusebenzisa izinqubo ezimbili ze-centrifugation.
Kulolu cwaningo, siphenye umjovo we-PRP ku-atrophic nasal mucosa, okwathuthukisa imvume ye-mucosal cilia kanye nezimpawu phakathi nenkathi yokulandelela yezinyanga ze-6, ikakhulukazi ezigulini ezincane, ngemiphumela evelele kakhulu uma kuqhathaniswa neqembu elikhulile.Ezimweni eziningi ze-atrophic rhinitis, kuhlanganise ne-rhinitis asebekhulile, ukukhishwa kwe-mucus kuyancipha.Ngakho-ke, ukuqina kwe-mucinous kuholela ekubambezelekeni kokucaciswa kwe-cilia yama-nasal mucosal.Ukugcwalisa amanzi nge-saline spray kuzothinta izakhiwo ze-viscous mucus, futhi ukucaciswa kwe-cilia ye-nasal mucosa kuzobuyiselwa ngezinga elithile.Kodwa-ke, indima ye-mucus yamakhala ehlanjululwe ekuxazululeni izimpawu zamakhala ingase ibe nomkhawulo.Ngakho-ke, nakuba i-conservative nasal hydration ingase futhi ithuthukise imvume ye-mucociliary, lolu hlobo lokwelapha aluzange luthuthukise kakhulu izimpawu zekhala.Ngaphezu kwalokho, i-spray yamakhala kanye nokunisela kudinga usawoti womzimba kanye nezinsimbi ezikhethekile, futhi kufanele zenziwe ngokuqhubekayo ukuze kulawule izimpawu.Ngokuphambene, umjovo we-PRP udinga kuphela umjovo owodwa ukuze uzuze imiphumela emihle.Ngemuva komjovo, umthamo we-turbinate ukhuphuka ngokushesha.Kodwa-ke, ekuvakasheni okulandelayo kwesiguli (amaviki angu-2 kamuva), kwakungekho umehluko kumthamo nokuma kwe-turbinate ephansi.Ngakho-ke, ukunyuka kwesikhashana kwevolumu okubangelwa umjovo kubhekwa njengento engenamsebenzi.Ukwengeza, njengoba kuboniswe ekuhlaziyweni kwesizinda esingaphansi kwe-SNOT-22, kwakungekho ukuthuthukiswa okuphawulekayo kusizinda somzwelo esingaphansi kweziguli ze-PRP zokujova.Imiphumela ayizange ihambisane nokuthuthukiswa kwesizinda semizwa, okubonisa ukuthi umphumela we-placebo awubalulekile esicini esithile.Isifutho samakhala kanye nokunisela kudinga usawoti ophilayo kanye nezinsimbi ezikhethekile, futhi kufanele kwenziwe ngokuqhubekayo ukuze kulawulwe izimpawu.Ngokuphambene, umjovo we-PRP udinga kuphela umjovo owodwa ukuze uzuze imiphumela emihle.Ngemuva komjovo, umthamo we-turbinate ukhuphuka ngokushesha.Kodwa-ke, ekuvakasheni okulandelayo kwesiguli (amaviki angu-2 kamuva), kwakungekho umehluko kumthamo nokuma kwe-turbinate ephansi.Ngakho-ke, ukunyuka kwesikhashana kwevolumu okubangelwa umjovo kubhekwa njengento engenamsebenzi.Ukwengeza, njengoba kuboniswe ekuhlaziyweni kwesizinda esingaphansi kwe-SNOT-22, kwakungekho ukuthuthukiswa okuphawulekayo kusizinda somzwelo esingaphansi kweziguli ze-PRP zokujova.Imiphumela ayizange ihambisane nokuthuthukiswa kwesizinda semizwa, okubonisa ukuthi umphumela we-placebo awubalulekile esicini esithile.Isifutho samakhala kanye nokunisela kudinga usawoti ophilayo kanye nezinsimbi ezikhethekile, futhi kufanele kwenziwe ngokuqhubekayo ukuze kulawulwe izimpawu.Ngokuphambene, umjovo we-PRP udinga kuphela umjovo owodwa ukuze uzuze imiphumela emihle.Ngemuva komjovo, umthamo we-turbinate ukhuphuka ngokushesha.Kodwa-ke, ekuvakasheni okulandelayo kwesiguli (amaviki angu-2 kamuva), kwakungekho umehluko kumthamo nokuma kwe-turbinate ephansi.Ngakho-ke, ukunyuka kwesikhashana kwevolumu okubangelwa umjovo kubhekwa njengento engenamsebenzi.Ukwengeza, njengoba kuboniswe ekuhlaziyweni kwesizinda esingaphansi kwe-SNOT-22, kwakungekho ukuthuthukiswa okuphawulekayo kusizinda somzwelo esingaphansi kweziguli ze-PRP zokujova.Imiphumela ayizange ihambisane nokuthuthukiswa kwesizinda semizwa, okubonisa ukuthi umphumela we-placebo awubalulekile esicini esithile.Umjovo we-PRP udinga kuphela umjovo owodwa ukuze uzuze imiphumela emihle.Ngemuva komjovo, umthamo we-turbinate ukhuphuka ngokushesha.Kodwa-ke, ekuvakasheni okulandelayo kwesiguli (amaviki angu-2 kamuva), kwakungekho umehluko kumthamo nokuma kwe-turbinate ephansi.Ngakho-ke, ukunyuka kwesikhashana kwevolumu okubangelwa umjovo kubhekwa njengento engenamsebenzi.Ukwengeza, njengoba kuboniswe ekuhlaziyweni kwesizinda esingaphansi kwe-SNOT-22, kwakungekho ukuthuthukiswa okuphawulekayo kusizinda somzwelo esingaphansi kweziguli ze-PRP zokujova.Imiphumela ayizange ihambisane nokuthuthukiswa kwesizinda semizwa, okubonisa ukuthi umphumela we-placebo awubalulekile esicini esithile.Umjovo we-PRP udinga kuphela umjovo owodwa ukuze uzuze imiphumela emihle.Ngemuva komjovo, umthamo we-turbinate ukhuphuka ngokushesha.Kodwa-ke, ekuvakasheni okulandelayo kwesiguli (amaviki angu-2 kamuva), kwakungekho umehluko kumthamo nokuma kwe-turbinate ephansi.Ngakho-ke, ukunyuka kwesikhashana kwevolumu okubangelwa umjovo kubhekwa njengento engenamsebenzi.Ukwengeza, njengoba kuboniswe ekuhlaziyweni kwesizinda esingaphansi kwe-SNOT-22, kwakungekho ukuthuthukiswa okuphawulekayo kusizinda somzwelo esingaphansi kweziguli ze-PRP zokujova.Imiphumela ayizange ihambisane nokuthuthukiswa kwesizinda semizwa, okubonisa ukuthi umphumela we-placebo awubalulekile esicini esithile.Awukho umehluko kumthamo nokuma kwe-turbinate ephansi.Ngakho-ke, ukunyuka kwesikhashana kwevolumu okubangelwa umjovo kubhekwa njengento engenamsebenzi.Ukwengeza, njengoba kuboniswe ekuhlaziyweni kwesizinda esingaphansi kwe-SNOT-22, kwakungekho ukuthuthukiswa okuphawulekayo kusizinda somzwelo esingaphansi kweziguli ze-PRP zokujova.Imiphumela ayizange ihambisane nokuthuthukiswa kwesizinda semizwa, okubonisa ukuthi umphumela we-placebo awubalulekile esicini esithile.Awukho umehluko kumthamo nokuma kwe-turbinate ephansi.Ngakho-ke, ukunyuka kwesikhashana kwevolumu okubangelwa umjovo kubhekwa njengento engenamsebenzi.Ukwengeza, njengoba kuboniswe ekuhlaziyweni kwesizinda esingaphansi kwe-SNOT-22, kwakungekho ukuthuthukiswa okuphawulekayo kusizinda somzwelo esingaphansi kweziguli ze-PRP zokujova.Imiphumela ayizange ihambisane nokuthuthukiswa kwesizinda semizwa, okubonisa ukuthi umphumela we-placebo awubalulekile esicini esithile.
Izinhlungu eziqhubekayo kanye nezimpawu ezihlobene nokungakhululeki ze-atrophic rhinitis azibucayi kwezokwelapha.Ngakho-ke, ukulahlekelwa kwezenhlalo nezomnotho kulinganiswa kancane.Nokho, ngokombono weziguli zangempela, kuyisifo esibucayi emphakathini.Ngaphezu kwalokho, ngokuguga kwesibalo sabantu, inani leziguli ezine-senile rhinitis likhula ngokukhula okukhulu.Ngakho-ke, kubaluleke kakhulu ukunikeza ukwelashwa okufanele kwe-atrophic rhinitis, kuhlanganise ne-rhinitis asebekhulile.
Inhloso yalolu cwaningo ukuphakamisa indlela entsha yokuvuselela yokwelapha i-atrophic rhinitis ngomjovo we-PRP we-autologous, nokuqhathanisa ukuthuthukiswa kwezimpawu phakathi kweqembu lokwelapha le-PRP kanye neqembu lokwelapha elilondolozayo lisebenzisa iqembu lokulawula.Ngenxa yokuthi i-atrophic rhinitis iyincazelo yomtholampilo, ucwaningo olwengeziwe luyadingeka ukuze kucatshangelwe indlela yokusebenza kwayo.Kodwa-ke, ukuze kuvinjwe ukulahlekelwa kwezenhlalo nezomnotho kanye nokwehla kwezinga lempilo yesiguli, kuyadingeka ukunikeza imiphumela yocwaningo enemiphumela yokwelapha engaba khona.
Nokho, lolu cwaningo lunemikhawulo eminingana.Lolu cwaningo lwaklanywa ngokulindelekile futhi alukwazi ukulawulwa ngokungahleliwe njengoba abanye ababambiqhaza benqabe uhlelo lomjovo wamakhala.Ngokwezimiso zokuziphatha, imisebenzi ehlaselayo ngezinjongo zemfundo eqenjini elilawulayo kufanele ikhawulelwe ukuze kuvikelwe amalungelo nezintshisakalo zeziguli.Ngakho-ke, ukwabela iziguli ngokusekelwe kulokho abakuthandayo kwenza imiphumela yocwaningo ibe buthaka kunaleyo ehlinzekwa izifundo ezilawulwa ngokungahleliwe.Ngaphezu kwalokho, i-atrophic rhinitis yesibili ibangelwa ukuguqulwa nokususwa kwesakhiwo sokuqala samakhala.Ukwenza i-biopsy kungase kubhebhethekise i-atrophy.Ngakho-ke, ngokombono wokuziphatha, akunakwenzeka ukwenza i-biopsy yezicubu zekhala ehambisanayo ezigulini ezine-atrophic rhinitis.Imiphumela ngemva kwezinyanga ezingu-6 zokulandelela ingase ingameleli imiphumela yesikhathi eside.Ngaphezu kwalokho, inani leziguli eqenjini elincane lincane.Ngakho-ke, ucwaningo lwesikhathi esizayo kufanele lufake iziguli eziningi ezisebenzisa umklamo olawulwa ngokungahleliwe phakathi nesikhathi eside sokulandelela.
(Okuqukethwe yile ndatshana kuphrintwe kabusha, futhi asinikezeli nganoma yisiphi isiqinisekiso esicacile noma esishiwoyo sokunemba, ukwethembeka noma ukuphelela kokuqukethwe okuqukethwe kulesi sihloko, futhi asinasibopho ngemibono yalesi sihloko, sicela uqonde.)
Isikhathi sokuthumela: May-23-2023