I-Platelet Rich Plasma (PRP)
I-epicondylitis ye-humeral yangaphandle yisifo esivamile somtholampilo esibonakala ngobuhlungu ohlangothini olungemuva lwendololwane.Kuwubuqili futhi kulula ukuphinda kwenzeke, okungabangela ubuhlungu bengalo kanye namandla esihlakala, futhi kuthinte kabi impilo yansuku zonke nomsebenzi weziguli.Kunezindlela ezihlukahlukene zokwelashwa kwe-lateral epicondylitis ye-humerus, enemiphumela ehlukene.Ayikho indlela yokwelapha ejwayelekile okwamanje.I-Platelet rich plasma (PRP) inomphumela omuhle ekulungiseni amathambo kanye ne-tendon, futhi iye yasetshenziswa kabanzi ukwelapha i-epicondylitis e-humeral yangaphandle.
Ngokuya ngokuqina kwezinga lokugunyazwa kokuvota, lihlukaniswe ngamabanga amathathu:
U-100% uvunyelwe ngokugcwele (Izinga I)
90%~99% ukuvumelana okuqinile (Izinga II)
70%~89% bayavumelana (Izinga III)
Umqondo we-PRP kanye Nezidingo Zezithako Zohlelo Lokusebenza
(1) Umqondo: I-PRP iwumphumela we-plasma.I-concentration yayo ye-platelet iphakeme kune-baseline.Iqukethe inani elikhulu lezici zokukhula kanye nama-cytokines, angakhuthaza ngokuphumelelayo ukulungiswa kwezicubu nokuphulukiswa.
(2) Izimfuneko zezithako ezisetshenzisiwe:
① Ukuhlushwa kweplatelet ye-PRP ekwelapheni i-epicondylitis ye-humeral yangaphandle kunconywa ukuthi ibe (1000 ~ 1500) × 109/L (izikhathi ezingu-3-5 zokuhlushwa kwesisekelo);
② Uncamela ukusebenzisa i-PRP ecebile ngamaseli egazi amhlophe;
③ Ukwenza kusebenze kwe-PRP akunconyiwe.
(Ukuqina okunconyiwe: Izinga I; izinga lobufakazi bezincwadi: A1)
Ukulawulwa Kwekhwalithi ye-PRP Yokulungiselela Ubuchwepheshe
(1) Izidingo zemfundo yabasebenzi: Ukulungiswa kanye nokusetshenziswa kwe-PRP kufanele kwenziwe ngabasebenzi bezokwelapha abaneziqu zodokotela abanelayisensi, abahlengikazi abanelayisensi kanye nabanye abasebenzi bezokwelapha abafanelekile, futhi kufanele kwenziwe ngemva kokuqeqeshwa okuqinile kokusebenza kwe-aseptic kanye nokuqeqeshwa kokulungiselela i-PRP.
(2) Izinsiza: I-PRP izolungiswa ngokusebenzisa uhlelo lokulungiselela lwemishini yezokwelapha ye-Class III evunyelwe.
(3) Indawo yokusebenza: Ukwelashwa kwe-PRP kuwumsebenzi ohlaselayo, futhi ukulungiswa kwawo nokusetshenziswa kunconywa ukuba kwenziwe ekamelweni elikhethekile lokwelapha noma igumbi lokuhlinza elihlangabezana nezidingo zokulawula izinzwa.
(Ukuqina okunconyiwe: Izinga I; izinga lobufakazi bemibhalo: Izinga E)
Izinkomba kanye Contraindications of PRP
(1) Izinkomba:
① Ukwelashwa kwe-PRP akunazo izidingo ezicacile zohlobo lomsebenzi wabantu, futhi kungabhekwa njengokwenziwa ezigulini ezinesidingo esikhulu (njengesixuku sezemidlalo) kanye nesidingo esiphansi (njengabasebenzi basehhovisi, abasebenzi bomndeni, njll. );
② Iziguli ezikhulelwe nezincelisayo zingasebenzisa i-PRP ngokuqapha lapho ukwelashwa ngokomzimba kungasebenzi;
③ I-PRP kufanele icatshangelwe lapho ukwelashwa okungezona okusebenzayo kwe-humeral epicondylitis kungasebenzi isikhathi esingaphezu kwezinyanga ze-3;
④ Ngemuva kokuthi ukwelashwa kwe-PRP kuphumelele, iziguli ezinokubuyela emuva zingacabanga ukuyisebenzisa futhi;
⑤ I-PRP ingasetshenziswa izinyanga ezingu-3 ngemuva komjovo we-steroid;
⑥ I-PRP ingasetshenziselwa ukwelapha isifo se-tendon extensor kanye nokudabuka kwe-tendon ingxenye.
(2) Ukuphikisana okuphelele: ① thrombocytopenia;② Isimila esiyingozi noma ukutheleleka.
(3) Ukuphikisana okuhlobene: ① iziguli ezinokujiya okungavamile kwegazi futhi ezithatha izidakamizwa ezilwa nokuvuvukala;② I-anemia, i-hemoglobin<100 g/L.
(Ukuqina okunconyiwe: Izinga II; izinga lobufakazi bezincwadi: A1)
I-PRP Injection Therapy
Uma umjovo we-PRP usetshenziselwa ukwelapha i-lateral epicondylitis ye-humerus, kunconywa ukusebenzisa isiqondiso se-ultrasound.Kunconywa ukuthi ujove u-1 ~ 3 ml we-PRP endaweni kanye naseduze nendawo yokulimala.Umjovo owodwa wanele, ngokuvamile awudluli izikhathi ezi-3, kanti isikhathi somjovo singamaviki angu-2 ~ 4.
(Ukuqina okunconyiwe: Izinga I; izinga lobufakazi bezincwadi: A1)
Ukusetshenziswa kwe-PRP Ekusebenzeni
Sebenzisa i-PRP ngokushesha ngemva kokuhlanza noma ukuthunga isilonda ngesikhathi sokuhlinzwa;Amafomu omthamo asetshenziswayo afaka i-PRP noma ahlanganiswe nejeli ecebile yeplatelet (PRF);I-PRP ingajova ekuhlanganiseni kwethambo le-tendon, indawo yokugxila ye-tendon ezindaweni eziningi, futhi i-PRF ingasetshenziswa ukugcwalisa indawo ye-tendon defect futhi imboze indawo ye-tendon.Umthamo ngu-1-5 ml.Akunconywa ukujova i-PRP emgodini ohlangene.
(Ukuqina okunconyiwe: Izinga II; izinga lobufakazi bemibhalo: Izinga E)
Izinkinga Ezihlobene Ne-PRP
(1) Ukuphathwa kobuhlungu: Ngemva kokwelashwa kwe-PRP kwe-epicondylitis e-humeral yangaphandle, i-acetaminophen (i-paracetamol) ne-opioid ebuthakathaka ingabhekwa njengokunciphisa ubuhlungu beziguli.
(2) Izinyathelo zokulwa nokusabela okubi: ubuhlungu obunzima, i-hematoma, ukutheleleka, ukuqina okuhlangene nezinye izimo ngemva kokwelashwa kwe-PRP kufanele kusingathwe ngenkuthalo, futhi izinhlelo zokwelashwa eziphumelelayo kufanele zenziwe ngemuva kokuthuthukisa ukuhlolwa nokuhlolwa kwe-laboratory kanye ne-imaging.
(3) Ukukhulumisana nodokotela kwesiguli kanye nemfundo yezempilo: Ngaphambi nangemva kokwelashwa kwe-PRP, yenza ngokugcwele ukuxhumana nodokotela nesiguli kanye nemfundo yezempilo, futhi usayine ifomu lemvume unolwazi.
(4) Uhlelo lokuvuselela: akukho ukulungiswa okudingekayo ngemva kokwelashwa komjovo we-PRP, futhi imisebenzi ebangela ubuhlungu kufanele igwenywe phakathi kwamahora angu-48 ngemva kokwelashwa.Ukuguquguquka kwendololwane nokunwetshwa kungenziwa emahoreni angama-48 kamuva.Ngemuva kokuhlinzwa kuhlanganiswe ne-PRP, uhlelo lokuvuselela ngemuva kokuhlinzwa kufanele lunikezwe kuqala.
(Ukuqina okunconyiwe: Izinga I; izinga lobufakazi bemibhalo: Izinga E)
Izithenjwa:Chin J Trauma, Agasti 2022, Vol.38, No. 8, Chinese Journal of Trauma, Agasti 2022
(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: Nov-28-2022