Umlando wePlatelet Rich Plasma (PRP)

Mayelana ne-Platelet Rich Plasma (PRP)

I-Platelet-rich rich plasma (PRP) inenani elilinganayo lokwelapha kuma-stem cells futhi okwamanje ingenye yezindlela zokwelapha ezithembisayo kakhulu emithini yokuvuselela.Isetshenziswa kakhulu emikhakheni ehlukene yezokwelapha, okuhlanganisa i-cosmetic dermatology, i-orthopedics, imithi yezemidlalo kanye nokuhlinzwa.

Ngo-1842, kwatholakala ezinye izakhiwo ngaphandle kwamangqamuzana egazi abomvu namhlophe egazini, okwamangaza abantu besikhathi sakhe.UJulius Bizozero waba ngowokuqala ukwetha isakhiwo esisha se-platelet "le piastrine del sangue" - ama-platelet.Ngo-1882, wachaza indima yamaplatelet ku-coagulation in vitro kanye nokubandakanyeka kwabo ku-etiology ye-thrombosis in vivo.Uthole nokuthi izindonga zemithambo yegazi zivimbela ukunamathela kweplatelet.U-Wright wenza inqubekelaphambili eyengeziwe ekuthuthukiseni amasu okwelapha okuzivuselela ngokuthola kwakhe ama-macrokaryocyte, ayisandulela samaplatelet.Ekuqaleni kwawo-1940, odokotela basebenzisa “izingcaphuno” ze-embryonic ezakhiwe izici zokukhula nama-cytokines ukukhuthaza ukuphulukiswa kwesilonda.Ukuphulukiswa kwesilonda ngokushesha nangempumelelo kubalulekile empumelelweni yezinqubo zokuhlinzwa.Ngakho-ke, u-Eugen Cronkite et al.yethula inhlanganisela ye-thrombin ne-fibrin ekuxhumeni kwesikhumba.Ngokusebenzisa izingxenye ezingenhla, ukunamathiselwe okuqinile nokuzinzile kwe-flap kuqinisekiswa, okudlala indima ebalulekile kulolu hlobo lokuhlinzwa.

Ekuqaleni kwekhulu lama-20, odokotela babona isidingo esiphuthumayo sokumpontshelwa kwe-platelet ukuze kwelashwe i-thrombocytopenia.Lokhu kuye kwaholela ekuthuthukisweni kwamasu okulungiselela ukugxila kwe-platelet.Ukwengezwa ngama-platelet concentrates kungavimbela ukopha ezigulini.Ngaleso sikhathi, odokotela nodokotela be-hematologist bazama ukulungisa ama-platelet concentrates ukuze bampontshelwe.Izindlela zokuthola okugxilile zithuthuke ngokushesha futhi sezithuthuke kakhulu, njengoba amapuleti ahlukanisiwe alahlekelwa ukusebenza kwawo ngokushesha futhi ngenxa yalokho kufanele agcinwe ku-4 °C futhi asetshenziswe phakathi namahora angu-24.

Izimpahla nezindlela

Ngawo-1920, i-citrate yayisetshenziswa njenge-anticoagulant ukuthola ukugxila kwe-platelet.Inqubekelaphambili ekulungiseni ukugxila kwe-platelet yashesha ngeminyaka yawo-1950 nawo-1960 lapho kwakhiwa iziqukathi zegazi zepulasitiki eziguquguqukayo.Igama elithi "plasma ecebile nge-platelet" laqala ukusetshenziswa nguKingsley et al.ngo-1954 ukuze kubhekiselwe ekugxilweni kweplatelet evamile esetshenziselwa ukumpontshelwa igazi.Ukwakhiwa kwebhange legazi lokuqala le-PRP kwavela kuma-1960 futhi kwaduma ngawo-1970.Ngasekupheleni kwawo-1950 nawo-1960, “amaphakethe e-EDTA platelet” asetshenziswa.Isethi iqukethe isikhwama sepulasitiki esinegazi le-EDTA elivumela ama-platelet ukuthi agxilwe yi-centrifugation, ehlala imisiwe ngenani elincane le-plasma ngemva kokuhlinzwa.

Umphumela

Kucatshangelwa ukuthi izici zokukhula (GFs) ziyizinhlanganisela ezengeziwe ze-PRP ezifihliwe kuma-platelet futhi zibandakanyeka esenzweni sayo.Lo mbono waqinisekiswa ngawo-1980.Kuvela ukuthi ama-platelet akhulula ama-molecule e-bioactive (GFs) ukuze alungise izicubu ezilimele, njengezilonda zesikhumba.Kuze kube manje, izifundo ezimbalwa ezihlola lolu daba zenziwe.Esinye sezifundo ezifundwe kakhulu kulo mkhakha inhlanganisela ye-PRP ne-hyaluronic acid.I-Epidermal growth factor (EGF) yatholwa nguCohen ku-1962. Ama-GF alandelayo kwakuyi-platelet-derived growth factor (PDGF) ku-1974 kanye ne-vascular endothelial growth factor (VEGF) ku-1989.

Sekukonke, intuthuko kwezokwelapha nayo iholele ekuthuthukisweni okusheshayo ekusetshenzisweni kweplatelet.Ngo-1972, i-Matras yaqala ukusebenzisa ama-platelet njengesivalo ukuze kutholakale i-homeostasis yegazi ngesikhathi sokuhlinzwa.Ngaphezu kwalokho, ngo-1975, u-Oon noHobbs babengososayensi bokuqala ukusebenzisa i-PRP ekwelashweni kokuvuselela.Ngo-1987, uFerrari et al waqala ukusebenzisa i-plasma ecebile nge-platelet njengomthombo ozenzakalelayo wokumpontshelwa kwegazi ekuhlinzeni inhliziyo, ngaleyo ndlela yehlisa ukulahleka kwegazi ngokusebenza, ukuphazamiseka kwegazi lokujikeleza kwe-peripheral pulmonary, kanye nokusetshenziswa kwemikhiqizo yegazi okwalandela.

Ngo-1986, uKnighton et al.babengososayensi bokuqala ukuchaza i-platelet enrichment protocol futhi bayiqamba ngokuthi i-autologous platelet-derived wound healing factor (PDWHF).Selokhu kwasungulwa iphrothokholi, le ndlela ibilokhu isetshenziswa kakhulu emithini yobuhle.I-PRP isetshenziswe emithini yokuvuselela kusukela ngasekupheleni kwawo-1980.

Ngaphandle kokuhlinzwa okuvamile nokuhlinzwa kwenhliziyo, ukuhlinzwa kwe-maxillofacial kwakungenye indawo lapho i-PRP yaduma khona ekuqaleni kwawo-1990.I-PRP isetshenziselwe ukuthuthukisa isibopho sokuxhunyelelwa ekwakhiweni kabusha kwe-mandibular.I-PRP isiqalile futhi ukusetshenziswa kudokotela wamazinyo futhi iye yasetshenziswa kusukela ngasekupheleni kwawo-1990 ukuze kuthuthukiswe isibopho sokufakelwa kwamazinyo nokukhuthaza ukuvuselelwa kwamathambo.Ngaphezu kwalokho, i-fibrin glue yayiyinto eyaziwayo ehlobene neyethulwa ngaleso sikhathi.Ukusetshenziswa kwe-PRP kudokotela wamazinyo kwathuthukiswa futhi ngokusungulwa kwe-platelet-rich fibrin (PRF), i-platelet concentrate engadingi ukungezwa kwama-anticoagulants, nguChoukroun.

I-PRF yaqala ukuduma ekuqaleni kwawo-2000, ngenani elandayo lezicelo ezinkambisweni zamazinyo, okuhlanganisa ukuvuselelwa kwezicubu ze-hyperplastic gingival kanye nokukhubazeka kwe-periodontal, ukuvalwa kwesilonda se-palatal, ukwelashwa kokuwohloka kwe-gingival, kanye nemikhono yokukhipha.

Xoxa

U-Anitua ku-1999 uchaze ukusetshenziswa kwe-PRP ukukhuthaza ukuvuselelwa kwamathambo ngesikhathi sokushintshaniswa kwe-plasma.Ngemva kokubona imiphumela enenzuzo yokwelashwa, ososayensi baqhubeka baphenya lesi simo.Amaphepha akhe alandelayo abika imiphumela yaleli gazi ezilonda zesikhumba ezingapheli, izimila zamazinyo, ukuphulukiswa kwe-tendon, nokulimala kwezemidlalo yamathambo.Izidakamizwa ezimbalwa ezenza kusebenze i-PRP, njenge-calcium chloride ne-bovine thrombin, zisetshenziswe kusukela ngo-2000.

Ngenxa yezakhiwo zayo ezinhle kakhulu, i-PRP isetshenziswa ku-orthopaedics.Imiphumela yocwaningo lokuqala olujulile lwemiphumela yezici zokukhula kwezicubu ze-tendon yomuntu yanyatheliswa ku-2005. Ukwelashwa kwe-PRP okwamanje kusetshenziselwa ukwelapha izifo eziwohlokayo nokugqugquzela ukuphulukiswa kwama-tendon, imigqa, imisipha kanye ne-cartilage.Ucwaningo lubonisa ukuthi ukuthandwa okuqhubekayo kwenqubo ku-orthopedics kungase kuhlotshaniswe nokusetshenziswa njalo kwe-PRP yizinkanyezi zezemidlalo.Ku-2009, isifundo sesilwane sokuhlola sanyatheliswa esiqinisekisa i-hypothesis yokuthi i-PRP igxile ekuthuthukiseni ukuphulukiswa kwezicubu zemisipha.Indlela eyisisekelo yesenzo se-PRP esikhumbeni okwamanje yisihloko socwaningo olujulile lwesayensi.

I-PRP isetshenziswe ngempumelelo ku-cosmetic dermatology kusukela ngo-2010 noma ngaphambili.Ngemuva kokujova i-PRP, isikhumba sibukeka sisincane futhi i-hydration, ukuguquguquka nombala kuthuthukiswa kakhulu.I-PRP isetshenziselwa ukuthuthukisa ukukhula kwezinwele.Kunezinhlobo ezimbili ze-PRP okwamanje ezisetshenziselwa ukwelashwa kokukhula kwezinwele - i-plasma ecebile ye-platelet engasebenzi (A-PRP) ne-plasma esebenzayo ye-platelet-rich (AA-PRP).Nokho, abeZizwe et al.wabonisa ukuthi ukuminyana kwezinwele kanye nemingcele yokubala izinwele kungathuthukiswa ngokujova i-A-PRP.Ukwengeza, kufakazelwe ukuthi ukusebenzisa ukwelashwa kwe-PRP ngaphambi kokufakelwa izinwele kungathuthukisa ukukhula kwezinwele kanye nokuminyana kwezinwele.Ngaphezu kwalokho, ngo-2009, ucwaningo lwabonisa ukuthi ukusetshenziswa kwengxube ye-PRP namafutha kungathuthukisa ukwamukelwa kwe-graft yamafutha kanye nokuphila, okungase kuthuthukise imiphumela yokuhlinzwa kwepulasitiki.

Okutholakele kwakamuva okuvela ku-Cosmetic Dermatology kubonisa ukuthi inhlanganisela yokwelapha nge-laser ye-PRP kanye ne-CO2 inganciphisa izibazi zezinduna kakhulu.Ngokufanayo, i-PRP kanye ne-microneedling kubangele inqwaba ye-collagen ehlelekile esikhumbeni kune-PRP yodwa.Umlando we-PRP awufushane, futhi okutholakele okuhlobene nale ngxenye yegazi kubalulekile.Odokotela nososayensi bafuna izindlela ezintsha zokwelapha.Njengendlela, i-PRP isetshenziswa emikhakheni eminingi yezokwelapha, kuhlanganise ne-gynecology, i-urology, kanye ne-ophthalmology.

Umlando we-PRP okungenani uneminyaka engu-70 ubudala.Ngakho-ke, indlela isungulwe kahle futhi ingasetshenziswa kabanzi kwezokwelapha.

(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.)