I-Primary atrophic rhinitis (i-1Ry AR) sisifo sempumlo esingapheliyo esibonakaliswe ngokulahleka komsebenzi we-mucociliary clearance, ubukho beemfihlo ezincangathi kunye ne-crusts eyomileyo, ekhokelela kwivumba elibi eliqhelekileyo, ngokuqhelekileyo kabini.Inani elikhulu leendlela zonyango zizanyiwe, kodwa akukabikho mvumelwano kunyango oluyimpumelelo lwexesha elide.Injongo yolu phononongo kukuvavanya ixabiso leplasma eneplatelet-rich njengesivuseleli sebhayoloji yokukhuthaza ukuphiliswa kwe-atrophic rhinitis ephambili.
Umbhali ubandakanya amatyala angama-78 afunyaniswe ekliniki ane-primary atrophic rhinitis.Iqela A (amatyala) kunye nezigulane ezineeplatelet ezihlwempuzekileyo ziye zafumana i-endoscopy yempumlo, i-questionnaire yeSino Sempumlo yoVavanyo-25, uvavanyo lwexesha le-saccharin ukuvavanya izinga lokucocwa kwe-mucosal ciliary, kunye ne-plasma kwi-biopsy specimen yeQela B (ulawulo) inyanga eyi-1 kunye neenyanga ezi-6 ngaphambi kwesicelo. iplatelet etyebileyo kwiplasma.
Iimpawu eziqhelekileyo ezidibana nazo zonke izigulane kwiQela A phambi kokuba i-injection ye-platelet ecebileyo ye-plasma iquka i-nasal scab, ebonisa ukuphuculwa kwe-endoscopic kunye nokunciphisa iziganeko, kunye namatyala angama-36 (92.30%);umlandeli, 31 (79.48%);Ukuvaleka kweempumlo, ama-30 (76.92%);Ukulahleka kwevumba, i-17 (43.58%);Kwaye epistaxis, 7 (17.94%) ukuya kwiimpumlo ukhwekhwe, 9 (23.07%);Iinyawo, 13 (33.33%);Ukuxinana kweempumlo, i-14 (35.89%);Ukulahleka kwevumba, i-13 (33.33%);Kwaye i-epistaxis, i-3 (7.69%), emva kweenyanga ze-6, oku kubonakaliswe ekunciphiseni kwinqanaba leSino seSiphumo seSiphumo seSiphumo-25, esilinganisa i-40 ngaphambi kwe-platelet ecebileyo ye-plasma kwaye yehla ukuya kwi-9 emva kweenyanga ze-6.Ngokufanayo, ixesha lokucocwa kwe-mucociliary lancitshiswa kakhulu emva kokutofa kweplasma etyebileyo yeplatelet;Uvavanyo lwexesha lokuqala lokuhamba kwe-saccharin yayiyimizuzwana ye-1980, kwaye yehla yaya kwimizuzwana engama-920 kwiinyanga ezi-6 emva kokutofwa kweplasma etyebileyo yeplatelet.
Ukusetyenziswa kweplasma etyebileyo yeplatelet njenge-agent yebhayoloji inokuba yindlela entsha yokuhlasela enokuthi ilungise ngokufanelekileyo ukungondleki kwezicubu ngophando olongezelelweyo.
Kukho iindlela ezine eziphambili zokunyanga i-atrophic rhinitis: ukunciphisa umngxuma wempumlo kunye nezinto ezahlukeneyo kunye nokufakelwa, ukukhuthaza ukuvuselelwa kwe-mucosal eqhelekileyo usebenzisa utyando lwe-Yang oluqhelekileyo okanye olulungisiweyo, ukuthambisa i-mucosa yeempumlo, okanye ukuphucula imithambo yegazi yeempumlo.Umngxunya.Ezinye iindlela ezininzi zonyango ziye zazama, kubandakanywa ukunkcenkceshela ngeempumlo kunye nokugungxulwa, i-glucose glycerol nasal drops, iparafini yolwelo, i-estradiol kwioli ye-peanut, isisombululo se-anti ozaena, i-antibiotics, isinyithi, i-zinc, i-protein, i-vitamin supplements, i-vasodilators, i-prostheses, izitofu, i-placental extracts. okanye i-acetylcholine, kunye okanye ngaphandle kwepilocarpine.Nangona kunjalo, ukusebenza kwezi ndlela kuyahluka.Kwinkqubo yonyango, ukuhlanjululwa komngxuma wempumlo ngesitshizi sempumlo yeyona ndlela isetyenziswa kakhulu ukunyanga iimpawu ze-atrophic rhinitis, njengoko inokunyakamisa i-mucosa yeempumlo kwaye ithintele ukukhuhla.
Phakathi kwezi ndlela zingasentla, utyando oluphuculweyo lweYang lubonakaliswe njengendlela esebenzayo kunye nexesha elide lokunyanga i-atrophic rhinitis.Nangona kunjalo, ukuphefumla komlomo ovulekileyo kunokubangela ukungonwabi kakhulu kwizigulana.I-Lubricants kunye nezongezelelo zibonakaliswe ukuba zineempembelelo ezinqamlekileyo kunye nexesha elifutshane.Ngoko ke, ezinye iindlela zokukhuthaza ukuvuselelwa kwe-mucosal yempumlo okanye i-angiogenesis ziye zafundwa.
I-PRPiqulethwe kugxininiso lweplasma oludlula uxinzelelo lweplatelet kwigazi elipheleleyo.I-PRP iphucula izinto ezichaphazela ukukhula kwezicubu, ukuhlukana, kunye nokuphulukiswa kwesilonda, njengeplatelet derived growth factor, ukuguqula ukukhula, i-fibroblast factor factor, i-endothelial growth factor, kunye ne-insulin-efana ne-insulin.Ngoko ke, i-PRP ibonakaliswe ukuba ineziphumo ezilungileyo ezamkelekileyo kwizifundo ezahlukeneyo zeklinikhi, ukukhuthaza ngokufanelekileyo ukuphulukiswa kwesilonda kunye nokuvuselelwa kwezicubu, kubandakanywa kwintsimi ye-otolaryngology.Ngokukodwa ngakumbi, kuye kwaxelwa ukuba i-PRP iphumelele ekuphuculeni ukuvuselelwa kwe-membrane ye-tympanic, iintambo zezwi kunye ne-facial nerve, kunye nokuphulukiswa emva kwe-myringoplasty okanye i-endoscopic sinus surgery.Ukongeza, uphononongo lokulinga lwaqhutywa kwiminyaka embalwa edlulileyo ukunyanga i-atrophic rhinitis ngenaliti yomxube we-PRP lipid.Ukongeza, i-PRP isebenzisa igazi elizenzekelayo kwaye ayinayo i-allergies okanye i-immune rejection reactions.Inokulungiswa lula kwimizuzu embalwa ngokusebenzisa iinkqubo ezimbini ze-centrifugation.
Kule sifundo, sihlolisise i-injection ye-PRP kwi-atrophic nasal mucosa, eyaphucula ukucocwa kwe-cilia ye-mucosal kunye neempawu ngexesha lokulandelelana kweenyanga ze-6, ngakumbi kwizigulane ezincinci, kunye neziphumo ezicacileyo xa kuthelekiswa neqela elidala.Kwiimeko ezininzi ze-atrophic rhinitis, kubandakanywa i-rhinitis esebekhulile, ukukhutshwa kwe-mucus kuyancipha.Ke ngoko, ukutyeba kwe-mucinous kukhokelela ekulibazisekeni ukucocwa kwe-cilia yempumlo yempumlo.Ukuzalisa amanzi nge-saline spray kuya kuchaphazela iimpawu ze-viscous mucus, kwaye ukucocwa kwe-cilia ye-nasal mucosa kuya kubuyiselwa kwinqanaba elithile.Nangona kunjalo, indima ye-mucus yempumlo ehlanjululweyo ekucombululeni iimpawu zempumlo inokulinganiselwa.Ke ngoko, nangona i-conservative nasal hydration inokuphucula ukucocwa kwe-mucociliary, le rejimeni yonyango ayizange iphucule kakhulu iimpawu zempumlo.Ukongezelela, ukutshiza ngeempumlo kunye nokunkcenkceshela kufuna i-saline ye-physiological kunye nezixhobo ezikhethekileyo, kwaye kufuneka ziqhutywe ngokuqhubekayo ukulawula iimpawu.Ngokwahlukileyo, inaliti ye-PRP ifuna inaliti enye kuphela ukufezekisa iziphumo ezilungileyo.Emva kwesitofu, umthamo we-turbinate uyanda ngokukhawuleza.Nangona kunjalo, kwi-outpatient elandelayo yokutyelela (iiveki ezi-2 kamva), kwakungekho mmahluko kumthamo kunye nokuma kwe-turbinate engaphantsi.Ngoko ke, ukunyuka okwethutyana kumthamo obangelwa yinaliti kuthathwa njengento engafanelekanga.Ukongeza, njengoko kubonisiwe kuhlalutyo lwe-subdomain ye-SNOT-22, akukho phuculo lubalulekileyo kwi-domain yeemvakalelo zezigulane ze-PRP.Iziphumo azizange zihambe kunye nokuphucula kwi-domain subdomain, ebonisa ukuba umphumo we-placebo wawungabalulekanga kwinkalo ethile.Ukutshiza ngeempumlo kunye nokunkcenkceshela kufuna i-saline ye-physiological kunye nezixhobo ezikhethekileyo, kwaye kufuneka ziqhutywe ngokuqhubekayo ukulawula iimpawu.Ngokwahlukileyo, inaliti ye-PRP ifuna inaliti enye kuphela ukufezekisa iziphumo ezilungileyo.Emva kwesitofu, umthamo we-turbinate uyanda ngokukhawuleza.Nangona kunjalo, kwi-outpatient elandelayo yokutyelela (iiveki ezi-2 kamva), kwakungekho mmahluko kumthamo kunye nokuma kwe-turbinate engaphantsi.Ngoko ke, ukunyuka okwethutyana kumthamo obangelwa yinaliti kuthathwa njengento engafanelekanga.Ukongeza, njengoko kubonisiwe kuhlalutyo lwe-subdomain ye-SNOT-22, akukho phuculo lubalulekileyo kwi-domain yeemvakalelo zezigulane ze-PRP.Iziphumo azizange zihambe kunye nokuphucula kwi-domain subdomain, ebonisa ukuba umphumo we-placebo wawungabalulekanga kwinkalo ethile.Ukutshiza ngeempumlo kunye nokunkcenkceshela kufuna i-saline ye-physiological kunye nezixhobo ezikhethekileyo, kwaye kufuneka ziqhutywe ngokuqhubekayo ukulawula iimpawu.Ngokwahlukileyo, inaliti ye-PRP ifuna inaliti enye kuphela ukufezekisa iziphumo ezilungileyo.Emva kwesitofu, umthamo we-turbinate uyanda ngokukhawuleza.Nangona kunjalo, kwi-outpatient elandelayo yokutyelela (iiveki ezi-2 kamva), kwakungekho mmahluko kumthamo kunye nokuma kwe-turbinate engaphantsi.Ngoko ke, ukunyuka okwethutyana kumthamo obangelwa yinaliti kuthathwa njengento engafanelekanga.Ukongeza, njengoko kubonisiwe kuhlalutyo lwe-subdomain ye-SNOT-22, akukho phuculo lubalulekileyo kwi-domain yeemvakalelo zezigulane ze-PRP.Iziphumo azizange zihambe kunye nokuphucula kwi-domain subdomain, ebonisa ukuba umphumo we-placebo wawungabalulekanga kwinkalo ethile.Inaliti ye-PRP ifuna inaliti enye kuphela ukufezekisa iziphumo ezilungileyo.Emva kwesitofu, umthamo we-turbinate uyanda ngokukhawuleza.Nangona kunjalo, kwi-outpatient elandelayo yokutyelela (iiveki ezi-2 kamva), kwakungekho mmahluko kumthamo kunye nokuma kwe-turbinate engaphantsi.Ngoko ke, ukunyuka okwethutyana kumthamo obangelwa yinaliti kuthathwa njengento engafanelekanga.Ukongeza, njengoko kubonisiwe kuhlalutyo lwe-subdomain ye-SNOT-22, akukho phuculo lubalulekileyo kwi-domain yeemvakalelo zezigulane ze-PRP.Iziphumo azizange zihambe kunye nokuphucula kwi-domain subdomain, ebonisa ukuba umphumo we-placebo wawungabalulekanga kwinkalo ethile.Inaliti ye-PRP ifuna inaliti enye kuphela ukufezekisa iziphumo ezilungileyo.Emva kwesitofu, umthamo we-turbinate uyanda ngokukhawuleza.Nangona kunjalo, kwi-outpatient elandelayo yokutyelela (iiveki ezi-2 kamva), kwakungekho mmahluko kumthamo kunye nokuma kwe-turbinate engaphantsi.Ngoko ke, ukunyuka okwethutyana kumthamo obangelwa yinaliti kuthathwa njengento engafanelekanga.Ukongeza, njengoko kubonisiwe kuhlalutyo lwe-subdomain ye-SNOT-22, akukho phuculo lubalulekileyo kwi-domain yeemvakalelo zezigulane ze-PRP.Iziphumo azizange zihambe kunye nokuphucula kwi-domain subdomain, ebonisa ukuba umphumo we-placebo wawungabalulekanga kwinkalo ethile.Akukho mahluko kumthamo kunye nokumila kwe-turbinate engaphantsi.Ngoko ke, ukunyuka okwethutyana kwivolumu ebangelwa yinaliti kuthathwa njengento engafanelekanga.Ukongeza, njengoko kubonisiwe kuhlalutyo lwe-subdomain ye-SNOT-22, akukho phuculo lubalulekileyo kwi-domain yeemvakalelo zezigulane ze-PRP.Iziphumo azizange zihambe kunye nokuphucula kwi-domain subdomain, ebonisa ukuba umphumo we-placebo wawungabalulekanga kwinkalo ethile.Akukho mahluko kumthamo kunye nokumila kwe-turbinate engaphantsi.Ngoko ke, ukunyuka okwethutyana kwivolumu ebangelwa yinaliti kuthathwa njengento engafanelekanga.Ukongeza, njengoko kubonisiwe kuhlalutyo lwe-subdomain ye-SNOT-22, akukho phuculo lubalulekileyo kwindawo yeemvakalelo zezigulane ze-PRP.Iziphumo azizange zihambe kunye nokuphucula kwi-subdomain yeemvakalelo, ebonisa ukuba umphumo we-placebo wawungabalulekanga kwinkalo ethile.
Iintlungu eziqhubekayo kunye neempawu ezinxulumene nokungonwabi kwe-atrophic rhinitis azikho mandundu kwezamayeza.Ke ngoko, ilahleko yezentlalo noqoqosho ijongelwa phantsi.Nangona kunjalo, ngokwembono yezigulane zokwenyani, sisifo esibaluleke kakhulu ekuhlaleni.Ukongezelela, ngokuguga kwabemi, inani lezigulane ezine-senile rhinitis landa ukukhula okubonakalayo.Ngoko ke, kubaluleke kakhulu ukubonelela unyango olufanelekileyo kwi-atrophic rhinitis, kuquka i-rhinitis esebekhulile.
Injongo yolu phononongo kukucebisa indlela entsha yokuvuselela ukunyanga i-atrophic rhinitis ngokusebenzisa i-autologous PRP injection, kunye nokuthelekisa ukuphuculwa kweempawu phakathi kweqela lonyango lwe-PRP kunye neqela lonyango elilondolozayo usebenzisa iqela lokulawula.Ngenxa yokuba i-atrophic rhinitis yinkcazo yeklinikhi, uphando oluninzi luyafuneka ukuze luchaze indlela yokusebenza.Nangona kunjalo, ukuze kuthintelwe ilahleko yentlalo-qoqosho kunye nokwehla komgangatho wobomi besigulane, kuyimfuneko ukubonelela ngeziphumo zophando kunye neziphumo zonyango ezinokubakho.
Nangona kunjalo, olu phononongo lunemida emininzi.Olu phononongo lwenziwe ngokulindelekileyo kwaye alunakulawulwa ngokungenamkhethe njengoko abanye abathathi-nxaxheba bala inkqubo yokutofa ngeempumlo.Ngokwemigaqo yokuziphatha, imisebenzi ehlaselayo yeenjongo zemfundo kwiqela lolawulo kufuneka ithintelwe ukukhusela amalungelo kunye nomdla wezigulane.Ngoko ke, ukwabela izigulane ngokusekelwe kwizinto abazithandayo kwenza ukuba iziphumo zophando zibe buthathaka kunezo zibonelelwa ngezifundo ezilawulwa ngokungahleliwe.Ukongezelela, i-rhinitis ye-atrophic yesibini ibangelwa ukuguqulwa kunye nokususwa kwesakhiwo sokuqala seempumlo.Ukwenza i-biopsy kunokwenza i-atrophy ibe mandundu.Ngoko ke, ngokwembono yokuziphatha, akunakwenzeka ukwenza i-biopsy yezicubu zeempumlo ezihambelanayo kwizigulane ezine-atrophic rhinitis.Iziphumo emva kweenyanga ze-6 zokulandelelana zingenakubonisa iziphumo zexesha elide.Ukongeza, inani lezigulane kwi-subgroup lincinci.Ngoko ke, uphando lwexesha elizayo kufuneka lubandakanye izigulane ezininzi zisebenzisa idizayini elawulwa ngokungahleliwe ngexesha elide lokulandelelana.
(Imixholo yeli nqaku ishicilelwe, kwaye asiboneleli nasiphi na isiqinisekiso esicacileyo okanye esichaziweyo sokuchaneka, ukuthembeka okanye ukugqibelela kokuqulathwe kweli nqaku, kwaye abanaxanduva ngezimvo zeli nqaku, nceda uqonde.)
Ixesha lokuposa: May-23-2023