I-Platelet Rich Plasma (PRP)
I-epicondylitis ye-humeral yangaphandle sisifo esiqhelekileyo seklinikhi esibonakaliswa yintlungu kwicala elisecaleni le-elbow.Bubuqhinga kwaye kulula ukuphinda bubuye, obunokubangela intlungu yengalo kunye nokwehla kwamandla esihlahla, kwaye buchaphazela kakhulu ubomi bemihla ngemihla kunye nomsebenzi wezigulana.Kukho iindlela ezahlukeneyo zonyango lwe-lateral epicondylitis ye-humerus, enemiphumo eyahlukeneyo.Akukho ndlela yonyango isemgangathweni okwangoku.I-Platelet ecebileyo ye-plasma (PRP) inefuthe elihle ekulungisweni kwamathambo kunye ne-tendon, kwaye isetyenziswe ngokubanzi ukuphatha i-epicondylitis ye-humeral yangaphandle.
Ngokobunzulu bereyithi yokuvunywa kokuvota, yahlulwe yangamanqanaba amathathu:
I-100% ivunyelwe ngokupheleleyo (iNqanaba I)
I-90% ~ 99% yimvumelwano enamandla (iNqanaba II)
I-70% ~ 89% iyavumelana (iNqanaba III)
Ingcamango ye-PRP kunye neeMfuno zeSithako seSicelo
(1) Ingcamango: I-PRP yi-plasma derivative.Uxinzelelo lweplatelet yayo iphezulu kunesiseko.Iqulethe inani elikhulu lezinto zokukhula kunye ne-cytokines, ezinokukhuthaza ngokufanelekileyo ukulungiswa kwezicubu kunye nokuphilisa.
(2) Iimfuno zezithako ezisetyenzisiweyo:
① Uxinzelelo lweplatelet ye-PRP kunyango lwe-epicondylitis ye-humeral yangaphandle inconywa ukuba ibe (1000 ~ 1500) × 109 / L (i-3-5 amaxesha okugxilwa kwesiseko);
② Khetha ukusebenzisa i-PRP ecebileyo kwiiseli zegazi ezimhlophe;
③ Ukuqalisa ukusebenza kwe-PRP akukhuthazwa.
(Ubunzulu obucetyiswayo: Inqanaba I; inqanaba lobungqina boncwadi: A1)
Ukulawulwa koMgangatho weTekhnoloji yokuLungiselela i-PRP
(1) Iimfuno zokufaneleka kwabasebenzi: Ukulungiswa kunye nokusetyenziswa kwe-PRP kufuneka kuqhutywe ngabasebenzi bezonyango abaneziqinisekiso zoogqirha abanelayisenisi, abongikazi abanelayisensi kunye nabanye abasebenzi bezonyango abafanelekileyo, kwaye kufuneka baqhutywe emva koqeqesho olungqongqo lwe-aseptic operation kunye noqeqesho lokulungiselela i-PRP.
(2) Izixhobo: I-PRP iya kulungiswa ngokusebenzisa inkqubo yokulungiselela izixhobo zonyango ezivunyiweyo zeCandelo III.
(3) Indawo yokusebenza: unyango lwe-PRP luyi-invasive operation, kwaye ukulungiswa kwayo kunye nokusetyenziswa kwayo kunconywa ukuba kuqhutywe kwigumbi lokunyanga elikhethekileyo okanye kwigumbi lokusebenza elihlangabezana neemfuno zokulawula imizwa.
(Ubunzulu obucetyiswayo: Inqanaba I; inqanaba lobungqina boncwadi: Inqanaba E)
Iimpawu kunye nokuchasana kwe-PRP
(1) Iimpawu:
① Unyango lwe-PRP alunayo imfuneko ecacileyo yohlobo lomsebenzi wabemi, kwaye inokuqwalaselwa ukuba iqhutywe kwizigulane ezinemfuno ephezulu (njengesihlwele sezemidlalo) kunye nemfuno ephantsi (njengabasebenzi beofisi, abasebenzi beentsapho, njl. );
② Izigulane ezikhulelweyo kunye nezanyisayo zingasebenzisa i-PRP ngokuqaphela xa unyango lomzimba lungasebenzi;
③ I-PRP kufuneka ithathelwe ingqalelo xa unyango olungasebenziyo lwe-humeral epicondylitis lungasebenzi ngaphezu kweenyanga ze-3;
④ Emva kokuba unyango lwe-PRP lusebenza kakuhle, izigulane ezinokuphinda ziphinde ziqwalasele ukuyisebenzisa kwakhona;
⑤ I-PRP ingasetyenziselwa iinyanga ezi-3 emva kwesitofu se-steroid;
⑥ I-PRP ingasetyenziselwa ukunyanga isifo se-tendon kunye nokukrazula kwe-tendon inxalenye.
(2) Ukuchasana ngokupheleleyo: ① thrombocytopenia;② Ithumba elibi okanye usulelo.
(3) Izithinteli ezihambelanayo: ① izigulane ezinegazi elingaqhelekanga kunye nokuthatha amachiza okulwa nokuqina kwegazi;② I-anemia, i-hemoglobin<100 g/L.
(Ubunzulu obucetyiswayo: iNqanaba II; inqanaba lobungqina boncwadi: A1)
I-PRP Injection Therapy
Xa i-PRP injection isetyenziselwa ukuphatha i-epicondylitis ye-lateral ye-humerus, kuyacetyiswa ukuba kusetyenziswe isikhokelo se-ultrasound.Kunconywa ukujova i-1 ~ 3 ml ye-PRP kwindawo kunye nakwindawo yokulimala.Isitofu esinye sanele, ngokuqhelekileyo akukho ngaphezu kwamaxesha e-3, kwaye ikhefu lokujova yi-2 ~ 4 iiveki.
(Ubunzulu obucetyiswayo: Inqanaba I; inqanaba lobungqina boncwadi: A1)
Ukusetyenziswa kwe-PRP kwi-Operation
Sebenzisa i-PRP ngokukhawuleza emva kokucoca okanye ukuthunga isilonda ngexesha lotyando;Iifom zedosi ezisetyenzisiweyo ziquka i-PRP okanye idibene ne-platelet rich gel (PRF);I-PRP inokuthi ifakwe kwi-tendon bone junction, indawo yokugxila kwi-tendon kumanqaku amaninzi, kwaye i-PRF ingasetyenziselwa ukuzalisa indawo ye-tendon defect kunye nokugubungela umphezulu we-tendon.Umthamo ngu-1-5ml.Akukhuthazwa ukuba ujobe i-PRP kwindawo edibeneyo.
(Ubunzulu obucetyiswayo: iNqanaba II; inqanaba lobungqina boncwadi: Inqanaba E)
Imiba eNxulumene ne-PRP
(1) Ukulawulwa kweentlungu: Emva kokunyangwa kwe-PRP ye-epicondylitis ye-humeral yangaphandle, i-acetaminophen (i-paracetamol) kunye ne-opioids ebuthathaka ingaqwalaselwa ukunciphisa intlungu yezigulane.
(2) Imilinganiselo yokuchasana nemiphumo emibi: intlungu ebuhlungu, i-hematoma, ukusuleleka, ukuqina okuhlangeneyo kunye nezinye iimeko emva kokuba unyango lwe-PRP lufanele luqhutywe ngenkuthalo, kwaye izicwangciso zonyango ezisebenzayo kufuneka zenziwe emva kokuphucula i-laboratory kunye nokuhlolwa kwemifanekiso kunye novavanyo.
(3) Unxibelelwano logqirha kunye nemfundo yezempilo: Ngaphambi nangemva kokunyanga kwe-PRP, ufeze ngokupheleleyo unxibelelwano logqirha-isigulane kunye nemfundo yezempilo, kwaye usayine ifom yemvume enolwazi.
(4) Isicwangciso sokubuyisela: akukho mfuneko yokulungiswa emva kokunyangwa kwe-PRP yonyango, kunye nemisebenzi ebangela intlungu kufuneka igwenywe kwiiyure ze-48 emva kokunyanga.I-elbow flexion kunye nokwandiswa kungenziwa kwiiyure ezingama-48 kamva.Emva kotyando oludityaniswe ne-PRP, inkqubo yokubuyisela emva kokuhlinzwa kufuneka inikwe kuqala.
(Ubunzulu obucetyiswayo: Inqanaba I; inqanaba lobungqina boncwadi: Inqanaba E)
IiReferensi:Chin J Trauma, Agasti 2022, Vol.38, No. 8, Chinese Journal of Trauma, Agasti 2022
(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: Nov-28-2022