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سانتریفیوژ PRP

سانتریفیوژ PRP

روند ترمیم
پاسخ بدن به آسیب ها و جراحات اختصاصی بوده و شامل مراحل شناخته شده ایی می باشد که به عنوان "روند ترمیم یا آبشار بهبودی" شناخته می شود. مراحل روند ترمیم شامل چند فاز مجزا می باشد. که شامل سیستمی است که از فاکتورهای رشد و سلول های بنیادین استفاده می کند و سبب ترمیم و نوسازی ماتریکس استخوانی و یا بافت های آسیب دیده می شود.


استفاده از این سلول های فعال زیستی برای افزایش و تسریع روند طبیعی ترمیم، به عنوان "مرزهای جدید درمان های بالینی" مورد توجه قرار گرفته است. پلاکت تغلیظ شده توسط کیتPRP یا کنسانتره پلاکتی را می تواند به هر بافت زخمی یا آسیب دیده، افزوده یا تزریق کرد تا وضعیتی را ایجاد کند که سبب افزایش سرعت روند ترمیم و التیام بافت آسیب دیده گردد.
پلاکت ها می توانند انواع کارکردهای گوناگون داشته باشند، که یکی ا ز آنها مبارزه ضد میکروارگانیسم های مضر است.
محافظت علیه میکروب ها
به نظر می رسد کنسانتره پلاکتی حاصل از کیتPRPدارای توانایی بالقوه ضد میکروبی علیه استافیلوکوکوس اورئوس باشد. استفاده از فرآورده پلاکتی تغلیظ یافته ممکن است یک عملکرد راهبردی علیه عفونت های بعد از اعمال جراحی باشد.
جراحی زیبایی : جراحی آبدومینوپلاستی
استفاده از کیتPRP در اعمال جراحی آبدومینوپلاستی و ساکشن چربی شکم منجر به ترمیم سریع تر زخم و ترومای کمتر همراه با زیبایی بیشتر می شود.
طب ورزشی : ترمیم آسیب رباط متقاطع قدامی ACL
نشان داده شده است در زانویی که ژل پلاکتی تزریق شده است، پیشرفت پر کردن نقص و افزایش قدرت مکانیکی در مقایسه با زانوی درمان نشده رخ می دهد.
فاکتورهای رشد
اثر فاکتورهای رشد مشخص در ترمیم جراحات مختلف و غلظت هایی از این فاکتورهای رشد که در PRP یافت می شود، اساس تئوری استفاده از PRP در ترمیم بافت هاست.
فاکتور رشد اپیدرم (EGF)
فاکتور رشد اپیدرم، پروتئینی است که بو طور طبیعی در سلول های بدن وجود دارد و باعث تحریک رشد بسیاری از سلول ها از جمله فیبروبلاست و سلول های اپیدرمی و سلول های پوست می شود
فاکتور رشد آندوتلیال عروقی (VEGF)
VEGF یکی از مهم ترین تنظیم کننده های اختصاصی رگزایی است. فاکتورهای رشد آندوتلیال عروقی عمل بیولوژیک خود را بر روی سلول های هدف از طریق میان کنش با گیرنده های تیروزین موجود در غشای پلاسمایی سلول به انجام می رسانند.
جراحی دهان و دندان : پیوند استخوانی بلند کردن سینوس
نشان داده شده است دانسیته استخوانی ترابکولار در پیوندهای استخوان همراه با فاکتورهای رشد مشتق PRP، بیشتر از پیوندهای استخوان بدون استفاده از PRP است.
زخم مزمن : سندروم پای دیابتی
در بیشتر بیماران درمان شده با PRP نسبت به گروه کنترل، به طور کامل زخم بهبود می یابد (55% در مقایسه با 24%).
سرعت ترمیم در گروه تحت درمان با PRP سریعتر بوده (2/9 در مقایسه یا 2/12 هفته).
بیماری های پا : خار پاشنه
تزریق PRP به درون خار پاشنه دردناک، ممکن است تاثیر جبرانی داشته باشد و منجر به کاهش علائم گردد.
مهاجرت شیمیایی
همانطور که زخم به رشد خود ادامه می دهد، روند ترمیم بوسیله فراخوانی و جذب سلولهای بنیادین از محیط اطراف به سمت ناحیه آسیب دیده دنبال می شود. فرآورده پلاکت تغلیظ شده PRP سرشار از مقادیر بالای فاکتورهای رشد درون گرانول های آلفای پلاکت ها است که آبشاری را آغاز می کنند که نتیجه آن جذب شیمیایی سلول های بنیادین درحال گردش در محیط اطراف، به سمت بافت آسیب دیده و شروع روند تمایز و تکثیر سلولی و بلوغ آن ها برای تشکیل بافت های جدید بالغ است.
فاکتور رشد تبدیل و تمایز بتا (TGF-β)
واجد توانایی افزایش کیموتاکسی و میتوژنزیس تحریک تجمع و ذخیره سازی کلاژن.
طب ورزشی : آرنج تنیس بازان
درمان با PRP در آسیب آرنج تنیس بازان با بهبود مستمر و کاهش قابل توجه در طول زمان، بدون عوارض جانبی و پذیرش بالای بیمار به اندازه عمل جراحی موثر است.
توجه :
از آنجایی که پلاکت ها موجودات پرتوپلاسمی هستند و دارای هسته نمی باشند، عواملی باعث لیز شدن و از بین رفتن پلاکت ها می شوند که عبارتند از :
خون گرفتن با نیدل 21
وکیوم داشتن لوله های آزمایشگاه و جت کردن خون در لوله.
لرزش سانتریفیوژPRP و سرعت زیاد سانتریفیوژPRP جهت تغلیظ.
نداشتن دور واقعی سانترفیوژPRP
گرم شدن برخی مدلهای سانتیریفیوژPRP بعلت مکانیزم ساختشان و انتقال گرما به کیتPRP و تخریب پلاکتها
در انتخاب مدل سانتریفیوژPRP مدلهای بازشونده بعلت بازشدن بالهای آن (swing) لرزش نداشته و نسبت به مدلهای fix آن عملکرد بهتری داراست.
مدلهای دیجیتال سانتریفیوژPRP بعلت نشان دادن دقیق دور و زمان امکان خطای کمتری نسبت به مدلهای آنالوگ دارند.

اینها مواردی هستند که باعث تکه تکه شدن پلاکت ها می شوند و دستگاه سل کانتر (Cell Counter) آزمایشگاه هر تکه را یک فرکانس محسوب کرده و باعث گمراهی پزشکان می گردد.
لذا برای داشتن کانت (Count) صحیح از لام آزمایشگاهی استفاده کنید. حداقل کانت قابل قبول پنج برابر نسبت به کانت اولیه بیمار می باشد. در غیر این صورت از کیتPRP توقع معجزه نداشته باشید.

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