Kukhazikitsa Pakati Pakati Pakati pa Ntchito Zotchulidwa Zoperekedwa kwa Knee Osteoarthritis
Kubwerera kumayambiriro kwa zaka za m'ma 1970, zinali zachilendo kumva munthu wodwala nyamakazi yemwe anali ndi vuto lokwanira. Zaka makumi angapo pambuyo pake, kugwirana pamodzi sikuli kofala. Ndipotu, kuchotsa pamodzi sikunatchulidwe pakati pa mankhwala ovomerezeka odwala mafupa a mawondo .
Kodi Kusunthira Pamodzi N'kutani?
M'magulu a osteoarthritis, monga katemera wotsekemera amathyoka, mitsempha ya minofu, tizilombo toyambitsa matenda ndi zowonongeka zimatha kukhala mkati mwa olowa.
Pakhoza kukhalanso makhiristo muzowonjezera kapena mu malo olowa . Kuwombera pamodzi ndi njira yomwe imatsuka minofu kapena zowonongeka kuchokera mu malo olowa.
Ndondomekoyi ikuphatikizapo kuika timachubu ting'onoting'onoting'ono ting'onoting'ono tomwe timaphatikizapo limodzi kapena malo angapo olowera. Pali mitundu itatu ya kusamba pamodzi:
- Kutsekemera kwachitsulo kogwiritsira ntchito - kumagwiritsa ntchito chinthu chimodzi cholowera mu jekeseni kuti muyikitsidwe madzi ndi kutulutsa madzi.
- Mankhwala osagwiritsidwa ntchito kwambiri - amagwiritsira ntchito mfundo ziwiri zolowera muzowonjezeramo, wina kuti ayambe kutulutsa madzi ndi wina kutulutsa madzi. Palibe kuyang'anitsitsa koyang'ana kwa mgwirizano ukuchitika.
- Zojambulajambula zogwiritsidwa ntchito kwambiri - kuphatikiza pamodzi ndi kuyang'anitsitsa chophatikizana (arthroscopy) .
Pogwiritsa ntchito mankhwalawa, jekeseni umalowetsedwa ndi mchere ndi madzi (ie, saline), ndipo mcherewo umachotsedwa. Kuthamanga kwa jekeseni ndi kukhetsa kungabwerezedwe kangapo. Zopeka, kuchotsa zowonongeka kwa zinyalala kumachepetsa kutupa ndi ululu wamodzi.
Koma kupambana kwa kusonkhana pamodzi kwafunsidwa ndikuphunzira.
Kafukufuku Wotsutsana Pamtundu wa Kuthetsa Kwachangu
Malinga ndi kafukufuku wa Cochrane wa mayesero asanu ndi awiri omwe akudwala odwala 567, ofufuza anapeza kuti kupha pamodzi sikubweretsa phindu lalikulu kwa odwala matenda opatsirana pogwiritsira ntchito kupwetekedwa mtima kapena kusintha kwa ntchito yogwirizana.
Zisanu ndi zitatu mwa mayesero asanu ndi awiriwa zinkaphatikizapo kusamba. Zomwe mwaphunzirazo zinaphatikizapo kusakaniza kophatikizana, ndipo zotsalira ziwiri zinali kuthirira.
Zomwe anapeza pa kafukufuku wa Cochrane zikusemphana ndi zochitika zafukufuku zomwe zinafalitsidwa mu Arthritis & Rheumatism mu 1999. Mu phunziro ili, odwala 98 omwe ali ndi matenda a mawere a tibiofemoral analembetsa maphunziro a miyezi isanu ndi umodzi ndipo mwadzidzidzi anapatsa chithandizo chimodzi mwazinayi: malo amtundu wa intraarticular , intraarticular corticosteroids , ophatikizana oundana ndi intraarticular placebo, ndi ophatikizana ndi intraarticular corticosteroids. Zotsatira zinasonyeza kuti, poyerekeza ndi placebo, onse opangira corticosteroids ndi ophatikizana nawo kwambiri amachepetsa ululu - koma ngakhale ntchito yabwino. The corticosteroid intraarticular inapereka mpumulo wafupipafupi, pamene ubwino wothandizira palimodzi unatenga mphindi makumi awiri ndi ziwiri.
Mu 2008, American Academy of Orthopedic Surgeons (AAOS) inafalitsa mayankho 22 ochizira matenda opatsirana pogwiritsa ntchito mabongo . Kupenda nyamakazi pogwiritsa ntchito mankhwala osokoneza bongo kapena kuphatikizana kwapadera sikunali kovomerezeka kuti muzitha kuchiritsa matenda a mafupa a knee. Malinga ndi AAOS, panalibe umboni wa phindu lalikulu.
Komabe, phunziro lina, lofalitsidwa mu Annals of Rheumatic Diseases mu 2004, linanena kuti sizingakhale pokhapokha kupanda phindu kumagwirizanitsidwa ndi mgwirizano wotsatizana, zovuta zokhudzana ndi njirayi n'zotheka.
Pseudogout ndizovuta kuphatikizapo kuyamwa kwa odwala omwe ali ndi chondrocalcinosis . Kuopsa kwa pseudogout mu nkhani ndi chondrocalcinosis, ndi / kapena khungu, asanayambe kusamba kanali kasanu ndi kawiri ka iwo omwe alibe chiopsezo.
Monga ndi jekeseni iliyonse, palinso kachilombo koyambitsa matendawa motsatizana. Kambiranani ndi dokotala wanu zosankha zanu zonse. Pamodzi, yesani phindu ndi zoopsa, ndipo pangani chisankho chodziwitsa.
Zotsatira:
Kuwombera pamodzi kwa osteoarthritis wa bondo. Reichenbach S. et al. Zosintha Zokambirana za Cochrane. 2010 May 12; (5): CD007320.
Zotsatira za jekeseni wothandizira ndi steroid kwa odwala osteoarthritis of knee: zotsatira za multicenter, randomized, kuyesedwa. Ravaud P. Arthritis & Rheumatism 42 (3): 475-82. 03/01/1999.
Kuchiza kwa Osteoarthritis ya Knee (Nonarthroplasty). Richmond, John MD. Journal of American Academy of Orthopedic Surgeons 17 (9): 591-600. September 2009.
Kuphatikizana ndi pseudogout. Pasquetti P. et al. Annals wa Rheumatic Diseases. 2004; 63: 1529-1530