Zotsatira za Mankhwala Okhudza Matenda Okhudzana ndi Olemala Ndi Ofunika Kwambiri
Gulu la Ntchito Yachilendo Imayesa Kachitidwe ka Osteoarthritis
Mankhwala opatsirana a m'mimba amachititsa 20 peresenti ya anthu oposa zaka 55. Gulu la asilikali la European League Against Rheumatism lomwe linatulutsa ndondomeko zothandizira opaoarthritis, zomwe zinatulutsidwa m'chaka cha 2006, zothandizidwa ndi matenda a osteoarthritis.
Gulu lamagulu la EULAR, lomwe lili ndi akatswiri 21, kuphatikizapo akatswiri ambiri a rheumatologists , opaleshoni ya mafupa, ndi physiatrist pakati pa akatswiri ena azaumoyo, anafufuza kafukufuku wotsutsa umboni ndipo adagwirizana kuti 11 malingaliro okhudza 17 njira zoyenera zinali zoyenera kwambiri kuchiza dzanja la osteoarthitis.
Izi zikulimbikitsidwa kuchokera pazomwe zimalimbikitsidwa kuti zitsimikizidwe molakwika malingana ndi msinkhu wa umboni. Zinanenedwa kuti njira zisanu zokha zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi ziwiri (17) zokhazokha zinkakhazikitsidwa ndi umboni wofufuza Zotsatira zina zinachokera ku luso lachipatala kapena deta zomwe zimachokera ku maphunziro a osteoarthritis a ziwalo zina kupatula dzanja.
Malangizo Khumi ndi Momwe Akuchiritsira Mankhwala Osakaniza Amanja
Gulu lamagulu la EULAR lapereka ndondomeko izi pakuyang'anira ndi kuchiza matenda a mitsempha:
- Kuphatikiza mankhwala osokoneza bongo (mankhwala osokoneza bongo) komanso mankhwala osagwiritsa ntchito mankhwala, omwe amadziwika kuti ndi odwala matenda a osteoarthritis, akulimbikitsidwa.
- Thandizo la matenda opatsirana m'magazi ayenera kudziwika payekha kwa wodwala. Zowopsa, mtundu wa osteoarthritis, mlingo wa kutupa, ululu waumphawi, kuuma, kulemala, umoyo wa moyo, kukhudzidwa, ndi mankhwala oyenera ayenera kuganiziridwa pamodzi ndi zofuna za wodwalayo.
- Odwala ayenera kuphunzitsidwa za chitetezo cha mgwirizano ndi kupatsidwa mphamvu zolimbitsa thupi.
- Kugwiritsa ntchito kutentha (mwachitsanzo phukusi lotentha , penti yotentha, paraffini sera ) ndi ultrasound zimathandiza kuti muziyang'anira matenda osteoarthritis a dzanja.
- Pansi pa chala chachikulu, kupatulidwa kumalimbikitsidwa. Orthotics imalimbikitsidwa kuti zisawonongeke zina zolakwika.
- Kupweteka kofatsa komanso mopitirira malire komanso pamene mankhwala ambiri samakhudzidwa, mankhwala am'deralo kapena apamwamba (mwachitsanzo, ma NSAID, ma kapsaicin ) amaposa mankhwala ochizira.
- Acetaminophen (mwachitsanzo, Tylenol) ndilo lovomerezeka la oral analgesic. Mpaka 4 g / tsiku amawoneka otetezeka komanso ogwira mtima.
- Kwa odwala omwe amalandira yankho losakhutiritsa kuchokera ku acetaminophen, chisankho chotsatira ndi NSAID zamlomo (mankhwala osakanikirana ndi othandizira) osagwira ntchito kwambiri, chifukwa nthawi yayitali imatha. Kusankhidwa kwa NSAID kwa wodwala aliyense ayenera kuganizira zoopsa za m'mimba komanso ngozi ya mtima.
- Glucosamine ndi chondroitin , avocado soybean osaponifiables , diacerein , ndi viscosupplementation onse amachiritsira pang'onopang'ono kwa osteoarthritis. Angapereke mpumulo ndi poizoni wochepa.
- Majekeseni a corticosteroid amathandiza kwambiri, makamaka panthawi yovuta kwambiri ya osteoarthritis.
- Kuchita opaleshoni (mwachitsanzo, arthroplasty, arthrodesis , kapena osteotomy) ingaganizidwe kwa odwala omwe analibe mwayi wokhala ndi mankhwala ochiritsira. Opaleshoni imalimbikitsidwa kwa odwala opweteka kwambiri ndi olumala kuchokera ku matenda a mitsempha.
Chifukwa Chiyani Malangizo Odziŵika Ogwira Ntchito Ankafunika
Osteoarthritis imakhudza manja, chiuno, ndi mawondo mosiyana.
Mapulogalamuwa ndi osiyana ndi ma anatomy ndi ntchito, ndipo odwala ali osiyana ndi machitidwe oyenera komanso mankhwala ochizira.
Malingaliro asanu ndi limodzi mwa khumi ndi anai, mu lipoti lomwe linalembedwa mu Annals la Rheumatic Diseases , linathandizidwa ndi deta yophunzira:
- maphunziro ndi maphunziro
- NSAIDs
- COX-2 inhibitors
- NSAID zamatsenga
- katswiri wamaseweraicin
- chondroitin sulfate
Malangizo a ACR a Mankhwala Ochepetsa Matenda a Odwala (2012)
M'chaka cha 2012, American College of Rheumatology inakonza zotsatila zothandizira osteoarthritis. Iwo adalimbikitsa kuti madokotala achite zotsatirazi kuti asakhale mankhwala osokoneza bongo:
- Ganizirani luso lochita zochitika za tsiku ndi tsiku (ADLs)
- Langizani njira zothandizira mgwirizano
- Perekani zipangizo zothandizira, ngati pakufunikira, kuthandiza odwala kupanga ADLs
- Phunzitsani pogwiritsa ntchito njira zowonjezera
- Perekani zidutswa za odwala ndi trapeziometacarpal joint osteoarthritis
Malingaliro ovomerezeka a mankhwalawa anaphatikizapo zotsatirazi (gwiritsani ntchito chimodzi kapena zingapo zotsatirazi):
- Mutu wa capsaicin
- NSAID zamasewero, kuphatikizapo trolamine salicylate
- NSAID zamlomo, kuphatikizapo COX-2 selective inhibitors
- Tramadol
ACR pansi pano inalimbikitsa kuti akatswiri azaumoyo asagwiritse ntchito zotsatirazi:
- Zochiritsira zamakono
- Mafilimu opioid
Komanso, odwala omwe ali ndi zaka 75 ayenera kugwiritsa ntchito mankhwala osokoneza bongo m'malo mowauza.
Zotsatira:
Zovomerezeka zapachiyambi zowonjezera zowonongeka kwa manja osteoarthritis. Zhang, W. Annals wa Rheumatic Diseases. Lofalitsidwa pa intaneti. October 17, 2006.
http://ard.bmj.com/content/66/3/377
American College of Rheumatology 2012 Malangizo Ogwiritsiridwa ntchito kwa Nonpharmacologic ndi Pharmacologic Therapies mu Osteoarthritis ya Dzanja, Hip, ndi Knee. Hochberg M. et al. Matenda a Nyamakazi & Kafukufuku Vol. 64, No. 4, April 2012.
http://www.rheumatology.org/Portals/0/Files/ACR%20Recommendations%20for%20the%20Use%20of%20Nonpharmacologic%20and%20Pharmacologic%20Therapies%20in%20OA%20of%20the%20Hand,%20Hip%20and % 20Knee.pdf