Kuneneratu Amene Angapeze Chikhululukiro
Pasanapite nthawi yaitali mutapezeka kuti muli ndi nyamakazi , mwinamwake munamva za "kutupa nyamakazi" monga cholinga chachikulu cha mankhwala a nyamakazi. Mwinamwake munali ndi mafunso ochepa ovuta. Kodi chikhululukiro ndi chiyani? Kodi kukhululukidwa kumatha nthawi yaitali bwanji? Kodi ambiri odwala nyamakazi amapeza chikhululukiro? Kodi mwayi wanu ndi wotani?
Katswiri wa Rheumatologist Akufotokoza Kukhululukidwa
Tinapempha thandizo la katswiri wa matenda a rheumatologist, Scott J.
Zashin, MD, kuti ayankhe mafunso athu okhudza zakhululukiro za nyamakazi. Mayankho ake amathandiza kufotokoza lingaliro ndikuthandizani kuzindikira ngati mwapeza chikhululuko. Kukhululukidwa kwachipatala makamaka kumakhudzana ndi matenda a nyamakazi , nyamakazi , yotupa, yowonongeka ya nyamakazi imene imakhudza anthu pafupifupi 1.5 miliyoni ku US
Tinamufunsa Dr. Zashin zomwe zimatanthawuza kukhululukidwa kweniyeni kwa odwala nyamakazi? Kodi dokotala anganenedwe ngati wodwalayo ati adzapulumutsidwa kapena kuti kukhululukidwa kwa nthawi yaitali bwanji? Kodi pali ziŵerengero za chiwerengero cha odwala nyamakazi omwe amatha kukhululukidwa? Kodi matenda a nyamakazi amatha kuchita chiyani chomwe chidzawapatsa mpata wabwino wopindula?
Malingana ndi Dr. Zashin, ngakhale palibe mankhwala omwe amadziwika ndi matenda a nyamakazi, odwala 30% akhoza "kumva kuti amachiritsidwa" pa matenda awo. Zomwe odwala awa akukumana nazo ndikutuluka kwachipatala.
Kukhululukidwa kwa nyamakazi ya nyamakazi kwa nthawi yaitali kunatanthauzidwa ngati kusapezeka kwa zizindikiro za kutupa . Ngakhale kuti ochepa peresenti ya odwala amatha kusiya mankhwala awo a nyamakazi , oposa 95% ayenera kupitiliza kumwa mankhwala awo kuti akhalebe okhululukidwa.
Milandu ya American College of Rheumatology (ACR) (1981) yotsimikizira kukhululukidwa kwachipatala ndi monga:
- kuuma kwa m'mawa kosakwana kapena kofanana ndi mphindi 15
- osati kutopa
- palibe kupweteka kwamagazi
- palibe kukhudzidwa mtima kapena kupsinjika pa kuyenda
- palibe minofu yofewa yotupa m'magulu kapena m'mimba
- Mlingo wamakono wa erythrocyte (kuyesa magazi komwe kumayesa kutupa) osachepera kapena wofanana ndi 30 mwa akazi ndi 20 mwa amuna
Dr. Zashin adalongosola kuti ngakhale palibe njira yodziwira omwe adzapindule ndi mankhwala, odwala omwe ali ndi vuto la nthenda yapachifuwa komanso CCP antibody , komanso mapuloteni achizoloŵezi a C , amakhala ndi zotsatira zabwino. Kuonjezera apo, odwala omwe amagwiritsira ntchito mankhwalawa (mwachitsanzo, methotrexate ndi TNF inhibitor ) amatha kupeza chikhululukiro kusiyana ndi omwe amamwa mankhwala okhaokha. Komabe, odwala pa monotherapy (mankhwala amodzi yekha) angakhalebe ochotsera kuchipatala. Kutalika kwa matendawa kumakhalabe kukhululukidwa, ndikosavuta kukhala wotanganidwa kachiwiri.
Kusinthidwa Tanthauzo la Kukhululukidwa
Mu 2011, zaka zopitirira khumi kuchokera pamene mankhwala oyambirira a biologic adavomerezedwa kuti athetse vuto la nyamakazi, adadziwika kuti tanthauzo la chikhululukiro cha nyamakazi liyenera kusinthidwa . Bungwe la American College of Rheumatology ndi European League Against Rheumatism linasanthula chidziwitso cha mayesero omwe adayang'aniridwa ndi a komiti, ndipo anaganiza pa ziganizo ziwiri za chikhululukiro cha nyamakazi zomwe zimagwiritsidwa ntchito m'mayesero a zachipatala.
Mafotokozedwe angathenso kugwiritsidwa ntchito muzipatala.
Ndikofunika kuzindikira kuti kukhululukira sikungakhale kosatha. Kusiya mankhwala anu kungayambitsenso kubwerera. Ngakhale kupitiriza chithandizo, mankhwala omwe amasiya kugwira ntchito angayambe kubwerera.
(Scott J. Zashin, MD, ndi pulofesa wothandizira pulogalamu ya yunivesite ya University of Texas Southwestern Medical School, Division of Rheumatology, ku Dallas, Texas; dokotala yemwe akupezeka ku chipatala cha Presbyterian ku Dallas ndi Plano; mnzake wa American College of Physicians American College of Rheumatology ndi membala wa American Medical Association.)
> Zotsatira:
> Chifuwa chachikulu cha nyamakazi Kafukufuku amatsitsimutseni. American College of Rheumatology. February 3, 2011.
> Zowonongeka Zoyamba za Kugonjetsedwa Kwachipatala mu Arthritis. Arthritis ndi Rheumatism. Mipukutu RS et al., October 1981.