Ubwino, Zowopsya, ndi Kulephera kwa Zowonongeka Pamodzi
Jekeseni ya intra-articular ndi mawu omwe amagwiritsidwa ntchito kufotokozera mfuti yomwe imatulutsidwa mwachindunji ndi cholinga chachikulu chochotsera ululu. Corticosteroids (steroids) ndiwo zinthu zoyamba kugwiritsidwa ntchito pa cholinga ichi. Mitundu ina ya mankhwala tsopano imagwiritsidwa ntchito mobwerezabwereza kuphatikizapo anesthetics, hyaluronic acid , komanso Botox .
Katemera wa intra-articular amaperekedwa makamaka ngati ululu sunayankhepo kwa mankhwala ochiritsira owonjezereka kuphatikizapo kupweteka kwapwetekedwe, mankhwala osokoneza bongo , ndi mankhwala.
Mitundu ya Intra-Articular Injections
Cholinga cha jekeseni wa intra-articular chikhoza kusiyana ndi mankhwala ogwiritsidwa ntchito. Ngakhale kupweteka kwapweteka ndilo cholinga chofala kwambiri, angagwiritsidwe ntchito popereka mankhwala monga mankhwala a doxil (doxorubicin) mwachindunji mu mgwirizano wokhudzidwa ndi khansa. Zikhozanso kukhala njira zothandiza kuthetsa matenda opatsirana m'matumbo (omwe amadziwika kuti fungal arthritis).
Pogwiritsidwa ntchito pofuna kuchepetsa kupweteka, njira zochiritsira zosiyana zimagwira ntchito m'njira zosiyanasiyana:
- Corticosteroids amagwira ntchito pochepetsa kuchepa kwanuko. Amachita zimenezi mwa kulepheretsa kupanga maselo opweteka omwe mwachibadwa amapangidwa chifukwa cha kuvulala koopsa kapena matenda aakulu. Mankhwala ochiritsira amagwiritsidwa ntchito kwambiri pochizira matenda a osteoarthritis , gout wakuya, ndi nyamakazi ya nyamakazi ya bondo. Komabe, ntchito yogwiritsira ntchito corticosteroid nthawi yayitali imadziwika kuti iwonongeke pang'onopang'ono kumalo.
- Hyaluronic acid ndi chinthu chachilengedwe chomwe chimapezeka mu synovial madzi omwe amachititsa kuti ziwalo zikhale bwino. Ndi matenda a osteoarthritis, mankhwalawa akhoza kutha mofulumira ndipo amachititsa kuti vutoli liwonjezeke. Majekeseni amathandizira kuonjezera mafuta, kuchepetsa kupweteka, ndi kupititsa patsogolo kayendetsedwe ka kayendedwe kamodzi. Maphunziro a zachipatala asakanikirana ndi momwe amawombera.
- Nthawi zina amadzimadzi am'thupi amathandizidwa ndi jekeseni la intra-articular monga mawonekedwe a kupweteka kwapweteka potsatira opaleshoni yamakono. Koma ndizochita zomwe zasanthuledwa monga momwe umboni umasonyezera kuti ukhoza kunyoza chondrocytes (maselo okhawo omwe amapezeka mu kaloti) mumodzi.
- Botox (botulinum neurotoxin A) jekeseni yasonyezedwa kuti imapereka mpumulo waukulu kwa anthu omwe ali ndi mafupa apamwamba a knee. Komabe, kugwiritsiridwa ntchito kwa Botox sikukuwoneka kuti kukuthandizani kapena kubwezeretsa ntchito ya mgwirizano.
- Magazi a pulasitiki otchedwa platelet (PRP) amachokera ku magazi athunthu ndipo ali ndi mapuloletsiti (maselo ofiira a m'magazi omwe ali pakatikati kuti atseke) ndi gawo la madzi lomwe limatchedwa plasma. Majekeseni amtundu wa PRP awonetsedwa kuti achepetse kupweteka ndikupangitsanso thupi labwino kwa anthu omwe ali ndi matenda odwala nyamakazi pamene akuthandizira kukonzanso kwa collagen m'magulu. Anthu ena amapindula kwambiri kuposa ena, komabe, ambiri samapanga bwino payekha koma amayamba kuchepa kwa nyamakazi.
Zotsatira za Chithandizo
Zotsatira zoyamba ziwiri zomwe zimagwirizanitsidwa ndi jekeseni wa intra-articular ndi matenda ndi zomwe zimachitika pamtunda. Zotsatira zina zingathe kuchitika poyerekeza ndi mankhwala kapena zinthu zomwe zimayikidwa.
Majekeseni am'kati, ambiri, sayenera kuonedwa kuti ndiyo njira yokhayo yothandizira osteoarthritis kapena mavuto ena. Zotsatira za mankhwala ambiriwa amatha kupitirira nthawi, ndipo zotsatira zolakwika pamalumiki pawokha nthawi zina zimakhala zovuta kwambiri.
Pakagwiritsidwa ntchito, ma shotti a corticosteroid ayenera kuperekedwa osachepera miyezi itatu. Kutalika kwa mpumulo kungasinthe malinga ndi mtundu wa steroid yogwiritsidwa ntchito:
- Hydrocortisone ndi yofooka komanso yochepa.
- Kukonzekera kwa Methylprednisolone kungagwire ntchito kwa masabata awiri kapena awiri.
- Celestone (betamethasone) ikhoza kugwira ntchito kwa milungu iwiri kapena eyiti.
- Kenalog ndi Aristocort (kukonzekera triamcinolone) akhoza kugwira ntchito kwa masabata anayi kapena 16.
- Aristopan (chokonzekera china cha triamcinolone) chingakhale kwa miyezi.
Hyaluronic acid jekeseni, poyerekeza, nthawi zambiri amawongolera ngati mndandanda wa mndandanda wa masabata atatu kapena asanu. Amagwiritsidwa ntchito kugula nthawi asanachite opaleshoni ya mawondo mmalo mwa anthu omwe satha kulekerera steroid ndipo sanapeze mpumulo ku mankhwala am'mamwa.
Botox, pakalipano, ikuwoneka kuti siipweteka kwambiri kwa kadoti, imakhala ndi zotsatira zochepa, ndipo imawoneka bwino pakuchiza matenda aakulu a osteoarthritis.
Ndikunenedwa kuti, palibe mgwirizano womveka pa ntchito yoyenera. Zotsatira za chithandizo zingathe kukhalapo kwa masabata khumi ndi awiri mwa anthu ena komanso mwachidule ngati milungu inayi kwa ena.
PRP sichidziwika ndi zotsatira zake, koma mphamvu zake zimasiyana kwambiri kuchokera kwa munthu ndi munthu. Zopindulitsa zothandizira zingathe kukhalapo kwa miyezi isanu ndi umodzi kapena isanu ndi iwiri.
Zotsatira:
> Evans, C .; Krause, V .; ndi Setton, L. "Kupititsa patsogolo mankhwala opatsirana." Nat Rev Rheumatol. 2014; 10 (1): 11-22.