Mapulotoni a Cortisone Athandizira Kuchepetsa Kutupa Kumalo Kapena Kachitidwe
Majekesiti a Steroid, omwe amatchedwanso kuti cortisone, amajambulidwa ndi mankhwala a corticosteroid . Jekeseni wa steroid ukhoza kuperekedwa monga jekeseni wamtunduwu (mwachitsanzo, intra-articular) kapena minofu (matako, mwachitsanzo) kapena mitsempha ya thupi (ie thupi lonse). Corticosteroids ndi mankhwala osokoneza bongo omwe amafanana kwambiri ndi cortisol, hormone mwachibadwa yopangidwa ndi adrenal glands.
Poyambitsa jekeseni, dokotala wanu akhoza kupereka mankhwala akuluakulu a mankhwala a corticosteroid mwachindunji kumalo opweteka a thupi kuti cholinga chake chichepetse kutupa mwa kuchepetsa ntchito ya chitetezo cha mthupi .
Zizindikiro za Steroid Injections
Corticosteroids amagwiritsidwa ntchito pofuna kuteteza kutupa kwa nyamakazi ndi zinthu zina zotupa. Corticosteroids ikhoza kulumikizidwa mwachindunji m'matenda opsa, kapena amatha kuperekedwa ku thupi lonse kudzera pamakonzedwe am'kamwa, jekeseni zamkati, kapena jekeseni ya m'mimba. Majekesiti a Steroid angathandize kwambiri odwala matenda a nyamakazi kapena masisitomala . Kwa odwala matenda a nyamakazi , jekeseni amaperekedwa nthawi zambiri pamene amodzi kapena awiri amodzi akuwonetsa synovitis yogwira ntchito. Cholinga cha chithandizo ndi kuchotsa zizindikiro za kutentha kapena kuthandiza mankhwala osokoneza bongo, monga methotrexate kapena Plaquenil , nthawi yogwira ntchito. Mwachitsanzo, m'matenda a nyamakazi oyambirira, zotsatira za kafukufuku zinawonetsa kuti kuphatikizapo DMARD ndi intra-articular steroid ndi bwino kuposa DMARD okha.
Bondo ndi gawo lofala lomwe limayikidwa. Ndikoyenera kuti odwala achepetse ntchito yawo yolemetsa kwa masiku 1 - 2 pambuyo pa jekeseni kuti apereke mwayi wapadera woti ukhale wogwira mtima. Kugwiritsa ntchito molakwa mu maola 6 oyambirira pambuyo pa jekeseni kukhoza kuchepetsa nyamakazi. Popeza kuti mankhwala amadzimadzi amadzimadzi amakhala amodzi ndi steroid, odwala sangadziwe kuti akudetsa nkhaŵa kwambiri pamagulu awo a nyamakazi, monga kupwetekedwa mtima, malinga ndi katswiri wa mafupa a zinyama Scott J. Zashin.
Malangizowo amasiyana, koma madokotala ambiri amapewa kulandira katemera kamodzi katatu pa chaka. Mwachitsanzo, mungakhale ndi jekeseni lanu lamanzere katatu patsiku ndikugwedeza bondo lanu lamanja nthawi ziwiri, koma osati maulendo 4 pambali imodzi. Chiwerengero chokwanira kapena mafupipafupi a jekeseni wa steroid angayambitse mafupa, ligament, kapena tendon.
Pali njira zingapo zothandizira steroid zomwe zimagwiritsidwa ntchito mu jekeseni. Makamaka, zimadalira madokotala omwe amakonda (mwachitsanzo, Depo-Medrol [methylprednisolone acetate], Aristospan [triamcinolone hexacetonide], Kenalog [triamcinolone acetonide] ndi Celestone [betamethasone]). Pamene odwala nthawi zambiri amamva bwino mu chipinda choyezetsa magazi, kamodzi kamene kafukufuku amatha kutaya, zingatenge masiku khumi kuti azindikire kuti apindulanso.
Zotsatira Zotsatira za Steroid Injections
Odwala ambiri omwe amalandira majeremusi a steroid sakhala ndi zotsatirapo, makamaka potsatira ndondomeko yomwe amalimbikitsa. Komabe, zotsatira zoyipa za jekeseni wa steroid ndizo:
- kupweteka kochuluka kapena kutupa kwa mgwirizano mu maola 24 oyambirira
- kutupa, kufiira, kapena kupweteka kochulukira pambuyo pa maola makumi awiri ndi awiri (kungasonyeze kuti pali matenda ovomerezeka)
- tendon kutha
- kutuluka kwa khungu
- kutuluka magazi komweko
- matenda
- zotsutsana nazo
Jekeseni wamtundu wa steroid mumtambo (mapako) amapereka njira yogwira ntchito. Ngati mgwirizano wapadera umakhudzidwa, jekeseni wa steroid m'mabowo sungakhale wothandiza kuposa injection ya intra-articular. Monga ndi oral oral corticosteroids, sichidziwika kuti mankhwala ochuluka amatha kufika pamtundu wotani. Komanso, ngati jekeseni m'makolo imabwerezedwa mobwerezabwereza, ikhoza kuonjezerapo mwayi wowonjezera mavuto ena omwe amachitidwa ndi oral steroids, kuphatikizapo osteoporosis ndi cataracts.
Mfundo Zofunika Zochepa
- Kawirikawiri, majekeseni a m'dera lanu amavomerezedwa bwino ndipo sangagwirizane ndi zotsatira zoyipa poyerekeza ndi oral corticosteroids.
- Steroids sayenera kukhala jekeseni ngati pali matenda pa malo omwe amayenera kupatsidwa kapena paliponse m'thupi.
- Ngati mgwirizano wokhudzidwawo wawonongeka kwambiri, palibe mwayi wochepa wa zotsatira zabwino ndi jekeseni wa steroid.
- Kawirikawiri, ndizolowera kuti azitsatira mchere wambiri poyesera asanayese jekeseni ndi steroids, makamaka ngati matendawa sali otsimikizika.
> Zotsatira:
> Steroid Injections. Clinical Cleveland.
> Kuyerekeza kwa intra-articular glucocorticoid jekeseni ndi DMARD potsutsa DMARD okha mu nyamakazi ya nyamakazi. Journal of Association of Physicians of India. Menon N. et al. August 2014.
> Kelley's Textbook of Rheumatology. Kusindikiza kwachisanu ndi chinayi. Elsevier. Thandizo la Glucocorticoid. Mutu 60.