MITU YA NKHANI Pakati pa Zopereka Zothandizira Zachirombo ndi Hip Osteoarthritis
Mankhwala osiyanasiyana a osteoarthritis akulimbikitsidwa kwa odwala opweteka m'magulu, kuuma, kutupa, ndi zizindikiro zina za m'mimba . Odwala nthawi zambiri amasokonezeka ndi njira zambiri zothandizira mankhwala - komanso moona mtima, angafune kudumpha zomwe sizigwira ntchito ndi kuganizira zomwe zikuchitika. Ndi mankhwala ati osteoarthritis omwe ali abwino kwambiri?
Osteoarthritis Research Society International (OARSI) inakhazikitsa komiti (11 rheumatologists, madokotala awiri oyang'anira chisamaliro, 1 dokotala wa opaleshoni wamatumbo, ndi akatswiri awiri pa mankhwala ochirikiza umboni ochokera m'mayiko 6) omwe anachita ndondomeko yoyenera ya malangizo othandizira omwe akhalapo kuyambira 1945 mpaka January 2006 chifukwa cha mawondo ndi chiuno cha osteoarthritis .
Kuchokera pa kufufuza, komitiyi inalongosola ndondomeko 23 zothandizira machitidwe otsogolera ma knee ndi hip osteoarthritis - 6 anali okhudzidwa ndi maganizo, 5 anali ozikidwa pa umboni, ndipo khumi ndi awiri adakhazikitsidwa pazidziwitso za akatswiri ndi umboni wofufuza. Kupyolera mu njira yovuta yomwe inaphatikizapo kuyesa kovuta kwa malangizo omwe alipo kale, kuyambiranso mwatsatanetsatane za umboni waposachedwapa, ndi kuchitapo kanthu kuti apange chigwirizano chovomerezeka - potsiriza mankhwala 25 adalengezedwa "ndondomeko imodzi yazinthu zatsopano."
Chithandizo chilichonse chinapatsidwa chiwerengero cha SOR (mphamvu ya ndondomeko). NTHAWI ya chithandizo chilichonse chinachokera pamaganizo a komiti yotsogoleredwa pambuyo pofufuza kafukufuku wokhudzana ndi chitetezo, mphamvu, ndi mtengo wabwino. Maluso a kachipatala a mamembala a komiti anathandizanso kupanga SOR, kuphatikizapo zinthu monga momwe amalingalira ndi kuleza mtima kwachilendo kuchipatala. SOR imayesedwa ngati peresenti yomwe imayimira pafupifupi SOR a mamembala awo pa mfundo iliyonse, pamene 0% ndi ofooka kwambiri ndipo 100% ndi amphamvu kwambiri.
Mwachitsanzo, SOR ya 97% imasonyeza kuti komitiyi, pafupifupi, inaganizira kuti ntchito yabwino, chitetezo, komanso mtengo wa mankhwalawa ndipamwamba kwambiri.
OARSI anagogomezera kuti chithandizo chabwino kwambiri cha osteoarthritis chimaphatikizapo mankhwala onse osokoneza bongo (mankhwala osokoneza bongo) komanso osagwiritsa ntchito mankhwala. Limenelo ndilo langizo loyamba.
Maphunziro 24wa anagawa m'magulu atatu - ospharmacologic, pharmacologic, ndi opaleshoni. Pafupi ndi iliyonse yothandizira chithandizo ndi chiwerengero cha SOR.
11 Nonpharmacologic Njira Zothandizira Osteoarthritis
- maphunziro ponena za zolinga za chithandizo ndi kudziletsa pochita zinthu zosintha moyo (97%)
- kuthamangitsa minofu, komanso madzi (96%)
- kuchepetsa kulemera (96%)
- Zothandizira kuyenda (90%)
- kutumiza kwa wodwala thupi (89%)
- footware ndi insoles (77%)
- mavoti a knee (76%)
- kulankhulana kwa foni nthawi zonse (66%)
- Makhalidwe otentha / kutentha (64%)
- matumbo (59%)
- Kutsatsa magetsi (58%)
8 Pharmacologic Chithandizo cha Osteoarthritis
- NALIDZI Zomlomo (93%)
- acetaminophen (92%)
- NSAID zamatsenga ndi capsaicin (85%)
- ofooids ofooka ndi mankhwala ozunguza bongo chifukwa cha ululu wosakanikirana (osagwirizana ndi mankhwala wamba) (82%)
- mazira a corticosteroids (78%)
- majekeseni a hyaluronan (64%)
- glucosamine ndi / kapena chondroitin sulphate for relief relief (63%)
- glucosamine sulfate , chondroitin sulphate , ndi / kapena diacerein kuti zitheke kusintha m'magulu ndi zomangamanga (41%)
5 Kuchiza Opaleshoni kwa Osteoarthritis
- chiwonetsero chonse (96%)
- Kusintha kwa mawondo osadziwika (76%)
- osteotomy ndi njira zina zopaleshoni zoteteza ziwalo (75%)
- Kusakanikirana kotsekedwa pambuyo potsitsirana kwalakwitsa (69%)
- kusambitsana (kutsuka kunja) ndi kukangana kwakukulu mu knee osteoarthritis (60%)
Zotsatira zakale za chithandizo cha osteoarthritis zinapangidwa zisanakhale NSAID ikuyang'aniridwa kuti iwonongeke mtima (matenda a mtima ndi kupwetekedwa mtima). Kuphatikiza kwa zotsatira za m'mimba ndi kuopsa kwa mtima kwachititsa kuti NSAID zisagwiritsidwe ntchito pang'ono. Mamembala a komiti amodzi amakhulupirira kuti NSAID ndi mankhwala odana ndi zotupa komanso kuti ntchito yaying'ono ingakhale yoyenera - ikaganiziridwa payekha.
OARSI sikulangiza a NSAID kuti agwiritse ntchito nthawi yaitali popanda kuganizira mbiri ya wodwalayo.
Zonsezi, panali zolephera za chitukuko cha OARSI. Mmodzi akhoza kuwonetsa kusagwirizana kwa madokotala pa komiti - ndi opaleshoni zamagetsi ndi madokotala oyambilira omwe akuyimira. Ndithudi munthu akhoza kuwonetsa kulemerera kwakukulu komwe kunaphatikizidwa pakukhazikitsa mgwirizano. Koma ngakhale zili choncho, pali zothandiza muzitsogozo zatsopano, makamaka kwa odwala, omwe alibe mwayi wotsatira malangizo onse omwe adayang'aniridwa ndi komitiyo.
Zotsatira:
> Osteoarthritis: Ndi Machiritso Otani Amene Amagwira Ntchito Ndiponso Amene Sali? Osteoarthritis Research Society International (OARSI). February 15, 2008.
http://www.oarsi.org/pdfs/pr_080215_guidelines.pdf
> Malangizo a OARSI otsogolera a hip ndi knee osteoarthritis, Gawo II: OARSI umboni-based, expert expert consensus guidelines. Osteoarthritis ndi Cartilage. W. Zhang et al. February 2008.