OTEOATHRITIS (OA)ndi wamba olowa ochiritsira matenda amene amayambitsa katundu wolemera kwa odwala, mabanja ndi anthu.Kuzindikira kokhazikika kwa OA ndi chithandizo ndikofunikira kwambiri pantchito zachipatala komanso chitukuko cha anthu.Zosintha zowongolera zidatsogozedwa ndi nthambi ya Chinese Medical Society's Orthopedic Science, gulu lamaphunziro a mafupa a mafupa a Nthambi ya Orthopaedician ya Chinese Medical Association, National Elderly Disease Clinical Medicine Research Center (Chipatala cha Xiangya) ndi dipatimenti yolemba magazini ya Chinese Orthopedic Magazine.Kukula kwa Recommentations Assessment, Development and Evaluation (Giredi) ndi malangizo othandiza padziko lonse lapansi (KULAMBIRA ZINTHU Mu Healthca) RE, KULADIRIRA) Sankhani nkhani zachipatala za 15 zomwe mafupa amakhudzidwa kwambiri, Pamapeto pake, malingaliro achipatala a 30 amapangidwa kuti apite patsogolo. sayansi ya matenda a OA ndipo pamapeto pake kupititsa patsogolo chithandizo chamankhwala chokhazikika pa odwala.
Fotokozani za matenda ndi kuwunika kwathunthu: Kuzindikira kwa OA ndi malingaliro okhudzana ndi kuwunika
OA ndi yofala kwa omwe ali ndi zaka ≥40 zaka, amayi, kunenepa kwambiri (kapena onenepa kwambiri), kapena mbiri yakuvulala.Ambiri matenda mawonetseredwe ululu olowa ndi olowa ntchito.Kufotokozera za matendawa ndi chinthu chofunikira kwambiri popanga dongosolo la chithandizo cha matenda.Kwa odwala omwe akuganiziridwa kuti ali ndi OA, malangizowo akulimbikitsidwa kuti asankhe kuyesa kwa X-ray.Ngati ndi kotheka, CT, MRI, ndi ultrasound akhoza kuchitidwa kuti apitirize kumveketsa malo osokonekera ndi kuchuluka kwa kuchepa kwake ndikupangitsa matenda osiyanasiyana.Inanenanso kuti matenda omwe amayenera kudziwika ndi OA ndi awa: nyamakazi, nyamakazi yopatsirana, gout, pseudo -gout, ndi kuvulala kwamagulu a autoimmune matenda.Kuwunika kwa laboratory sikofunikira chifukwa chodziwira OA, koma ngati wodwalayo ali ndi matenda. mawonetseredwe si mmene kapena sangathe kusaganizira matenda ena, mukhoza kuganizira kusankha zoyenera zasayansi kuyezetsa kuzindikira matenda.
Pambuyo pozindikira kuti ali ndi OA, kuyezetsa kokwanira kwa odwala kuyenera kuchitidwa kuti apange njira zochizira odwala.Guide inanena kuti kuwunika kwa matenda kwa odwala OA kuyenera kuphatikizapo matenda osiyanasiyana, digiri ya ululu, ndi matenda ophatikiza.Sikovuta kuwona kuchokera mu chithunzi cha OA chozindikiritsa ndikuwunika.Kuzindikira momveka bwino komanso kuunika kwathunthu ndizofunikira kwambiri pakuchiza kwa OA.
Kuyenda, chithandizo chamunthu payekha: Malangizo okhudzana ndi chithandizo cha OA
Pankhani ya chithandizo, malangizo omwe chithandizo cha OA chiyenera kukhazikitsidwa pa mfundo za makwerero ndi chithandizo cha munthu payekha kuti akwaniritse cholinga chochepetsera ululu, kuwongolera kapena kubwezeretsa ntchito yolumikizana, kuwongolera moyo wa odwala, kuchedwetsa kupita patsogolo kwa matenda, ndi anakonza zolakwika.Thandizo lapadera limaphatikizapo chithandizo choyambirira, chithandizo chamankhwala, kukonza ndi kumanganso chithandizo.
1) Chithandizo choyambirira
Pachithandizo chaposachedwa cha OA, wowongolera amalimbikitsa chithandizo chofunikira chomwe chimakondedwa.Mwachitsanzo, maphunziro a zaumoyo, masewero olimbitsa thupi, masewero olimbitsa thupi ndi kuthandizira kuchitapo kanthu.
Pochita masewera olimbitsa thupi, masewera olimbitsa thupi komanso masewera olimbitsa thupi amadzi amatha kusintha bwino zizindikiro za ululu ndi thupi la odwala omwe ali ndi bondo ndi chiuno cha OA;kuchita masewera olimbitsa thupi pamanja kumatha kuchepetsa kupweteka komanso kulimba kwa mafupa a odwala OA.Knee joint OA itha kuganizira kugwiritsa ntchito chithandizo chamankhwala monga kusokoneza magetsi olimbikitsa mphamvu komanso pulse ultrasound therapy kuti muchepetse odwala omwe ali ndi ululu.
2) Chithandizo cha mankhwala
Local apakhungu sanali steroidal odana ndi yotupa mankhwala (NSAIDS) angagwiritsidwe ntchito monga woyamba mzere mankhwala mankhwala bondo OA ululu, makamaka odwala m`mimba matenda, matenda a mtima kapena kufooka.Odwala omwe ali ndi zizindikiro zosalekeza za ululu kapena kupweteka kwapakati pa OA amalangizidwa kuti amwe NSAIDS pakamwa, koma ayenera kukhala tcheru ndi zochitika zawo za m'mimba ndi zamtima.
Wowongolerayo adati OA siyikulimbikitsidwa kugwiritsa ntchito mankhwala amphamvu a opioid analgesic, ndipo ndikofunikira kugwiritsa ntchito opioid analgesic ofooka monga Qu Maodo.Kwa odwala omwe ali ndi nthawi yayitali, yopweteka, yopweteka kwambiri komanso (kapena), odwala matenda ovutika maganizo amatha kugwiritsa ntchito mankhwala odana ndi nkhawa monga Rostein.Poyerekeza ndi chithandizo cha glucocorticoids mumtsempha wolumikizana, sodium ya jakisoni ya arthrine imatha kuthetsa ululu kwakanthawi kochepa, koma chitetezo ndi chapamwamba, ndipo malangizowo akulimbikitsidwa ngati oyenera.Kuphatikiza apo, mankhwala achi China ndi acupuncture amathanso kugwiritsidwa ntchito pochiza OA.
Mphamvu ya jakisoni wapakatikati
Umboni mwachidule: Glucocorticoids ndi oyenera kukulitsa kupweteka kwa bondo, makamaka odwala a Knee OA omwe amatsatiridwa ndi effusion.Zotsatira zake zimakhala zofulumira, zotsatira za nthawi yayitali zochepetsera ululu ndizofunika kwambiri, koma kusintha kwa nthawi yayitali kwa ululu ndi ntchito ya ululu ndi ntchito sizodziwikiratu, ndipo mobwerezabwereza kugwiritsa ntchito chiopsezo chofulumira kutayika kwa chiwombankhanga pogwiritsira ntchito. mahomoni.Ndibwino kuti mugwiritse ntchito jekeseni ya glucocorticoids muzitsulo zolumikizana.Ndipo osapitilira 2 mpaka 3 pachaka, ndipo nthawi ya jakisoni sayenera kuchepera miyezi 3 mpaka 6.Kuonjezera apo, kupatula odwala OA odwala omwe amamva kupweteka kwambiri zala, mfundo za mafupa nthawi zambiri sizimagwiritsidwa ntchito pochiza OA ya dzanja.Kwa odwala matenda a shuga, makamaka omwe ali ndi vuto lowongolera shuga m'magazi, adziwitse jekeseni wa glucocorticoids kuti awonjezere chiopsezo cha shuga m'magazi kwakanthawi, ndipo tikulimbikitsidwa kuti wodwala wamtunduwu aziwunika kuchuluka kwa shuga m'magazi mkati mwa masiku atatu atabaya.
Galasi ya sodium imatha kupititsa patsogolo ntchito zolumikizana, kuchepetsa kupweteka kwakanthawi kochepa komanso kuchepetsa kuchuluka kwa mankhwala ochepetsa ululu, komanso kukhala ndi chitetezo chokwanira.Ndiwoyenera kwa odwala OA omwe ali ndi vuto la m'mimba komanso (kapena) matenda a mtima, koma ali mu Ntchito ya chitetezo cha cartilage ndi kuchedwetsa matendawa akadali kutsutsana.Ndibwino kuti tigwiritse ntchito monga zoyenera malinga ndi momwe wodwalayo alili.Kukula kwa plasma ndi mapulateleti a plasma amatha kusintha kuyankha kwa kutupa kwa m'deralo, koma njira yake, mphamvu zake, ndi chitetezo zimafunikira kutsata nthawi yayitali, kuyesa kwapamwamba kwambiri (RCT) kuti apereke umboni wochuluka.Kuphatikiza apo, mayeso azachipatala a stem cell therapy OA achitikanso ku China.
3) Kukonza
Ponena za kukonza chithandizo, choyamba, m'pofunika kumvetsetsa kuti opaleshoni ya arthroscopy imakhala yothandiza pa bondo lophatikizana OA ndi zizindikiro zowawa zokha, ndipo palibe kusiyana kwakukulu pakati pa mphamvu yapakati komanso yayitali komanso yochepetsetsa.Bondo olowa OA ndi zizindikiro zokhota maloko angagwiritsidwe ntchito kusintha zizindikiro za arthroscopy kuyeretsa;njira zina zothandizira ndizosavomerezeka, ndipo odwala omwe ali ndi mapewa chifukwa cha msinkhu, ntchito kapena zofuna zaumwini sizoyenera kugwirizanitsa mapewa.Mirror Qingli.
Komanso, tibia katundu chipinda OA ndi osauka mawondo olowa mphamvu, makamaka odwala ndi achinyamata ndi azaka zapakati ndi ntchito yaikulu, akhoza kusankha tibial mkulu - mlingo fupa interceptation, femoral fupa kudula, kapena fibula proximal fupa interception opaleshoni;OA yofatsa ya m'chiuno chifukwa cha dysplasia ya acetabular acetic ikhoza kusankhidwa.
4) Kumanganso
Kulowa m'malo mochita kupanga ndikofunikira kwa odwala omwe ali ndi vuto la OA omwe ali ndi mphamvu zowoneka bwino za njira zina zothandizira.Komabe, zochitika zenizeni, kufunitsitsa kwaumwini ndi ziyembekezo za wodwalayo ziyeneranso kuganiziridwa.
Kuphweka kwina kwa zilumikizidwe zamagulu amagulu owoneka bwino a zotsatira zina zamankhwala, malangizo otsogolera osankhidwa a ziwalo za magawo a magawo;The tibia stock single room OA ndi mphamvu mzere wa 5 ° ~ 10 °, wathunthu ligament, ndi flexion ndi contracture wa flexion osapitirira 15 °, tikulimbikitsidwa kusankha imodzi yokhazikika m'malo.
OA, monga matenda osokonekera, ali ndi kuchuluka kwa OA yapachiyambi pakati pa anthu azaka zopitilira 40 m'dziko langa.Ndipo ndikukula kwa ukalamba, kufalikira kwa OA kumakwerabe.Pachifukwa ichi, bungwe lachipatala latulutsa malangizo angapo / mgwirizano wa akatswiri m'zaka zaposachedwa, kuphatikizapo "Consensus Experts of Clinical Drug Therapy of orthopedic arthritis" ndi "Maganizo a Management Expert of Chronic Diseases of osteoarthritis" kuti atsogolere ndi kulinganiza matenda a chipatala. ndi chithandizo.Ndi kutulutsidwa kwa malangizo ndi kafukufuku wambiri, ndikuyembekeza kupititsa patsogolo thanzi la odwala OA kwambiri.
Kwa odwala OA, pansi pa chidziwitso chodziwikiratu, kuunika kwathunthu kwa matenda kumafunikanso.Zochokera pa mfundo sitepe - mlingo ndi payekha mankhwala, zofunika mankhwala, pamodzi ndi thupi mankhwala, kukonza ndi kumanganso mankhwala, etc. dongosolo.
(Zomwe zili m'nkhaniyi zidasindikizidwanso, ndipo sitikupereka chitsimikizo chotsimikizika kapena chotsimikizika pakulondola, kudalirika kapena kukwanira kwa zomwe zili m'nkhaniyi, ndipo sitili ndi udindo pamalingaliro ankhaniyi, chonde mvetsetsani.）
Nthawi yotumiza: May-11-2023