I-Osteoathritis (OA)sisifo esixhaphakileyo esidibeneyo esibangela umthwalo onzima kwizigulane, iintsapho kunye noluntu.Uxilongo olusemgangathweni lwe-OA kunye nonyango lubaluleke kakhulu kumsebenzi wezonyango kunye nophuhliso lwentlalo.Uhlaziyo lweSikhokelo lwalukhokelwa yiCandelo leSayensi yezoNyango lwaseTshayina, iqela lezifundo ze-orthopedic arthritis leSebe lamathambo le-Chinese Medical Association, iZiko leSizwe loPhando lweSifo seKlinikhi yoNyango (iSibhedlele saseXiangya) kunye nesebe lokuhlela leMagazini yaseTshayina yamathambo.Ukuphakanyiswa kweeNgcebiso zoVavanyo, uPhuhliso kunye noVavanyo (iBanga) kunye nezikhokelo ezisebenzayo zamazwe ngamazwe (UKUBEKA IZINTO kwi-Healthca) RE, OKULUNGILEYO) Khetha imiba yekliniki ye-15 eyona nto ixhalabele ngayo i-orthopedics, ekugqibeleni, iingcebiso ze-30 ezisekelwe kubungqina zonyango zenziwe ukuphucula. ubunzululwazi bokuxilongwa kwe-OA kwaye ekugqibeleni kuphuculwe umgangatho weenkonzo zonyango ezigxile kwizigulane.
Cacisa ukuxilongwa kunye novavanyo olubanzi: ukuxilongwa kwe-OA kunye neengcebiso ezinxulumene novavanyo
I-OA ixhaphakile kwabo baneminyaka yobudala ≥40 iminyaka, abafazi, ukutyeba (okanye ukutyeba), okanye imbali yokwenzakala.Izibonakaliso eziqhelekileyo zeklinikhi ziyintlungu edibeneyo kunye nomsebenzi odibeneyo.Ukucacisa ukuxilongwa kuyimfuno ebalulekileyo yokuqulunqwa kwesicwangciso sonyango lwesifo.Kwizigulane ezirhanelwa yi-OA, izikhokelo zicetyiswa ukuba zikhethe uvavanyo lwe-X-reyi.Ukuba kuyimfuneko, i-CT, i-MRI, kunye ne-ultrasound inokwenziwa ukuze icacise ngakumbi indawo yokutshatyalaliswa kunye neqondo lokunciphisa kwaye iqhube ukuxilongwa okwahlukileyo.Kwakhona kwabonisa ukuba izifo ezifuna ukuchongwa nge-OA ziquka: i-arthritis, isifo samathambo, i-gout, i-pseudo-gout, kunye nokulimala ngokubambisana kwezifo ezizimelayo. ukubonakaliswa akuqhelekanga okanye akunakubandakanyi olunye uxilongo, unokucinga ngokukhetha uviwo olufanelekileyo lwebhubhoratri yokuchonga ukuxilongwa.
Emva kokuxilongwa kwe-OA, uvavanyo lwezigulo olubanzi lwezigulane kufuneka lwenziwe ukuze kuqulunqwe izicwangciso zonyango ezijoliswe kwizigulane.Isikhokelo sibonise ukuba uvavanyo lwesifo lwezigulane ze-OA kufuneka lubandakanye izifo ezahlukeneyo, isidanga seentlungu, kunye nokudibanisa izifo.Akukho nzima ukubona kuxilongo lwe-OA kunye nomzobo wokuhamba kovavanyo.Uxilongo olucacileyo kunye novavanyo olubanzi yimfuneko ebalulekileyo kunyango lwe-OA.
Ukunyathela, unyango lomntu ngamnye: Iingcebiso ezinxulumene nonyango lwe-OA
Ngokuphathelele unyango, izikhokelo ukuba unyango lwe-OA kufuneka lusekelwe kwimigaqo ye-ladderization kunye nonyango lomntu ngamnye ukufezekisa injongo yokunciphisa intlungu, ukuphucula okanye ukubuyisela umsebenzi odibeneyo, ukuphucula umgangatho wobomi bezigulane, ukulibazisa ukuqhubela phambili kwesifo, kunye ukusilela okulungisiweyo.Unyango oluthile lubandakanya unyango olusisiseko, unyango lweziyobisi, ukulungiswa nokwakhiwa kwakhona.
1) Unyango olusisiseko
Kunyango olunyathelweyo lwe-OA, isikhokelo sicebisa unyango olusisiseko olukhethwayo.Umzekelo, imfundo yezempilo, unyango lokuzilolonga, unyango lomzimba kunye noncedo lwesenzo.
Ekwenzeni unyango, ukuzivocavoca kwe-aerobic kunye nokuzivocavoca kwamanzi kunokuphucula ngokufanelekileyo iimpawu zentlungu kunye nomsebenzi womzimba wezigulane ezinamadolo kunye ne-hip joint OA;umthambo wezandla unokuphelisa ngempumelelo iintlungu kunye nokuqina kwamalungu kwizigulana ze-OA.I-OA yedolo edibeneyo inokuthathela ingqalelo ukusebenzisa unyango lomzimba olufana nophazamiseko lwangoku lonyango lokuvuselela umbane kunye nonyango lwe-pulse ultrasound ukuthomalalisa izigulana ezineempawu zeentlungu.
2) Unyango lweziyobisi
Iziyobisi zendawo ezingeyo-steroidal ezichasene nokudumba (NSAIDS) zingasetyenziswa njengamachiza onyango lokuqala kwiintlungu ze-OA edolweni, ngakumbi kwizigulane ezinezifo zesisu, izifo zentliziyo okanye ubuthathaka.Izigulane ezineempawu eziqhubekayo zentlungu okanye iintlungu ze-OA eziphakathi zicetyiswa ukuba zithathe i-NSAIDS yomlomo, kodwa kufuneka ziqaphele indlela yazo yesisu kunye neziganeko ezimbi ze-cardiovascular.
Isikhokelo sathi i-OA ayikhuthazwa ukuba isebenzise i-analgesic ye-opioid enamandla, kwaye kuyimfuneko ukusebenzisa i-opioid analgesic ebuthathaka njenge-Qu Maodo.Kwizigulane ezinexesha elide, elingapheliyo, intlungu ebanzi kunye (okanye), izigulane ezinoxinzelelo zingasebenzisa iziyobisi ezichasayo ezifana ne-Rostein.Xa kuthelekiswa nokunyangwa kwe-glucocorticoids kwi-joint cavity, i-sodium ye-injection ye-arthrine inokunciphisa intlungu kwixesha elifutshane, kodwa ukhuseleko luphezulu, kwaye izikhokelo zinconywa ngokufanelekileyo.Ukongeza, iyeza laseTshayina kunye ne-acupuncture nalo lingasetyenziselwa ukunyanga i-OA.
Ukusebenza kwenaliti yomngxuma odibeneyo
Isishwankathelo sobungqina: I-Glucocorticoids ifanelekile ukunyanzeliswa kweentlungu zedolo, ngakumbi izigulane ze-Knee OA ezihamba kunye ne-effusion.Isiphumo salo sikhawuleza, isiphumo esifutshane sokunciphisa intlungu sibalulekile, kodwa ukuphuculwa kwexesha elide lentlungu kunye nomsebenzi wentlungu kunye nomsebenzi awubonakali, kwaye ngokuphindaphindiweyo kusetyenziswa umngcipheko wokukhawuleza ukulahlekelwa kwe-cartilage edibeneyo ekusetyenzisweni kwe-cartilage. iihomoni.Kunconywa ukusebenzisa i-glucocorticoids yokutofa kwindawo edibeneyo.Kwaye akukho ngaphezu kwe-2 ukuya ku-3 amaxesha ngonyaka, kwaye ikhefu lokutofa akufanele libe lifutshane kuneenyanga ezi-3 ukuya kwezi-6.Ukongeza, ngaphandle kwezigulana ze-OA ezineentlungu ezibuhlungu kwiminwe, amalungu amalunga ajongwa njengenganyanga i-OA yesandla.Izigulana ezinesifo seswekile, ngakumbi ezo zinolawulo olulambathayo lweswekile yegazi, kufuneka zazise inaliti yomngxunya weglucocorticoids ukunyusa okwethutyana umngcipheko weswekile yegazi, kwaye kuyacetyiswa ukuba olu hlobo lwesigulana lubeke iliso kumaqondo eswekile yegazi ngaphakathi kwe-3 d emva kokutofa.
Iglasi yesodium inokuphucula umsebenzi odibeneyo, ixesha elifutshane lokukhulula intlungu kunye nokunciphisa inani leziyobisi ze-analgesic, kwaye inokhuseleko oluphezulu.Ifanelekile izigulane ze-OA ezine-gastrointestinal kunye (okanye) izinto ezinobungozi be-cardiovascular risk, kodwa ku-Indima yokukhusela i-cartilage kunye nokulibazisa isifo kuseyingxabano.Kunconywa ukuba ufake isicelo ngokufanelekileyo ngokwemiqathango yomntu ngamnye yesigulane.Ukukhula kunye ne-platelet plasma inokuphucula impendulo yokuvuvukala kwendawo, kodwa indlela yayo, ukusebenza kakuhle, kunye nokhuseleko lufuna ukulandelwa kwexesha elide, uvavanyo oluphezulu lwe-random control (RCT) ukunika ubungqina obungakumbi.Ukongeza, ulingo lwezonyango lwe-stem cell unyango lwe-OA luye lwenziwa eTshayina.
3) Ukulungisa
Ngokumalunga nokulungisa unyango, okokuqala, kuyimfuneko ukuqonda ukuba utyando lwe-arthroscopy lusebenza kakuhle kwi-joint joint OA eneempawu zentlungu kuphela, kwaye akukho mahluko ubalulekileyo phakathi kokusebenza kwexesha eliphakathi kunye nexesha elide kunye nonyango olulondolozayo.Idolo elidibeneyo i-OA eneempawu zokutshixa eziphothiweyo zingasetyenziselwa ukuphucula iimpawu zokuhlanjululwa kwe-arthroscopy;amanye amanyathelo okungenelela awavumelekanga, kwaye izigulane ezinamagxa amagxa ngenxa yobudala, umsebenzi okanye iminqweno yomntu ayifanelekanga kumalungu ehlombe.Isipili Qingli.
Ukongezelela, i-tibia stock room i-OA ene-force edibeneyo yamadolo, ngakumbi izigulane ezinomncinci kunye nabaneminyaka ephakathi kunye nomsebenzi omkhulu, zinokukhetha i-tibial high-level bone interceptation, i-femoral bone cutting, okanye i-fibula proximal bone interception surgery;I-mild hip joint OA ebangelwa yi-dysplasia ye-acetabular acetic inokukhethwa.
4) Ukwakhiwa kwakhona
Ukutshintshwa kwe-Artificial joint replacement ifanelekile kwizigulane ze-OA ezinzima kunye nokusebenza okucacileyo kwamanye amanyathelo okungenelela.Nangona kunjalo, imeko ethile, ukuzimisela okuzimeleyo kunye nokulindela kwesigulane kufuneka kuthathelwe ingqalelo.
Okunye ukulula kwamalungu okubambisana kwezabelo ezibunjiweyo zezinye iziphumo zonyango, ukukhethwa kwengcebiso yesikhokelo kumalungu ezabelo zezabelo;i-tibia stock igumbi elinye i-OA kunye nomgca wamandla we-5 ° ~ 10 °, i-ligament epheleleyo, i-flexion kunye nekhontrakthi ye-flexion engadluli kwi-15 °, kuyacetyiswa ukuba kunconywe Khetha enye indawo yokumisa.
I-OA, njengesifo esidityanisiweyo sokonakala, inokuxhaphaka ngokubanzi kwe-OA yokuqala phakathi kwabantu abangaphezu kweminyaka engama-40 kwilizwe lam.Kwaye ngokwanda kokuguga, ukuxhaphaka kwe-OA kusenokwenyuka.Kule nkalo, umbutho wezonyango ukhuphe izikhokelo ezininzi / ukuvumelana kweengcali kwiminyaka yamuva, kubandakanywa "Iingcali ze-Consensus ze-Clinical Drug Therapy ye-orthopedic arthritis" kunye "Iingcebiso kwiNgcali yoLawulo lweZifo eziPhambili ze-osteoarthritis" ukukhokela kunye nokulinganisa ukuxilongwa kwekliniki. kunye nonyango.Ngokukhutshwa kwezikhokelo ezininzi kunye nophando, ndiyathemba ukuphucula impilo yezigulane ze-OA ngakumbi.
Kwizigulane ze-OA, phantsi kwesiseko soxilongo olucacileyo, uvavanyo olubanzi lwesifo nalo luyafuneka.Ngokusekelwe kumgaqo wenyathelo-inqanaba kunye nonyango lomntu ngamnye, unyango olusisiseko, oludityaniswe nonyango lomzimba, ukulungiswa nokwakhiwa kwakhona unyango, njl.
(Imixholo yeli nqaku ishicilelwe, kwaye asiboneleli nasiphi na isiqinisekiso esicacileyo okanye esichaziweyo sokuchaneka, ukuthembeka okanye ukugqibelela kokuqulathwe kweli nqaku, kwaye abanaxanduva ngezimvo zeli nqaku, nceda uqonde.)
Ixesha lokuposa: May-11-2023