NZVIMBO Dzechirwere Kurapa Zvikurudzira zveKnee uye Hip Osteoarthritis
Mishonga yakasiyana-siyana yeasteoarthritis inokurudzirwa kuvarwere vane marwadzo emakumbo, kuomesera, kuzvimba, uye dzimwe zviratidzo zveosteoarthritis . Varwere vanowanzovhiringidzika nemabasa akawanda ekurapa zvakadaro-uye zvechokwadi vakatendeseka, vangada kudarika izvo zvisingashandisi uye kutarisa pane zvinorevei. Ndeapi mazamu osteoarthritis ari nani?
Osteoarthritis Research Society International (OARSI) yakagadzira komiti (11 rheumatologists, 2 nyanzvi yekuchengeta vana, 1 chiremba wechiremba, uye nyanzvi 2 pamusoro pemishonga inopupurirwa kubva kune dzimwe nyika 6) iyo yakaita kurongeka kwakarongeka kwemishonga yekurapa yakavapo kubva muna 1945 kusvika munaJanuary 2006 nokuda kwamabvi uye hip osteoarthritis .
Kubvira pakutsvaga, komiti yakaratidza mirayiridzo yehutano 23 yehutongi hwemabvi uye hip osteoarthritis - 6 yaiva mafungiro-based, 5 aiva uchapupu hunotungamirirwa, uye 12 yakabva kune vose nyanzvi maonero uye uchapupu hwekutsvakurudza. Nenzira yakaoma iyo yaisanganisira kuongororwa kwakajeka kwemitemo yakarongeka, kurongeka kwakarongeka kwehuchapupu huchangobva kuitika, uye kudzidzira kuita zviratidzo zvekubvumirana - pakupedzisira zvirwere 25 zvakaparidzirwa "imwe chete yezvokurudzira kusvika kunezvino."
Purogiramu imwe neimwe inorayirwa yakapiwa SOR (simba rekurumbidza) chikwata. SOR yekurapa imwe neimwe yakabva pamagariro ekomiti inotungamirira mushure mekutsvakurudza ruzivo rwekutsvakurudza kwekuchengetedza, kubudirira, uye kugadzirisa-kubudirira. Kwenyanzvi yekliniki yemakambani emukomiti yakabatsira kubatanidza SOR zvakare, kusanganisira zvinhu zvakadai sekuona kwavo kwekushivirira kushivirira kwekurapa. SOR inoratidzirwa se peresenti iyo inomiririra yevadzidzi vemakomiti 'SOR mazita ekurudziro imwe neimwe, umo 0% ndiyo isina simba uye 100% ndiyo yakasimba.
Semuenzaniso, SOR ye 97% inoratidza kuti komiti, pamwero, inofunga kuti inobudirira, kuchengeteka, uye kugadzirisa-kurasikirwa kwerapi kuti ive yakakwirira kwazvo.
NYAYA yakasimbisa kuti kurapa kwakanaka kweasteoarthritis kunosanganisira zvose pharmacologic (zvinodhaka) uye kwete-pharmacologic (kwete-zvinodhaka) mishonga. Icho chaiva chirevo chekutanga chekurudziro.
Mamwe mazano makumi maviri nemaviri akaparadzaniswa akaita zvitatu-nonpharmacologic, pharmacologic, uye chirwere. Kutevera kune imwe neimwe inorayirwa kurapwa ndiyo inenge yeSOR.
11 Nonpharmacologic Modes of Treatment for Osteoarthritis
- dzidzo pamusoro pezvinangwa zvekurapa uye kuzvidzora kuburikidza nehupenyu huri kugadziriswa (97%)
- aerobic, kusimbisa musimba, uye mvura inoshandiswa (96%)
- kurema kuderedza (96%)
- kufamba-famba (90%)
- kutumira kune mumwe mupfungwa (89%)
- footware uye insoles (77%)
- mabheji (76%)
- nguva dzose contact contact (66%)
- thermal modalities / heat (64%)
- acupuncture (59%)
- transcutaneous electrical stimulation (58%)
8 Pharmacologic Treatments for Osteoarthritis
- Nyaya NSAIDs (93%)
- acetaminophen (92%)
- nhepfenyuro NSAIDs uye capsaicin (85%)
- opioid isina simba uye narcotic analgesics nekuda kwekunetseka kunorwadza (kusagadzikana nekurapa kwakanyanya) (82%)
- intraarticular (mujeri) injections ye corticosteroids (78%)
- intraarticular injections ye hyaluronan (64%)
- glucosamine uye / kana chondroitin sulfate nokuda kwekusunungurwa kwezviratidzo (63%)
- glucosamine sulfate , chondroitin sulfate , uye / kana diacerein kuitira kuti zvigone kuvandudzwa muzvikamu uye zvivako zvakapoteredza (41%)
5 Kurapa Kwokuvhiya kweOsteoarthritis
- huwandu hwekubatanidzwa (96%)
- unicompartmental knee replacement (76%)
- osteotomy uye dzimwe nzira dzokuvhiya kuchengetedza manotsi (75%)
- kubatana kwechisungo mushure mekugadziriswa kwekubatanidza kwakakundikana (69%)
- gorofa (wash out) uye arthroscopic debridement in knee osteoarthritis (60%)
Nzira dzekare dzekurapa maosteoarthritis dzakagadziriswa vasati vaona NSAID dziri kuongororwa kuti zvingangodaro mwoyo (zvinokonzerwa nemwoyo uye kurohwa). Kushamwaridzana kwemigumisiro yemigumisiro nemigumisiro yemwoyo zvakakonzera NSAID kushandiswa zvishomanana. Nhengo dzekomiti dzakawanda dzinofunga kuti NSAIDs zvinoshanda zvinopesana nezvinokonzera zvinodhaka uye kuti kushandiswa kwenguva pfupi kungave kwakakodzera - kana zvichionekwa pane mumwe munhu.
NYAYA haigoni kukurudzira NSAID kwenguva refu yekushandisa musingatarisiri nhoroondo yemurwere.
Pasi pose, pane zvikanganiso zvekufambiswa kwekutungamirirwa naOARSI. Imwe inogona kutarisa kusaenzana kwechiremba pane komiti - nevarapi vezvemapfupa uye vanachiremba vanonyanya kutarisirwa pasi. Zvechokwadi munhu aigona kuratidza kuzvininipisa kunorema kwakabatanidzwa pakuvandudza kubvumirana. Asi kunyange zvakadaro, kune kukosha mune zvitsva zvinotungamirirwa, kunyanya kune varwere, avo vasingakwanisi kuwana mazano ose apfuura akaonekwa nekomiti.
Sources:
> Osteoarthritis: Ndeapi Mishonga Inoshanda uye Izvo Zvisingaiti? Osteoarthritis Research Society International (OARSI). February 15, 2008.
http://www.oarsi.org/pdfs/pr_080215_guidelines.pdf
> OARSI mazano pamusoro pekutungamira kwehup and knee osteoarthritis, Chikamu II: Uchapupu hweARAR-based, expert expert consensus guidelines. Osteoarthritis uye Cartilage. W. Zhang et al. February 2008.