Makomborero, Ngozi, uye Kukwana Kwemajoini Akabatana
Inject-articular injection ishoko rinoshandiswa kutsanangura pfuti inonunurwa zvakananga mubatanidzwa nechinangwa chekutanga chekudzivirira marwadzo. Corticosteroids (steroid) ndiyo yekutanga zvinhu zvinoshandiswa nokuda kwechinangwa ichi. Mamwe marudzi emishonga iye zvino anowanzoshandiswa kusanganisira anesthetics munharaunda, hyaluronic acid , uye kunyange Botox .
Mujoyi we-intra-articular unowanzopiwa apo marwadzo asina kubvuma kune mamwe maitiro anochengetedza akadai kusanganisira kurwadziwa kunorwadza, muromo unorwisa-kupisa zvinodhaka , uye kurapa kwepanyama.
Mhando dzeIntra-Articular Injections
Chinangwa chema intra-articular inogona kusiyaniswa nemishonga inoshandiswa. Kunyange zvazvo kupukunyuka kunorwadza ndicho chinangwa chinowanzodiwa, zvinogonawo kushandiswa kupa chemotherapy madhiraki seDexil (doxorubicin) zvakananga mujoka inobatwa nekenza. Inogonawo kuva nzira inobatsira yekupedza utachiona hwehutachiona muzvikamu (zvinonziwo fungal arthritis).
Kana yakashandiswa pakurwadziwa kunorwadza, kusiyana kwakasiyana-siyana kwemaitiro kunoshanda nenzira dzakasiyana-siyana:
- Corticosteroids inoshanda nekuderedza kupisa kwemukati. Vanodaro nokudzivisa kubudiswa kwemasero ekuvhiringidza ayo akangoerekana abudiswa mukupindura kwekukuvara kwakanyanya kana chirwere chisingaperi. Mishonga intra-articular inonyanya kushandiswa kurapa osteoarthritis , gout guru, uye rheumatoid arthritis yemabvi. Zvisinei, kushandiswa kwenguva refu kwegoroticosteroid kushandiswa kunozivikanwa nekukuvadza zvishoma nezvishoma kumasangano.
- Hyaluronic acid inowanzoitika inowanikwa mu synovial fluid inobatanidza majoini. Ne osteoarthritis, ichi chinogona kukurumidza kuputsa uye chinotungamirira ku kuwedzera kwechiitiko chacho. Intra-articular injections inosvitsa kuwedzera kugadzika, kuderedza marwadzo, nekuvandudza mararamiro ekufamba mumubatanidzwa. Zvidzidzo zvekliniki zvakange zvichisanganiswa pakubudirira kwemashoko aya chaizvo.
- Nharaunda yeanesthetics dzimwe nguva inotambirwa nemajekiseni e-intra-articular sechimiro chekusunungurwa kwekunorwa pashure pekuvhiyiwa kweArthroscopic. Asi iyo tsika inowanzoongororwa sezvo uchapupu hunoratidza kuti inogona kuderedza chondrocytes (chete masero anowanikwa mukartilage) mubatanidzwa.
- Botox (botulinum neurotoxin A) majikisi ave akaratidzirwa kupa hurombo hukuru hwevanhu vane knee osteoarthritis yakakwirira. Zvisinei, kushandiswa kunoenderera mberi kweBotox hakuratidzi kuvandudza kana kudzorera basa remuviri wekubatana.
- Platelet-rich plasma (PRP) inobva muropa rose uye ine maplatelets (masero matsvuku eropa ari pakati pekuvhara) uye chikamu chemvura chechizivo chinonzi plasma. Intra-articular injections ye PRP yakaratidzwa kuderedza marwadzo uye kuvandudza basa remuviri kuvanhu vane osteoarthritis vachisimbisa kuberekwa kwegorgen muzvibatanidzwa. Vamwe vanhu vanobatsirwa kupfuura vamwe, zvisinei, uye vazhinji havavandudzi pane imwe chete asi vanonzwa kuchinjeka mukufambira mberi kweArthritis.
Kurapa Kufungidzirwa
Iyo miviri mikuru yemigumisiro inobatanidza ne intra-articular injections ishutachiona uye kugadzirisa nzvimbo yepaiti. Dzimwe mimwe migumisiro inogona kuitika maererano nemishonga chaiyo kana zvinhu zvakakonzerwa.
Intra-articular injections, uye yakawanda, haifaniri kuonekwa seyo chete nzira yekurapa osteoarthritis kana zvimwe zvinetso zvekubatana. Migumisiro yezhinji yemishonga iyi inowanzowedzera nguva, uye kuipa kwemajoini pachako kunogona kunge kwakanyanya.
Kana yakashandiswa, corticosteroid shots inofanira kupiwa mushure memwedzi mitatu yakaparadzana. Nguva yekusunungurwa inogona kusiyanisa maererano nerudzi rwe steroid inoshandiswa:
- Hydrocortisone inowanzoshaya simba uye pfupi-kuita.
- Methylprednisolone magadzirira anogona kushanda kwevhiki rimwe chete kana maviri.
- Celestone (betamethasone) inogona kushanda kwevhiki mbiri kusvika masere.
- Kenalog naAristocort (kugadzirira triamcinolone) vanogona kushanda kwemavhiki mana kusvika ku16.
- Aristopan (rimwe gadziriro ye triamcinolone) inogona kugara kwemwedzi.
Hyaluronic acid injections, nokuenzanisa, inowanzoitwa sezvikamu zvakapetwa zvepfuti zvakarongwa kwemavhiki matatu kusvika mashanu. Zvinonyanya kushandiswa kutenga nguva isati yashandurwa kugadzirwa kwebvi kune vanhu vasingakwanisi kutsungirira steroid uye vasina kuwana zororo kubva mumishonga yemuromo.
Botox, panguva ino, inoita kuti irege kukuvadza kudonha, inokonzerwa nemigumisiro, uye inooneka inoshanda mukurapa maitiro akaoma osteoarthritis.
Nezvo izvo zvataurwa, hapana chibvumirano chakajeka pamusoro pokushandiswa kwakakodzera. Mishonga inorapwa ingaguma chero bedzi masvondo gumi nemaviri mune vamwe vanhu uye sepfupi semavhiki mana kune vamwe.
PRP haina mhedziso inozivikanwa, asi kubudirira kwayo kunogona kusiyanisa zvikuru kubva kumunhu kusvika kune munhu. Mishonga inorapwa inogona kupedza chero ipi zvayo kubva pamwedzi mitanhatu kusvika kupfumbamwe.
Sources:
> Evans, C .; Krause, V .; uye Setton, L. "Kufambira mberi mukurapa kwepfungwa." Nat Rev Rheumatol. 2014; 10 (1): 11-22.