Impact ya Hand Osteoarthritis Nekuremara Inokosha
EULAR Task Force Inoongorora Maoko Osteoarthritis
Symptomatic hand osteoarthritis inobata 20 muzana yevanhu vanopfuura makore 55 emakore. IEULAR (European League Against Rheumatism) boka rebasa iro rakambobudisa mazano ekurapa kwechiputi uye bhute osteoarthritis, yakabudiswa mirayiridzo muna 2006 yekurapwa kwemaoko osteoarthritis.
Dare rebasa reEULAR, rakagadzirwa nenyanzvi 21 dzinosanganisira maverengi eheheatatologists , chirwere chechiremba, uye physiatrist pakati pevamwe vashandi vehutano, vakatsvakurudza uchapupu hunotsvakurudzwa-uye vakazobvumirana kuti mazano gumi nemanomwe anotsvaga maitiro gumi nematatu ekurapa akanga akakodzera kurapa ruoko osteoarthitis.
Izvi zvinokurudzirwa zvakabva pane zvakanyatsorudzirwa kuti zvinyarare zvakarongedzwa zvichienderana nehuwandu hwouchapupu. Zvakaonekwa kuti 6 chete yemapato gumi nemanomwe ekurapa aive akavakirwa pane uchapupu hwekutsvakurudza. Zvimwe zvinorayira zvaive zvichienderana nehutano hwekliniki kana deta yakabva kune osteoarthritis zvidzidzo zvemasangano kunze kwechikafu.
Zano Negumi Negumi Nezvekurapa Kwemaoko Osteoarthritis
Dare rebasa reEULAR rakataurira mazano aya ekutarisa nekubata maoko osteoarthritis:
- Kusanganiswa kwe pharmacologic (zvinodhaka) uye kwete-pharmacologic (kwete-zvinodhaka) mishonga, yakasarudzika nokuda kwechigunwe chetachiona chetachiona, rinokurudzirwa.
- Therapy for hand osteoarthritis inofanira kuenzaniswa kune mumwe murwere. Zvinokonzera njodzi, rudzi rwehasteoarthritis, urwere hwokuputika, marwadzo ekurwa, kuoma, kuremara, hutano hwehupenyu, kurwara, uye kupindira mishonga kunofanira kufungwa pamwe chete nezvido zvevarwere.
- Varwere vanofanira kudzidziswa nezvekuchengetedzwa kwekuchengetedzwa uye kupa chirongwa chekudzidzira.
- Kushandiswa kwehuya (semuenzaniso moto unopisa , kupisa pad, parafini yakisi ) uye ultrasound inobatsira kutarisira osteoarthritis yoruoko.
- Pamusoro pechigunwe chechigunwe, kubwinya kunokurudzirwa. Orthotics inokurudzirwa kuti idzivirire zvimwe zvimwe zvakashata.
- Kuti uwane kurwadziwa kunononoka uye kana pasina majoini mazhinji akanganiswa, mishonga yemunharaunda kana yemazamu (semuenzaniso inonzi NSAIDs, inonzi capsaicin ) iri nani kudarika maitiro ekurapa.
- Acetaminophen (semuenzaniso, Tylenol) ndiyo yakakurudzirwa murals analgesic. Kusvika 4 g / zuva inonzi yakachengeteka uye inobudirira.
- Kune varwere vanowana mhinduro isina kugutsikana kubva kuAcetaminophen, sarudzo inotevera ndeyomutemo NSAIDs (nonsteroidal anti-inflammatory drugs) pamvura yakaderera zvikuru, nokuti nguva shoma inogoneka inogoneka. Kusarudzwa kweNSAID kune mumwe murwere mumwe nomumwe kunofanirwa kuve nehanya nehutachiona hwehutano uye ngozi yemwoyo.
- Glucosamine uye chondroitin , avocado soybean unsaponifiables , diacerein , uye viscosupplementation zvose zvinononoka-kutora maitiro ekupa osteoarthritis. Vanogona kupa ruremekedzo nechepasi chekushaya chepfu.
- Intra-articular corticosteroid injections inoshanda, kunyanya panguva yemakumbo anorwadza osteoarthritis.
- Kuvhiya (semuenzaniso, arthroplasty, arthrodesis , kana osteotomy) inogona kuonekwa kune varwere vakanga vasina ruzivo rwemishonga yakawanda. Kuvhiya kunokurudzirwa kune varwere vane kurwadziwa kukuru uye kuremara kubva paoko osteoarthritis.
Chikonzero Nei Mazano Akanyatsotsanangurwa Aidiwa
Osteoarthritis inobata maoko, mahudyu, nemabvi zvakasiyana.
Masangano acho akasiyana nemaitiro ehutachiona uye hutano, uye varwere vakasiyana nenzira yekufanirwa kwekurapa uye kugadzirisa kurapwa.
Zvitanhatu zvevane gumi nhatu, mumushumo wakaonekwa mu Annals weRheumatic Diseases , zvakatsigirwa nedzidzo yekudzidza:
- dzidzo uye kurovedza muviri
- NSAIDs
- COX-2 inhibitors
- nhepfenyuro NSAIDs
- topical capsaicin
- chondroitin sulfate
ACR Zvirongwa zveMaoko Osteoarthritis (2012)
Muna 2012, American College of Rheumatology yakarongedza mazano ekurapisa maoko osteoarthritis. Ivo vakafanirwa kurumbidza kuti vanachiremba vanoita izvi zvinotevera kurapa kusina zvinodhaka:
- Ongorora kukwanisa kuita mabasa ehupenyu hwezuva nezuva (ADLs)
- Raira maitiro ekudzivirira pamwe
- Ipa mazano ekutsigira, sezvinodiwa, kubatsira varwere kuita ADLs
- Raira mukushandiswa kwemafuta ekugadzirisa
- Ipa zvidimbu zvevarwere vane trapeziometacarpal joint osteoarthritis
Mitezo yemitemo yemakemikari inosanganisira izvi zvinotevera (shandisa imwe kana zvimwe zvinotevera):
- Nyaya yepamusoro capsaicin
- Nyaya dzepamusoro dzeNSAID, kusanganisira trolamine salicylate
- Oral NSAIDs, kusanganisira COX-2 selective inhibitors
- Tramadol
ACR mamiriro ezvinhu akakurudzira kuti vashandi vehutano vasashandise zvinotevera:
- Intra-articular therapies
- Opioid analgesics
Uyezve, varwere vane makore makumi manomwe nemazana manomwe vanofanira kushandisa nheyo dzepamusoro panzvimbo yeNSAID.
Sources:
Eular uchapupu hwakagadzirirwa huri kutungamirirwa kwemaoko osteoarthritis. Zhang, W. Annals weRheumatic Diseases. Yakabudiswa paIndaneti. Gumiguru 17, 2006.
http://ard.bmj.com/content/66/3/377
American College of Rheumatology 2012 Zvikurudzira zveKushandiswa kweAngpharmacologic uye Pharmacologic Therapies muOsteoarthritis yeHoko, Hip, uye Knee. Hochberg M. et al. Arthritis Care & Research Vol. 64, Nha. 4, April 2012.
http://www.rheumatology.org/Portals/0/Files/ACR%20Recommendations%20for%20the%20Use%20of%20Nonpharmacologic%20and%20Pharmacologic%20Therapies%20in%20OA%20of%20the%20Hand,%20Hip%20and % 20Knee.pdf