Izinzuzo, Izingozi, Nokulinganiselwa Kwezifo Ezihlangene
Umjovo we-intra-articular yigama elisetshenziselwa ukuchaza ukudubula okulethwe ngqo ngokuhlanganyela nomgomo oyinhloko wokukhulula ubuhlungu. Ama-corticosteroids (i-steroids) yizinto zokuqala ezisetshenziselwa le njongo. Ezinye izinhlobo zezidakamizwa manje sezivame ukusetshenziselwa ukufaka ama-anesthetics wendawo, i- hyaluronic acid , ngisho ne- Botox .
Umjovo we-intra-articular uvame ukuhlinzeka lapho ubuhlungu obungaphenduli nakwezinye izindlela zokwelashwa ezidinga ukwelashwa okubandakanya ukuxoshwa ubuhlungu, izidakamizwa ezithintekayo zokuvuvukala , kanye nokwelapha ngokomzimba.
Izinhlobo ze-Intraction Articular
Inhloso ye-intra-articular injection ingashintsha yizidakamizwa ezisetshenzisiwe. Ngenkathi ukuphumula ubuhlungu kungumgomo ovame kakhulu, kungase kusetshenziselwe ukuletha izidakamizwa ze-chemotherapy njenge-Doxil (doxorubicin) ngokuqondile esihlangene esithintekile ngumdlavuza. Kungase kube yindlela ephumelelayo yokuqeda ukutheleleka kwamafayalini emajoyini (eyaziwa nangokuthi i-arthritis fungal).
Lapho isetshenziselwa ukunciphisa ubuhlungu, izindlela zokwelashwa ezihlukahlukene zakwa-intra-articular zisebenza ngezindlela ezahlukene:
- I-Corticosteroids isebenza ngokuncipha ukuvuvukala kwendawo. Benza kanjalo ngokuvimbela ukukhiqizwa kwamaseli avuthayo okwenziwa ngokwemvelo ekuphenduleni ukulimala kanzima noma isimo esingapheli. Imithi yokwelapha isetshenziswa kakhulu ukuphatha i- osteoarthritis , i-gout ephawulekayo, nesifo samathambo sogu. Noma kunjalo, ukusebenzisa isikhathi eside ukusetshenziswa kwe-corticosteroid kuyaziwa ngokulimaza kancane kwamalungu.
- I-Hyaluronic acid iyinto eyenzeka ngokwemvelo etholakala emanzini e-synovial egcwala amalunga. Nge-osteoarthritis, lesi sici singasheshe siphume futhi siholele ekubuyeni kwesimo. Imishanguzo ye-intra-articular ihlose ukwandisa ukugcoba, ukunciphisa ubuhlungu, nokuthuthukisa ububanzi bokuhamba ngokuhlanganyela. Ucwaningo lwezokwelapha luye lwaxubaniswa ngendlela okuphumelelayo ngayo lezi zibhamu.
- Ama-anesthetics asekhaya ahanjiswa nge-intra-articular injection njengendlela yokuphumula kobuhlungu elandela ukuhlinzwa kwe-arthroscopic. Kodwa umkhuba oye wahlolisiswa njengoba ubufakazi bubonisa ukuthi kungadambisa ama-chondrocytes (amangqamuzana kuphela atholakala ku-cartilage) kuhlangene.
- I-Botox (i-botulinum neurotoxin A) imijovo iye yaboniswa ukuhlinzeka ukukhululeka okukhulu kobuhlungu kubantu abane-knee osteoarthritis ephakeme. Noma kunjalo, ukusebenzisa okuqhubekayo kwe-Botox akubonakali ukuthuthukisa noma ukubuyisela umsebenzi womzimba wokuhlanganyela.
- I-plasma ene-platelet ecebile (i-PRP) itholakala egazini lonke futhi iqukethe amaplatelet (amangqamuzana egazi abomvu aphakathi nendawo ukuvala i-clotting) nengxenye yegazi ebizwa ngokuthi i-plasma. Imishanguzo ye-intra-articular ye-PRP iye yaboniswa ukunciphisa ubuhlungu nokuthuthukisa umsebenzi womzimba kubantu abane-osteoarthritis ngenkathi kusekela ukuvuselelwa kwe-collagen emalungwini. Abanye abantu bayazuza kakhulu kunabanye, noma kunjalo, futhi iningi alithuthuki nge-se ngayinye kodwa kunalokho lizwa ukuphuza ekuqhubekeleni kwe-arthritis.
Ukucatshangelwa Ukwelashwa
Imiphumela emibili eyinhloko ehlotshaniswa nemigomo ye-intra-articular yintsholongwane kanye nokuphendula kwesayithi lendawo. Ezinye imiphumela emibi ingenzeka ngokuphathelene nemithi ethile noma izinto ezijowe.
Imishanguzo ye-intra-articular, ngokubanzi, akufanele ibhekwe njengendlela kuphela yokwelashwa kwe-osteoarthritis noma ezinye izifo ezihlangene. Imiphumela eminingi yalezi zidakamizwa zivame ukudlula isikhathi, futhi umthelela omubi emalungwini ngokwabo ngezinye izikhathi kungase kube nkulu.
Uma isetshenziswe, izibhamu ze-corticosteroid kufanele zinikezwe ngaphansi kwezinyanga ezintathu ngaphandle. Isikhathi sokuphumula singashintsha ngokususelwa kuhlobo lwe-steroid esetshenziswa:
- I-Hydrocortisone ngokuvamile ibuthakathaka futhi ibambe isikhathi esifushane.
- Amalungiselelo e-Methylprednisolone angasebenza amasonto amabili kuya kwamabili.
- I-Celestone (i-betamethasone) ingasebenza amasonto amabili kuya kwangu-8.
- UKenalog no-Aristocort (amalungiselelo e-triamcinolone) angasebenza amasonto amane kuya kwangu-16.
- I-Aristopan (enye i-triamcinolone yokulungiselela) ingahlala izinyanga.
I-Hyaluronic acid injection, ngokuqhathanisa, ijwayele ukuphathwa njengezicucu zezibhamu ezihlelwe amasonto amathathu kuya kwahlanu. Zivame ukusetshenziselwa ukuthenga isikhathi ngaphambi kokuhlinzwa ukuguqulwa kwamadolo kubantu abangakwazi ukubekezelela i-steroid futhi abatholanga usizo emithini yomlomo.
I-Botox, okwamanje, ibonakala ibangela ukulimala okuncane kwe-cartilage, inemiphumela emibi embalwa, futhi ibonakala isebenza ngokuphumelelayo ekwelapheni amacala aqinile we-osteoarthritis.
Uma kuthiwa, akukho ukuvumelana okucacile mayelana nokusetshenziswa okufanele. Imiphumela yokwelashwa ingahlala isikhathi esingangamaviki angu-12 kwabanye abantu futhi ifushane njengamaviki amane kwabanye.
I-PRP ayikho imiphumela emibi eyaziwayo, kodwa ukusebenza kwayo kungahluka kakhulu kusuka komunye nomuntu. Izinzuzo zokwelapha zingadlulela noma kuphi kusukela ezinyangeni eziyisithupha kuya kweziyisishiyagalolunye.
Imithombo:
> Evans, C .; I-Krause, i-V .; no-Setton, L. "Intuthuko ekwelapheni kwangaphakathi." Nat Rev Rheumatol. 2014; 10 (1): 11-22.