Izigaba ze-OARSI Izincomo Zezokwelapha ze-Knee ne-Hip Osteoarthritis
Kunezinhlobo ezahlukene zokwelashwa kwe-osteoarthritis kunconywa iziguli ezinezinhlungu ezihlangene, ukuqina, ukuvuvukala, nezinye izimpawu ze-osteoarthritis . Iziguli zivame ukudideka yizinketho eziningi zokwelapha - futhi ngokuthembeka, bangathanda ukweqa lokho okungasebenzi futhi kugxile kulokho okukwenzayo. Yikuphi ukwelashwa kwe-osteoarthritis okungcono kakhulu?
I-Osteoarthritis Research Society International (i-OARSI) yakha ikomiti (ama-rheumatologists ayi-11, odokotela ababili bokunakekelwa okuyisisekelo, udokotela ohlinzayo wama-ortho, kanye nochwepheshe ababili mayelana nomuthi osekelwe ebufakazini abavela emazweni angu-6) abaye bahlola ngokuhlelekile imihlahlandlela yokwelapha eyayivela ngo-1945 kuya kuJanuwari 2006 for knees and hip osteoarthritis .
Kusukela ekusesheni, ikomidi lathola iziqondiso ezingu-23 zokwelashwa zokuphatha amadolo nokuqhaqhaza i-osteoarthritis - 6 zaziyi-opinion based based, 5 zazingu-based based evidence, futhi ezingu-12 zisekelwe kokubili imibono yobuchwepheshe nobufakazi bokucwaninga. Ngenqubo ephoqelekile ehlanganisa ukuhlolwa okubalulekile kwemikhombandlela ekhona, ukubuyekezwa okuhlelekile kobufakazi obamuva, nokuzivocavoca ukudala izincomo zokuvumelana - ekugcineni imithi engu-25 yamenyezelwa "isethi esisodwa sezincomo zakamuva."
Ukwelashwa okunconywe ngalunye kunikezwe isaphulelo se-SOR (amandla okuncoma). I-SOR yokwelashwa ngalunye isekelwe kwimibono yekomidi eliqondisayo ngemuva kokucubungula ubufakazi bokucwaninga ngokuphepha, ukusebenza, nokubiza. Ubuchwepheshe bemitholampilo yamalungu ekomidi basize ekufakela i-SOR futhi, kufaka phakathi izinto ezifana nokubona kwabo kokubekezela kokubekezela kokwelashwa. I-SOR iboniswe njengephesenti emele isilinganiso samanani ekomidi amalungu e-SOR ngencomo ngayinye, lapho i-0% ibuthakathaka futhi i-100% iyona enamandla kakhulu.
Isibonelo, i-SOR ka-97% ibonisa ukuthi ikomidi, ngokwesilinganiso, libheke ukuthi ukusebenza kahle, ukuphepha, nokusebenza kahle kwelashwa ukuthi kuphakame kakhulu.
I-OARSI igcizelele ukuthi ukwelashwa okuhle kwe-osteoarthritis kuhilela kokubili ukwelashwa kwemithi (izidakamizwa) kanye non-pharmacologic (okungewona izidakamizwa). Lokho kwakuyisiphakamiso sokuqala esivamile.
Ezinye izincomo ezingu-24 zahlukaniswa ngezigaba ezintathu - i-nonpharmacologic, i-pharmacologic, nokuhlinzwa. Ngokulandela ukwelashwa okunconywa ngalunye kungumaphesenti we-SOR.
Ama-Modeling Treatment for Osteoarthritis ayi-Nonpharmacologic
- imfundo mayelana nezinhloso zokwelapha nokuziphathisa ngokwazo ngokuguqula indlela yokuphila (97%)
- i-aerobic, ukuqinisa imisipha, nokusetshenziswa kwamanzi (96%)
- ukunciphisa kwesisindo (96%)
- izinsiza zokuhamba (90%)
- ukudluliselwa kumthandi wengqondo (89%)
- i-footware ne- insoles (77%)
- ama-knees braces (76%)
- oxhumana nabo ocingweni njalo (66%)
- izindlela zokushisa / ukushisa (64%)
- ukukhishwa kwesikhumba (59%)
- ukugqugquzela kagesi kagesi (58%)
I-Pharmacologic Treatment ye-Osteoarthritis
- Ama- NSAID omlomo (93%)
- i-acetaminophen (92%)
- Ama-NSAID angama-topical kanye ne- capsaicin (85%)
- ama-opioid abuthakathaka kanye nama- analgesics e- narcotic ngenxa yobuhlungu obuphikisayo (okungahambisani nokuphathwa okuvamile) (82%)
- i-intraarticular (engxenyeni ehlanganisiwe) ye-corticosteroids (78%)
- izijovo zangaphakathi ze-hyaluronan (64%)
- i-glucosamine kanye / noma i- chondroitin sulfate yokuphumula kwesifo (63%)
- i-glucosamine sulfate , i- chondroitin sulfate , kanye / noma i- diacerein yokuthuthukiswa okungenzeka kumalungu kanye nezakhiwo ezizungezile (41%)
5 Ukwelashwa Okuhlinzekwa Osteoarthritis
- ukugujwa kwamadolo okungabonakali (76%)
- i-osteotomy nezinye izinqubo zokuhlinza ukugcina amalunga (75%)
- ukuhlanganiswa okuhlangene ngemuva kokushintshaniswa kwamajoyina kuhlulekile (69%)
- ukuhlanza okuhlangene (ukuhlanza) nokuxilongwa kwe-arthroscopic e-knee osteoarthritis (60%)
Imikhombandlela endala yokwelashwa kwe-osteoarthritis yasungulwa ngaphambi kokuba ama-NSAID ahlolwe ngezinkinga zezinhliziyo ezingahle zibe khona (ukuhlasela kwenhliziyo nokushaya kwesifo). Ukuhlangana kwemiphumela emibi yamathunjini nezinhliziyo zengozi kuye kwabangela ukuthi i-NSAID isetshenziswe kancane. Amalungu ekomidi le-OARSI akholelwa ukuthi i-NSAID yizidakamizwa eziphikisanayo zokulwa nokuvuvukala nokuthi lokho kusetshenziswa okwesikhashana kungafaneleka - uma kucatshangwa ngesinye isinye.
I-OARSI ayincoma ama-NSAID ukusetshenziswa kwesikhathi eside ngaphandle kokucabangela umlando wesiguli.
Konke, kwakukhona ukulinganiselwa kokuthuthukiswa kokuqondiswa ngu-OARSI. Omunye angase akhombe ukungalingani odokotela ekomidini - odokotela bamazinyo nabahlengikazi bezinsizakalo eziyinhloko abaqokwe. Ngokuqinisekile umuntu angabonisa ukuzithoba okukhulu okwakubandakanyeka ekwenzeni ukuvumelana. Kodwa-ke, kukhona ukubaluleka kweziqondiso ezintsha, ikakhulukazi ezigulini, ezingenakho ukufinyelela kuzo zonke iziqondiso zangaphambilini ezacatshangwa yikomiti.
Imithombo:
> I-Osteoarthritis: Yikuphi Ukwelashwa Okusebenzayo futhi Okungeyona? I-Osteoarthritis Research Society International (i-OARSI). Februwari 15, 2008.
http://www.oarsi.org/pdfs/pr_080215_guidelines.pdf
> Izincomo ze-OARSI zokuphathwa kwe-hip ne-knee-osteoarthritis, Ingxenye II: Ubufakazi be-OARSI-based, izinkombandlela zokuvumelanisa. I-osteoarthritis ne-Cartilage. W. Zhang et al. February 2008.