Ukwelashwa kwe-Osteoarthritis
Abantu abangaphezu kwezigidi ezingu-27 base-US bane- osteoarthritis . Ngokuqondile, ngokusho kwamaCenters for Disease Control and Prevention (CDC), i-osteoarthritis ithinta amaphesenti angu-13,9 abantu abadala abaneminyaka engama-25 ubudala nangaphezulu kanye namaphesenti angu-33.6 abantu abadala 65 nangaphezulu. Uhlobo oluvame kakhulu lwe-arthritis. Amadolo , izandla , izinyawo , iziqhwa , nomgogodla yizingxenyana ezivame ukhathazwa yi-osteoarthritis.
Abantu abane- osteoarthritis ephawulekayo badinga ukwelashwa okuphumelelayo ukulawula ubuhlungu obuhlangene, ukuqina, ukuvuvukala, nezinye izimpawu.
Ezinye izinhloso zokwelapha zihlanganisa ukulondoloza noma ukuthuthukisa umsebenzi ohlangene, ukunciphisa ukukhubazeka, nokuthuthukisa ikhwalithi yokuphila.
Abantu abanesifo bavame ukudideka yizinketho eziningi zokwelapha-futhi ngobuqotho, bangathanda ukweqa lokho okungasebenzi futhi kugxile kulokho okushiwo. Asikho isixazululo esisodwa kubo bonke, kodwa abacwaningi baye bakhiqiza iziqondiso zokwelashwa kwe-osteoarthritis.
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Uyini umehluko phakathi kwe-Advil and Aleve?
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Ukusebenzisa i-Viscosupplement Hyalgan Yokuphatha I-Knee Osteoarthritis
Kukhona izinketho zokwelapha ezingekho ze-pharmacologic (okungezona izidakamizwa) ze-osteoarthritis, ukwelashwa kwe-pharmacologic (izidakamizwa), imishanguzo yezokwelapha, imishanguzo ye-intra-articular, ukuguqulwa kokuphila-kanye nokusetshenziswa kokugcina, ukuhlinzwa.
Ngonyaka ka-2012, i-American College of Rheumatology (ACR), izinkampani zokwelashwa ezishicilelwe nge-pharmacologic kanye ne-non-pharmacologic ngezandla, i-hip, namadolo. Iphaneli labachwepheshe bezokwelapha babanikezela isincomo esinamandla, ukuncoma okunemibandela, noma akukho izincomo zokhetho oluthile lwezokwelapha. Ukuze kuthathwe njengesincoma esinamandla, ubufakazi obuphezulu bekhwalithi babuyadingeka, kanye nobufakazi bokuthi izinzuzo ezithandwa kakhulu kunoma yiziphi izingozi ezihambisana nokwelashwa.
Ukuncoma okunemibandela kwakuhlobene nokuntuleka kobufakazi obuningi obuphezulu bokufakazela ubufakazi noma ubufakazi obungacacile uma ulinganisa izinzuzo ezihambisana nezingozi. Uma kungenasiphakamiso esinikezwayo, kunedatha enganele noma ayikho idatha evela ezivivinyweni zomtholampilo ezilawulwe ngokungahleliwe.
Izandla (Pharmacologic Treatment Options)
Azikho izincomo ezinamandla ezenziwa ochwepheshe abahambisana ne-ACR kule sigaba sokwelashwa. Ochwepheshe basemthethweni bancoma ukusetshenziswa kweyodwa noma ngaphezulu kulezi zindlela zokwelashwa ezilandelayo:
- i- capsaicin yocingo
- ama-NSAID enhlobonhlobo, kufaka phakathi i-trolamine salicylate
- I- NSAID yomlomo, kuhlanganise ne- COX-2 inhibitors
- Ultram (tramadol)
Iphaneli lobuchwepheshe ngokwemvelo lancoma ukuthi okulandelayo KUNGISEBENZISWA:
- izindlela zokwelashwa zangaphakathi
- imithi ye- opioid analgesic
Futhi, kunconywa ngokomthetho ukuthi abantu abane-osteoarthritis abaneminyaka engu-75 ubudala noma ngaphezulu kufanele basebenzise ama-NSAID ama-topical esikhundleni se-NSAID zomlomo.
Izandla (okungezona-Pharmacologic Treatment Options)
Kube nobufakazi obanele bokuthola izincomo eziqinile kulezi zindlela zokwelapha, kodwa izincomo eziningana zemiqathango zenziwe.
I-ACR ngokomthetho incoma ukuthi ochwepheshe bezempilo (umhlinzeki oyinhloko, umhlinzeki wezitho zomzimba, noma uchwepheshe wezokwelapha) kufanele:
- ukuhlola ikhono lesiguli ukwenza imisebenzi yokuphila kwansuku zonke
- unikeza ukufundisa ngamasu okuvikelwa ngokuhlanganyela
- unikeze amadivaysi okusiza asetshenziselwe ukusiza ngemisebenzi yokuphila kwansuku zonke
- ukuhlinzeka ngemfundo yokusebenzisa izindlela zokushisa (ie, ukushisa nokubandayo)
- ukuhlinzeka iziqephu kubantu abane-osteoarthritis ehlangene ye-trapeziometacarpal (isisekelo sesithupha )
I-Hip (Pharmacologic Treatment Options)
Azikho izincomo ezinamandla ezenzelwe izinketho zokuqala ze-pharmacologic ukuphatha i-hip osteoarthritis. Izincomo ezinemibandela zihlanganisa ukusetshenziswa komunye wemithi elandelayo yokwelapha kokuqala:
- i-acetaminophen
- I-NSAID yomlomo
- tramadol
- ama-intra-articular injections ye-corticosteroid
Ochwepheshe batusa ukuthi izinketho zokwelapha ezilandelayo zingasetshenziselwa i-hip osteoarthritis:
Azikho izincomo ezenziwe mayelana nokusetshenziswa kwe:
- Ama-NSAID angama-topical
- i-intra-articular injection ye-hyaluronate
- I-Cymbalta (i-duloxetine)
- imithi ye-opioid analgesic
Izinketho ze-Hip (okungewona i-Pharmacologic Treatment)
Ochwepheshe batusa kakhulu ukuthi abantu abane-osteoarthritis ye-hip:
- bahlanganyele ekuzivocavoca komzimba noma kokumelana nomhlaba, noma kokubili
- bahlanganyele ekuzivocavoca kwamanzi
- ukulahlekelwa isisindo, uma ukwedlula ngokweqile
Ochwepheshe basuke bekhuthaza ukuthi abantu abane-osteoarthritis ye-hip:
- bahlanganyele ohlelweni lokuzilawula
- thola imithi yokwelapha (ukubhuca umzimba) kuhlangene nokuzivocavoca okuqondisiwe
- thola ukungenelela kwengqondo
- thola imfundo mayelana nokusetshenziswa kwezimo ezishisayo
- thola futhi usebenzise izinsiza zokuhamba , njengoba kudingekile
Ochwepheshe abazange banikeze isincomo ngokuphathelene nezinketho zokwelashwa ezilandelayo:
- ukulinganisela ukuzivocavoca, okuwukuphela noma okuhlangene nokuvivinya umzimba
- tai chi
- ukwelashwa okuwodwa kuphela
I-Knee (I-Pharmacologic Treatment Options)
Azikho izincomo ezinamandla zokwelapha kokuqala kwe-knee arthritis ezenziwe. Ochwepheshe basesimweni batusa ukuthi okulandelayo kusetshenziswe:
- i-acetaminophen
- I-NSAID yomlomo
- Ama-NSAID angama-topical
- tramadol
- ama-intra-articular injections ye-corticosteroid
Abacwaningi basemazweni batusa ukuthi abantu abane-knee-osteoarthritis bangasebenzi:
- chondroitin sulfate
- i-glucosamine
- i-capsaicin yocingo
Azikho izincomo ezenzelwe ukusetshenziswa kwe-hyaluronate yangaphakathi, i-duloxetine, noma imithi e-opioid analgesic.
I-Knee (Okungeyona-Pharmacologic Treatment Options)
Ochwepheshe batusa ngokuqinile izinketho zokwelashwa ezilandelayo ezingekho ze-pharmacologic kubantu abane-knee-osteoarthritis:
- bahlanganyele ekuzivocavoca kwe-aerobic noma ukuvivinya umzimba okusekelwe emhlabathini, noma kokubili
- bahlanganyele ekuzivocavoca kwamanzi
- ukulahlekelwa isisindo, uma ukwedlula ngokweqile
Ochwepheshe basikisela ukuthi abantu abane-osteoarthritis emadolweni:
- bahlanganyele ohlelweni lokuzilawula
- thola ukwelapha okubhaliwe kuhlanganise nokuzivocavoca okuqondisiwe
- thola ukungenelela kwengqondo
- sebenzisa i-patellar ephathekayo ngokulandelana
- gqoka insoles ehlanganisiwe (uma ukuxilongwa yi-lateral compartment osteoarthritis)
- ukugqoka ama-insoles angenwe eceleni kamuva (uma ukuxilongwa kuyinto ye-medial compartment osteoarthritis)
- thola imfundo mayelana nokusetshenziswa kwezimo ezishisayo
- thola futhi usebenzise izinsiza zokuhamba, uma kubonisiwe
- bahlanganyele ohlelweni lwe-tai
Azikho izincomo ezinikezwayo:
- ukulinganisela ukuzivocavoca, okuwukuphela noma okuhlangene nokuvivinya umzimba
- sigqoke ama-insoles agqoke kamuva
- ukwamukela ukwelashwa kweyodwa yedwa
- sigqoke amabhande emadolo
- usebenzisa ukubethelwa kwe-patellar eqondiswa kamuva
Kwakukhona futhi izinketho ezimbili zokwelashwa ezazinconywa ngokomzimba KUPHELA kubantu abane-knee-osteoarthritis abangenasifo esilinganiselwe ebuhlungu obukhulu futhi abafuna ukwenziwa ukuguqulwa kwamadolo okuphelele kodwa bengathandi noma bangakwazi ukwenza inqubo:
- ukukhishwa kwesidakamizwa se-Chinese
- ukugqugquzela kagesi okwenziwe nge-transcutaneous
Ukwelashwa Kwamanye Amalungu
Nakuba izinyawo nomgogodla, kanye namanye amalunga, azange zifakwe ezinkampanini zokwelashwa ezivela e-American College of Rheumatology, eziningi zeziqondiso zisebenza kunoma yikuphi ukuhlanganiswa okuhlangene-ikakhulukazi izincomo ze-pharmacologic. I-osteoarthritis yomgogodla iyenzeka uma kunokukhubazeka kuma-discs phakathi kwama-vertebrae. Iningi labantu abanezinkinga ze-dis degenerative akudingi ukuhlinzwa futhi basizwa ngokwanele ngemithi yokwelapha. Uma izinyathelo zokuzivikela zihluleka, noma kunjalo, izinketho zokuhlinzwa zingabandakanya i-lminar laminectomy, i-discectomy, noma i-fusion fusion .
Njengamanye amalunga, ukwelashwa kwezinyawo ze-osteoarthritis kuhloswe ukukhululeka kwezimpawu. Ukugqoka izintambo noma ukusekelwa kwezinyawo kungasiza. Ukulahlekelwa isisindo uma ukugqithisa ngokweqile kuzosiza wonke amalunga wokucindezela. Uma izinketho zokwelashwa ezizimele zingaphumeleli ukwenza impendulo eyanele, ukuhlinzwa kungase kubhekwe njengento yokugcina. I-arthroscopy , i- arthrodesis (i-fusion), noma i-arthroplasty (ukushintshwa okuhlangene) ingacatshangwa, kuye ngokuhlanganyela okubandakanyeka ezinyaweni noma ezinyaweni. Umgomo wokuhlinzwa ngezinyawo ukukhulula ubuhlungu nokuthuthukisa umsebenzi ohlangene.
Izwi elivela
I-American College of Rheumatology izincomo zokwelashwa kwesandla, i-hip, ne-knee osteoarthritis zisekelwe ebufakazini obukhona ngo-2010. Iphaneli lobuchwepheshe lalibandakanya odokotela bokunakekelwa okuyinhloko, izidakamizwa, ama-geriatricians, ama- rheumatologists , udokotela ohlinzayo wamazinyo, kanye nabahlinzeki bomzimba kanye nabahlengikazi bokusebenza. Iphaneli elihlanganisiwe lanikeza umbono wokuzibandakanya kwamanye amazwe ukuze uhlole kahle ubufakazi.
Izincomo zibalulekile ngoba kunezinketho eziningi zokwelapha ze-osteoarthritis-nesiphakamiso mayelana nokuthi kufanele uqale kuphi. Iningi labantu elibhekene ne-osteoarthritis zisebenzisa inhlanganisela yokwelapha ye-pharmacologic kanye nokungewona i-pharmacologic.
ukunikeze le dokhumenti yokubhekisela ngoba kulula ukuyiqonda futhi kuzokuvumela ukuba uxoxe ngezinketho zakho zokuqala zokwelashwa nodokotela wakho. Uma impendulo yakho ingenele, ungabona futhi kalula ezinye izinketho zakho. Futhi, ukuze uthole ukwelashwa okuqondile, kukhona izixhumanisi kolwazi oluthe xaxa.
> Imithombo:
> Hochberg MC, Altman RD, April KT, et al. I-American College of Rheumatology 2012 Izincomo zokusetshenziswa kweMithi ye-Nonpharmacologic ne-Pharmacologic e-Osteoarthritis ye-Hand, Hip, ne-Knee. Ukunakekelwa Kwe-Arthritis Nokucwaninga . 2012; Umq. 64 No. 4, iphe. 465-474.
> Kalunian KC. I-Initial Pharmacologic Therapy ye-Osteoarthritis. Kusesikhathini. Kubuyekezwe uMeyi 19, 2016.
> Moskowitz RW, et al. I-Osteoarthritis - Ukuxilongwa Nokuphathwa Kwezokwelapha / Ukuhlinza. Uhlelo lwesine. LWW.