OTEOATHRITIS (OA)Chirwere chejoint degenerative chinokonzera mutoro unorema kune varwere, mhuri uye nzanga.Iyo yakamisikidzwa OA kuongororwa uye kurapwa kwakakosha zvikuru kubasa rekiriniki nekusimudzira magariro.Kugadziridzwa kwegwaro kwakatungamirwa neChinese Medical Society's Orthopedic Science Branch, boka reOrthopedic arthritis yedzidzo yeOrthopedician Branch yeChinese Medical Association, National Elderly Disease Clinical Medicine Research Center (Xiangya Hospital) uye dhipatimendi rekupepeta reChinese Orthopedic Magazine.Kukura Kwekurudziro Kuongorora, Kuvandudza uye Kuongorora (Giredhi) giredhi dhizaini uye epasi rese anoshanda nhungamiro (KUREKOTA ZVINHU MuHealthca) RE, KURUDZERA) Sarudza 15 nyaya dzekiriniki iyo orthopedics inonyanya kunetseka pamusoro payo, Pakupedzisira, makumi matatu ehuchapupu-hwakavakirwa mazano ekurapa anoumbwa kuti avandudze. sainzi yeOA yekuongororwa uye pakupedzisira inovandudza mhando yemabasa ekurapa anonangana nevarwere.
Kujekesa kuongororwa uye kuongororwa kwakazara: OA kuongororwa uye kuongororwa kwakabatana mazano
OA inowanzoitika kune avo vane makore ≥40 makore, vakadzi, kufutisa (kana kuwandisa), kana nhoroondo yekushungurudzika.Chiratidzo chekiriniki chinowanzoitika marwadzo emajoini uye basa rekubatana.Kujekesa kuongororwa chinhu chakakosha chinodiwa pakugadzirwa kwechirongwa chekurapa chirwere.Kuvarwere vanofungidzirwa kuti OA, nhungamiro inokurudzirwa kuti usarudze kuongororwa kweX-ray.Kana zvichidikanwa, CT, MRI, uye ultrasound inogona kuitwa kuti iwedzere kujekesa nzvimbo yekuora uye dhigirii yekuderera uye kuitisa kusiyanisa kuongororwa.Yakaratidzawo kuti zvirwere zvinoda kuonekwa neOA zvinosanganisira: arthritis, infectious arthritis, gout, pseudo -gout, uye kukuvara kwemajoini ezvirwere zvemuviri. zviratidzo hazvina kujairika kana kuti hazvigone kusarura kumwe kuongororwa, unogona kufunga kusarudza yakakodzera murabhoritari bvunzo yekuona kuongororwa.
Mushure mekuongororwa kweOA, kuongororwa kwehurwere kwakadzama kwevarwere kunofanirwa kuitwa kuitira kugadzira zvirongwa zvekurapa zvakanangwa kune varwere.Nhungamiro yakaratidza kuti kuongororwa kwechirwere chevarwere veOA kunofanirwa kusanganisira zvirwere zvakasiyana-siyana, dhigirii remarwadzo, uye zvirwere zvekubatanidza.Hazvina kuoma kuona kubva kuOA kuongororwa uye evaluation yekuyerera dhayagiramu.Kuongororwa kwakajeka uye kuongororwa kwakazara chinhu chakakosha chinodiwa pakurapa OA.
Kutsika, kurapwa kwakasiyana-siyana: OA kurapwa kwakabatana kurudziro
Panyaya yekurapa, nhungamiro yekuti kurapwa kweOA kunofanirwa kuenderana nemisimboti yekukwirisa uye kurapa kwemunhu mumwe nemumwe kuti aite chinangwa chekudzikisa marwadzo, kuvandudza kana kudzoreredza kushanda kwemajoini, kuvandudza hupenyu hwevarwere, kunonoka kufambira mberi kwechirwere, uye akagadzirisa zvikanganiso.Kurapa chaiko kunosanganisira kurapwa kwekutanga, kurapwa kwezvinodhaka, kugadzirisa uye kugadzirisazve kurapwa.
1) Basic kurapwa
Mukurapa kweOA, gwara rinokurudzira kurapwa kwakakosha kunodiwa.Semuenzaniso, dzidzo yehutano, kurovedza muviri, kurapwa kwemuviri uye rubatsiro rwekuita.
Mukurapa kwekurovedza muviri, kurovedza muviri uye kushandiswa kwemvura kunogona kuvandudza zvinorwadza zviratidzo uye kushanda kwemuviri wevarwere vane mabvi uye hip joint OA;maekisesaizi emaoko anogona kunyatso kudzikisa marwadzo nekuomarara kwemajoini evarwere vane OA.Knee joint OA inogona kufunga nezvekushandisa kurapa kwemuviri senge kuvhiringidza ikozvino magetsi ekusimudzira kurapa uye pulse ultrasound kurapa kunyaradza varwere vane zviratidzo zvinorwadza.
2) Kurapa zvinodhaka
Local topical non-steroidal anti-inflammatory drugs (NSAIDS) inogona kushandiswa seyekutanga-line kurapa mishonga yebvi OA kurwadziwa, kunyanya kuvarwere vane zvirwere zvemudumbu, zvirwere zvemwoyo kana kushaya simba.Varwere vane zviratidzo zvinoramba zvichirwadza kana kurwadziwa kwepakati-huremu hweOA vanokurudzirwa kutora nemuromo NSAIDs, asi vanofanira kuchenjerera kumararamiro avo uye zviitiko zvemwoyo.
Nhungamiro yakataura kuti OA haina kukurudzirwa kushandisa yakasimba opioid mushonga analgesic, uye zvinodikanwa kushandisa isina simba opioid analgesic yakadai seQu Maodo.Kune varwere vane nguva refu, kusingaperi, kurwadziwa kwakanyanya uye (kana), varwere vane kuora mwoyo vanogona kushandisa anti-anxiety zvinodhaka zvakadai saRostein.Kuenzaniswa nekurapa kweglucocorticoids muhutano hwekubatana, sodium yejojo yeArthrine inogona kungobvisa marwadzo munguva pfupi, asi kuchengetedzwa kwakakwirira, uye nhungamiro inokurudzirwa sezvakakodzera.Pamusoro pezvo, mushonga weChinese uye acupuncture zvinogona kushandiswa kurapa OA.
Kushanda kwejoint cavity injection
Humbowo hwekutarisa: Glucocorticoids inokodzera kuwedzeredza kwakanyanya kwekurwadziwa kwemabvi, kunyanya varwere veKnee OA vanoperekedzwa nekuputika.Mhedzisiro yaro inokurumidza, iyo pfupi-yenguva-yenguva yekubvisa marwadzo mhedzisiro yakakosha, asi kwenguva refu kuvandudzwa kwemarwadzo uye basa rekurwadziwa uye basa hazvisi pachena, uye kakawanda kushandisa njodzi yekukurumidza kurasikirwa kwejojo cartilage mukushandiswa kwe. mahomoni.Inokurudzirwa kushandisa injecting glucocorticoids mujoint cavity.Uye kwete kupfuura 2 kusvika ku3 nguva pagore, uye nguva yejekiseni haifaniri kupfupika kupfuura mwedzi mitatu kusvika ku6.Pamusoro pezvo, kunze kwevarwere veOA vane kurwadziwa kwakanyanya muzvigunwe, majoini emajoini kazhinji haafungirwe kurapa ruoko OA.Kune varwere vane chirwere cheshuga, kunyanya avo vane hurombo hwehuga yeropa, vanofanira kuzivisa jekiseni rejoint cavity yeglucocorticoids kuti iwedzere kwenguva pfupi njodzi yeshuga yeropa, uye zvinokurudzirwa kuti rudzi urwu rwemurwere hutarise huwandu hweshuga yeropa mukati me3 d mushure mejekiseni.
Girazi resodium rinogona kuvandudza kushanda kwemajoini, kwenguva pfupi-kubvisa marwadzo uye kuderedza huwandu hwemishonga yeanalgesic, uye ine kuchengetedzwa kwakanyanya.Inokodzera varwere veOA vane gastrointestinal uye (kana) yemwoyo ngozi zvinhu, asi zviri muBasa rekudzivirira kwecartilage uye kunonoka chirwere chichiri kukakavara.Inokurudzirwa kushandisa zvakakodzera maererano nemamiriro ega ega emurwere.Kukura kwechikonzero uye platelet plasma inogona kuvandudza mhinduro yekuzvimba kwenzvimbo, asi maitiro ayo, kushanda, uye kuchengetedzwa kunoda nguva yakareba yekutevera-up, high-quality random control test (RCT) kupa humwe uchapupu hunotsigira.Pamusoro pezvo, miedzo yekiriniki ye stem cell therapy OA yakaitwawo muChina.
3) Gadzirisa
Nezvekugadzirisa kurapwa, kutanga kwezvose, zvakakosha kunzwisisa kuti kuvhiyiwa kwe arthroscopy kunoshanda mumabvi akabatanidzwa OA ane zviratidzo zvinorwadza chete, uye hapana musiyano mukuru pakati pekushanda kwepakati uye kwenguva refu uye kurapa kwekuchengetedza.Mabvi akabatanidzwa OA ane zviratidzo zvekuvhara mabheji anogona kushandiswa kuvandudza zviratidzo zvekuchenesa arthroscopy;mamwe matanho ekupindira haakodzeri, uye varwere vane majoini emafudzi nekuda kwezera, basa kana zvido zvemunhu hazvina kukodzera kubatanidzwa kwepafudzi.Mirror Qingli.
Mukuwedzera, iyo tibia stock room OA ine urombo husina simba hwemabvi akabatanidzwa, kunyanya varwere vane vechidiki nevepakati-kati uye basa guru, vanogona kusarudza tibial high-level bone interceptation, femoral bone cutting, kana fibula proximal bone interception surgery;Iyo yakapfava hip joint OA inokonzerwa nedysplasia yeacetabular acetic inogona kusarudzwa.
4) Kuvakazve
Artificial joint replacement inokodzera varwere veOA yakaoma vane humbowo huri pachena hwemamwe matanho ekupindira.Nekudaro, iyo chaiyo mamiriro, subjective kuda uye zvinotarisirwa nemurwere zvinofanirwa kutariswa.
Zvimwe zviri nyore zvezvisungo zvezvibatanidza zvezvikamu zvakaumbwa zvezvimwe migumisiro yekurapa, nhungamiro yekuraira kusarudzwa kwezvibatanidza zvezvikamu zvezvikamu;iyo tibia stock single room OA uye mutsara wesimba we5 ° ~ 10 °, iyo yakazara ligament, kuchinjika uye kuchinjika kweiyo flexion isingadariki 15 °, inokurudzirwa kukurudzirwa Sarudza imwe yekugadziriswa yekutsiva.
OA, sechirwere chejoint degenerative, ine kupararira kwekutanga kweOA pakati pevanhu vanopfuura makore makumi mana munyika yangu.Uye nekuwedzera kwekuchembera, kuwanda kweOA kuchiri kukwira.Panyaya iyi, sangano rezvokurapa rakaburitsa nhungamiro dzakawanda / kubvumirana kwenyanzvi mumakore achangopfuura, kusanganisira "Consensus Experts of Clinical Drug Therapy of orthopedic arthritis" uye "Mazano eManagement Expert of Chronic Diseases of osteoarthritis" kutungamira uye kumisa kuongororwa kwekiriniki. uye kurapwa.Nekuburitswa kwemamwe nhungamiro netsvagiridzo, ndinotarisira kuvandudza hutano hwevarwere veOA zvakanyanya.
Kune varwere veOA, pasi pechikonzero chekuongororwa kwakajeka, kuongororwa kwechirwere kwakadzama kunodiwa zvakare.Kubva pamusimboti wenhanho-yepamusoro uye kurapa kwakasarudzika, kurapwa kwekutanga, kusanganiswa nekurapa kwemuviri, kugadzirisa uye kugadzirisazve kurapwa, nezvimwewo chirongwa.
(Zviri muchinyorwa ichi zvakadhindwa patsva, uye isu hatipe chero vimbiso yechokwadi, kuvimbika kana kuzara kwezviri muchinyorwa chino, uye hatina mhosva yemafungiro echinyorwa ichi, ndapota nzwisisa.)
Nguva yekutumira: May-11-2023