I-OSTEOATHRITIS (OA)yisifo esivamile sokuwohloka kwamalungu esidala umthwalo osindayo ezigulini, emindenini nasemphakathini.Ukuxilongwa nokwelashwa kwe-OA okujwayelekile kubaluleke kakhulu emsebenzini womtholampilo nasekuthuthukisweni komphakathi.Ukubuyekezwa komhlahlandlela bekuholwa Igatsha Lesayensi Yamathambo Lenhlangano Yezokwelapha YaseShayina, iqembu lezemfundo yamathambo leGatsha Lamathambo le-Chinese Medical Association, iNational Elderly Clinical Medicine Research Center (Isibhedlela saseXiangya) kanye nomnyango wokuhlela we-Chinese Orthopedic Magazine.Ukukhuliswa Kwezincomo Ukuhlola, Ukuthuthukiswa Nokuhlola (iBanga) uhlelo lokugreda kanye neziqondiso ezisebenzayo zomhlaba wonke (UKUBIKA IZINTO E-Healthca) RE, RIGHT) Khetha izindaba ezingu-15 zemitholampilo odokotela bamathambo abakhathazeke kakhulu ngazo, Ekugcineni, izincomo zezokwelapha ezisekelwe ebufakazini ezingu-30 zakhiwa ukuze zithuthuke. isayensi yokuxilongwa kwe-OA futhi ekugcineni ithuthukise ikhwalithi yezinsizakalo zezokwelapha ezigxile ezigulini.
Cacisa ukuxilongwa kanye nokuhlola okuphelele: Ukuxilongwa kwe-OA kanye nezincomo ezihlobene nokuhlola
I-OA ivamile kulabo abaneminyaka engu-≥40 iminyaka, abesifazane, ukukhuluphala (noma abakhuluphele), noma abanomlando wokuhlukumezeka.Ukubonakaliswa komtholampilo okuvame kakhulu ubuhlungu obuhlangene nomsebenzi ohlangene.Ukucacisa ukuxilongwa kuyisidingo esibalulekile sokwakhiwa kohlelo lokwelapha isifo.Ezigulini ezisolwa nge-OA, imihlahlandlela iyanconywa ukuthi ikhethe ukuhlolwa kwe-X-ray.Uma kunesidingo, i-CT, i-MRI, ne-ultrasound ingenziwa ukuze kuqhutshekwe nokucacisa indawo yokuwohloka kanye nezinga lokuwohloka futhi kwenziwe ukuxilongwa okuhlukile.Iphinde yaveza ukuthi izifo ezidinga ukuhlonzwa nge-OA zihlanganisa: isifo samathambo, isifo samathambo esithathelwanayo, i-gout, i-pseudo -gout, nokulimala kwamalunga kwezifo ezizimele. ukubonakaliswa akujwayelekile noma akukwazi ukukhipha okunye ukuxilongwa, ungacabangela ukukhetha ukuhlolwa kwelabhorethri efanele ukuze uthole ukuxilongwa.
Ngemva kokuxilongwa kwe-OA, ukuhlolwa okuphelele kokugula kweziguli kudingeka kwenziwe ukuze kwenziwe izinhlelo zokwelashwa eziqondiswe ezigulini.Umhlahlandlela uveze ukuthi ukuhlolwa kwesifo kweziguli ze-OA kufanele kufake izifo ezihlukahlukene, izinga lobuhlungu, kanye nezifo ezihlanganisayo.Akunzima ukubona kumdwebo we-OA wokuxilongwa nokuhlola ukugeleza.Ukuxilongwa okucacile nokuhlola okuphelele kuyisidingo esibalulekile sokwelashwa kwe-OA.
Ukunyathela, ukwelashwa komuntu ngamunye: Izincomo ezihlobene nokwelashwa kwe-OA
Mayelana nokwelashwa, imihlahlandlela yokuthi ukwelashwa kwe-OA kufanele kusekelwe ezimisweni zokwehliswa kwezitebhisi kanye nokwelashwa komuntu ngamunye ukuze kufinyelelwe inhloso yokunciphisa ubuhlungu, ukuthuthukisa noma ukubuyisela ukusebenza kwamalunga, ukuthuthukisa izinga lempilo yeziguli, ukubambezela ukuqhubeka kwesifo, kanye ukukhubazeka okulungisiwe.Ukwelashwa okuqondile kuhlanganisa ukwelashwa okuyisisekelo, ukwelashwa kwezidakamizwa, ukukhanda nokwakhiwa kabusha.
1) Ukwelashwa okuyisisekelo
Ekwelashweni okunyathelwe kwe-OA, umhlahlandlela uncoma ukwelashwa okuyisisekelo okuncanyelwayo.Isibonelo, imfundo yezempilo, ukuvivinya umzimba, ukwelapha ngokomzimba kanye nosizo lwesenzo.
Ekwelashweni kokuzivocavoca, ukuvivinya umzimba kwe-aerobic kanye nokuzivocavoca kwamanzi kungathuthukisa ngokuphumelelayo izimpawu zobuhlungu kanye nokusebenza ngokomzimba kweziguli ezine-OA ehlangene yamadolo ne-hip;ukuvivinya umzimba kwezandla kungadambisa ngempumelelo ubuhlungu nokuqina kwamalunga eziguli ze-OA.I-OA ehlangene edolweni ingacabangela ukusebenzisa ukwelapha ngokomzimba okunjengokuphazamiseka kwamanje kokwelashwa kokuvuselela ugesi kanye nokwelashwa kwe-pulse ultrasound ukuze kudambise iziguli ezinezimpawu zobuhlungu.
2) Ukwelashwa kwezidakamizwa
Izidakamizwa zasendaweni ezingezona ukuvuvukala (i-NSAIDS) zingasetshenziswa njengemithi yokwelapha yokuqala yobuhlungu be-OA yamadolo, ikakhulukazi ezigulini ezinezifo zesisu, izifo zenhliziyo nemithambo yegazi noma ubuthakathaka.Iziguli ezinezimpawu eziphikelelayo zobuhlungu noma izinhlungu ze-OA ezinesisindo esimaphakathi zituswa ukuba ziphuze i-NSAIDS yomlomo, kodwa kudingeka ziqaphele umgudu wazo wamathumbu kanye nezigameko ezimbi zenhliziyo nemithambo yegazi.
Umhlahlandlela uthe i-OA ayinconyiwe ukusebenzisa umuthi oqinile we-opioid analgesic, futhi kuyadingeka ukusebenzisa i-opioid analgesic ebuthakathaka njenge-Qu Maodo.Ezigulini ezinobuhlungu besikhathi eside, obungapheli, obukhulu kanye (noma), iziguli ezinokucindezeleka zingasebenzisa izidakamizwa ezilwa nokukhathazeka njenge-Rostein.Uma kuqhathaniswa nokwelashwa kwe-glucocorticoids emgodini ohlangene, i-sodium yomjovo we-arthrine ingakwazi ukukhulula ubuhlungu ngesikhathi esifushane, kodwa ukuphepha kuphezulu, futhi iziqondiso zinconywa ngokufanele.Ngaphezu kwalokho, umuthi wamaShayina kanye ne-acupuncture nakho kungasetshenziswa ukwelapha i-OA.
Ukusebenza komjovo we-joint cavity
Uhlolojikelele lobufakazi: Ama-Glucocorticoid afanele ukubhebhetheka kobuhlungu bamadolo, ikakhulukazi iziguli ze-Knee OA ezihambisana nokuphuma kwamanzi.Umphumela wawo uyashesha, umphumela wobuhlungu wesikhathi esifushane wokudambisa ubuhlungu ubalulekile, kodwa ukuthuthukiswa kwesikhathi eside kobuhlungu kanye nomsebenzi wobuhlungu nomsebenzi akubonakali, futhi ngokuphindaphindiwe kusebenzisa ingozi yokusheshisa ukulahleka kwe-cartilage ehlangene ekusetshenzisweni amahomoni.Kunconywa ukusebenzisa i-glucocorticoids yokujova endaweni ehlangene.Futhi hhayi izikhathi ezingaphezu kwezi-2 kuya kwezi-3 ngonyaka, futhi isikhathi somjovo akufanele sibe sifushane kunezinyanga ezi-3 kuya kwezi-6.Ngaphezu kwalokho, ngaphandle kweziguli ezine-OA ezinezinhlungu ezinzima eminwe, amalunga amalunga ngokuvamile awabhekwa njengokwelapha i-OA yesandla.Ezigulini ezinesifo sikashukela, ikakhulukazi lezo ezinezinga eliphansi le-glucose egazini, kufanele zazise umjovo ohlangene we-glucocorticoids ukuze ukhulise okwesikhashana ubungozi boshukela egazini, futhi kunconywa ukuthi lolu hlobo lwesiguli luqaphe amazinga kashukela egazini phakathi nezinsuku ezi-3 ngemuva komjovo.
Ingilazi ye-sodium ingathuthukisa ukusebenza kwamalunga, ubuhlungu obudambisa isikhathi esifushane futhi inciphise inani lezidakamizwa ezidambisa ubuhlungu, futhi inokuphepha okuphezulu.Ilungele iziguli ze-OA ezinezici eziyingozi zesisu kanye (noma) zenhliziyo, kodwa iku Indima yokuvikela uqwanga nokubambezeleka kwesifo kuseyimpikiswano.Kunconywa ukuthi ufake isicelo ngokufanele ngokwemibandela yomuntu ngamunye yesiguli.Isici sokukhula kanye ne-platelet plasma ingathuthukisa impendulo yendawo yokuvuvukala, kodwa indlela yayo, ukusebenza kahle, nokuphepha kudinga ukulandelwa kwesikhathi eside, ukuhlolwa kokulawulwa okungahleliwe kwekhwalithi ephezulu (RCT) ukuze kunikeze ukwesekwa okwengeziwe kobufakazi.Ngaphezu kwalokho, izivivinyo zomtholampilo ze-stem cell therapy OA nazo zenziwe eShayina.
3) Ukulungisa
Ngokuphathelene nokulungisa ukwelashwa, okokuqala, kuyadingeka ukuqonda ukuthi ukuhlinzwa kwe-arthroscopy kusebenza kahle emadolweni e-OA enezimpawu zobuhlungu kuphela, futhi akukho mehluko omkhulu phakathi kokusebenza okuphakathi nesikhathi eside kanye nokwelashwa okulondolozayo.I-OA ehlangene yamadolo enezimpawu zokukhiya okusontekile ingasetshenziswa ukuthuthukisa izimpawu zokuhlanza i-arthroscopy;ezinye izinyathelo zokungenelela azivumelekile, futhi iziguli ezinamahlombe ehlombe ngenxa yobudala, umsebenzi noma izifiso zomuntu siqu azifaneleki ukuhlanganisa amahlombe.Isibuko se-Qingli.
Ukwengeza, i-tibia stock room OA enamandla ahlangene amadolo ampofu, ikakhulukazi iziguli ezinezingane ezincane nezineminyaka ephakathi nendawo kanye nomsebenzi omkhulu, zingakhetha i-tibial high -level bone interceptation, i-femoral bone cutting, noma i-fibula proximal bone interception surgery;I-OA ehlangene ye-hip emnene ebangelwa i-dysplasia ye-acetabular acetic ingakhethwa.
4) Ukwakhiwa kabusha
Ukushintshwa kwamalunga okwenziwa kulungele iziguli ze-OA ezinzima ezisebenza ngokusobala kwezinye izindlela zokungenelela.Nokho, isimo esithile, ukuzimisela subjective kanye okulindelwe isiguli kufanele kucatshangelwe.
Okunye ukulula kwamalunga amalunga amasheya abunjiwe weminye imiphumela yokwelashwa, ukukhethwa kwezincomo zesiqondiso sokuhlanganisa amasheya amasheya;i-tibia stock single room OA kanye ne-force line ye-5 ° ~ 10 °, i-ligament ephelele, i-flexion kanye nenkontileka ye-flexion engeqile ku-15 °, kunconywa ukuba Kunconywa Khetha ukushintshwa okukodwa kokuxazulula.
I-OA, njengesifo esihlangene esiwohlokayo, inokwanda okuphelele kwe-OA eyisisekelo phakathi kwabantu abangaphezu kweminyaka engama-40 ezweni lami.Futhi ngokuqina kokuguga, ukusabalala kwe-OA kusenomkhuba okhuphukayo.Mayelana nalokhu, inhlangano yezokwelapha ikhiphe imihlahlandlela eminingi/ukuvumelana kochwepheshe eminyakeni yamuva nje, okuhlanganisa “Ochwepheshe Bezivumelwano Zokwelashwa Kwezidakamizwa Zomtholampilo ze-orthopedic arthritis” kanye “Neziphakamiso ZokuPhatha Isazi Sezifo Ezingamahlalakhona ze-osteoarthritis” ukuze ziqondise futhi zilinganise ukuxilongwa komtholampilo. kanye nokwelashwa.Ngokukhishwa kwemihlahlandlela eminingi nocwaningo, ngithemba ukuthuthukisa impilo yeziguli ze-OA kakhulu.
Ezigulini ezine-OA, ngaphansi kwesisekelo sokuxilongwa okucacile, ukuhlolwa okuphelele kwesifo nakho kuyadingeka.Ngokusekelwe esimisweni se-step -level kanye nokwelashwa komuntu ngamunye, ukwelashwa okuyisisekelo, okuhlangene nokwelashwa ngokomzimba, ukulungiswa nokwelashwa kokwakhiwa kabusha, njll.
(Okuqukethwe yile ndatshana kuphrintwe kabusha, futhi asinikezeli nganoma yisiphi isiqinisekiso esicacile noma esishiwoyo sokunemba, ukwethembeka noma ukuphelela kokuqukethwe okuqukethwe kulesi sihloko, futhi asinasibopho ngemibono yalesi sihloko, sicela uqonde.)
Isikhathi sokuthumela: May-11-2023