Tšusumetso ea letsoho la letsoho la bokooa ke la bohlokoa
EULAR Task Force e Hlahloba Manonyeletso a Mahetla a Hand
Matšoao a masapo a lefu la letsoho a ama karolo ea 20 lekholong ea batho ba fetang lilemo tse 55. Sehlopha se sebetsang sa European League khahlanong le Rheumatism se neng se ntšitse pele litlhahiso bakeng sa ho phekoloa ha masapo a masapo le maotong, se ile sa lokolloa ka 2006 bakeng sa phekolo ea lefu la letsoho la osteoarthritis.
Sehlopha se sebetsang sa EULAR, se nang le litsebi tse 21 ho kopanyelletsa le li- rheumatologists tse 'maloa, ngaka ea masapo, le physatrist har'a ba bang ba litsebi tsa bophelo bo botle, ba hlahlobisisa lipatlisiso tse thehiloeng bopaking' me ba lumellana hore lits'ebeletso tse 11 tse thehiloeng ho 17 mekhoa ea phekolo e ne e nepahetse ka ho fetisisa kalafo ea letsoho la osteoarthitis.
Litlhahiso tsena li ne li thehiloe haholo ho khothalletsoa ho fokolloa ho fokolloa ho latela boholo ba bopaki. Ho ile ha boleloa hore ke tse 6 feela tsa tse 17 tsa mekhoa ea phekolo e neng e thehiloe bopaking ba lipatlisiso. Litlhahiso tse ling li ne li itšetlehile ka tsebo ea litsebi kapa litsebi tse tsoang liphuputsong tsa osteoarthritis tse ling ntle le letsoho.
Litlhahiso tse leshome le metso e 'meli bakeng sa phekolo ea letsoho la masapo
Sehlopha sa ts'ebetso ea EULAR se hlahisitse litlhahiso tsena bakeng sa ho laola le ho phekola maqeba a lefu la matsoho:
- Ho kopantsoe ka phekolo ea pharmacologic (lithethefatsi) le mekhoa e seng ea lithethefatsi (e seng lithethefatsi), e ikemetseng bakeng sa letsoho la osteoarthritis, e khothalletsoa.
- Therapy bakeng sa letsoho la masapo a moriana o lokela ho ba motho ka mong bakeng sa mokuli. Mathata a kotsi, mofuta oa lefu la masapo a pelo, boemo ba ho ruruha, boemo ba bohloko, ho ba boima, bokooa, boleng ba bophelo, ho kula le ho noa meriana kaofela ho lokela ho nkoa hammoho le litakatso tsa mokuli.
- Bakuli ba lokela ho rutoa ka tšireletso ea mmoho le ho fuoa mekhoa ea ho ikoetlisa.
- Mokhoa oa ho futhumatsa (mohlala, pakete e chesang , pente ea ho futhumatsa, boka ba parafine ) le ultrasound li thusa ho laola osteoarthritis ea letsoho.
- Bakeng sa motheo oa lesela le motona, ho kgothaletswa ka bophara. Li-Orthotics li khothalletsoa ho thibela mefokolo e meng.
- Bakeng sa mahlaba a bonolo ho isa boemong bo botle le ha ho se na manonyeletso a mangata, phekolo ea metseng kapa ea lihlooho (mohlala, li-NSAID tsa li-topical, capsaicin ) li molemo ho feta mekhoa ea phekolo.
- Acetaminophen (mohlala, Tylenol) ke khothalletsoang molomo oa analgesic. Ho fihlela ho 4 g / letsatsi ho nkoa e sireletsehile ebile e sebetsa.
- Bakeng sa bakuli ba fumanang karabo e sa khotsofatsang ho tloha ho acetaminophen, khetho e latelang ke li- NSAID tsa molomo (li-anti-inflammatory drugs) tse fokolang ka ho fetisisa, ka nako e khutšoanyane haholo e ka khonehang. Khetho ea NSAID bakeng sa mokuli e mong le e mong o lokela ho nahana ka kotsi ea meno le lefu la pelo.
- Glucosamine le chondroitin , li- socase tsa avocase tse sa pheleng , li- diacerein le li- viscosupplementation kaofela li phekola ka nakoana bakeng sa lefu la osteoarthritis. Ba ka 'na ba fana ka liphallelo ka chefo e tlaase.
- Liente tsa corticosteroid tsa intra-articular li atleha, haholo-holo nakong ea li-osteoarthritis tse utloisang bohloko.
- Ho buuoa (mohlala, arthroplasty, arthrodesis , kapa osteotomy) ho ka nkoa kalafo bakeng sa bakuli ba neng ba se na mahlohonolo a nang le phekolo e nepahetseng haholoanyane. Ho buelloa ho buuoa bakeng sa bakuli ba nang le bohloko bo tebileng le bokooa bo tsoang matsohong a lefu la letsoho.
Ke Hobane'ng ha Likhothatso Tse Sebetsang ka Kakaretso li ne li Hlokahala
Osteoarthritis e ama matsoho, letheka le mangole ka tsela e fapaneng.
Manonyeletso a fapane ho latela mokhoa oa sebōpeho le ho sebetsa, 'me bakuli ba fapane ka mokhoa o nepahetseng oa phekolo le karabelo ea phekolo.
Litlhahiso tse tšeletseng ho tse 11, tlalehong e hlahang ho Annals ea Rheumatic Diseases , li ne li tšehetsoa ke boitsebiso ba thuto:
- thuto le ho ikoetlisa
- NSAIDs
- COX-2 inhibitors
- NSAID ea lihlooho
- capiaicin ea lihlooho
- chondroitin sulfate
Litlhahiso tsa ACR bakeng sa Mahetla a Mahetla a Majoe (2012)
Ka 2012, American College of Rheumatology e ntlafalitse litlhahiso tsa ho phekola letsoho la masapo a masapo. Ba ile ba etsa tlhahiso ea hore lingaka li etse tse latelang bakeng sa phekolo e se nang lithethefatsi:
- Hlahloba bokhoni ba ho etsa mesebetsi ea bophelo ba letsatsi le letsatsi (ADLs)
- Ruta ka mekhoa ea ho sireletsa hammoho
- Fana ka lisebelisuoa tsa thepa, ha ho hlokahala, ho thusa bakuli ho etsa ADLs
- Ruta ho sebelisa mekhoa ea ho chesa
- Fana ka marotholi bakeng sa bakuli ba nang le lefuba la majoe a lefuba la trapeziometacarpal
Litlhahiso tsa pharmacologic tse ikemetseng li kenyeletsa tse latelang (sebelisa e 'ngoe kapa tse ling tse latelang):
- Capsaicin ea sehlooho
- Li-NSAID tsa lihlooho, ho kenyelletsa le trolamine salicylate
- Li-NSAID tsa molomo, tse kenyeletsang COX-2 tse khethollang li-inhibitor
- Tramadol
Mokhatlo oa ACR o khothalletsa hore litsebi tsa bophelo bo botle li se ke tsa sebelisa tse latelang:
- Mekhoa ea phekolo ea meriana
- Ma-analgesics a opioid
Hape, bakuli ba lilemo li 75 ba lokela ho sebelisa li-NSAID tse nang le li-topical.
Lisebelisoa:
Litlhahiso tse fanoeng ka bopaki tse thehiloeng bakeng sa tsamaiso ea lefu la letsoho la masapo. Zhang, W. Annals ea Rheumatic Diseases. E hatisitsoe inthaneteng La 17 October, 2006.
http://ard.bmj.com/content/66/3/377
K'holejini ea Amerika ea Rheumatology 2012 Litlhahiso tsa Tšebeliso ea Meriana ea Boipheliso le ea Pharmacologic ea Osteoarthritis ea Hand, Hip le Knee. Hochberg M. et al. Tlhokomelo ea Ramatiki le Lipatlisiso Vol. 64, No. 4, April 2012.
http://www.rheumatology.org/Portals/0/Files/ACR%20Recommendations%20for%20the%20Use%20of%20Nonpharmacologic%20and%20Pharmacologic%20Therapies%20in%20OA%20of%20the%20Hand,%20Hip%20and % 20Knee.pdf