Kalafo ea Osteoarthritis
Batho ba fetang limilione tse 27 ba US ba na le lefu la osteoarthritis . Ka ho khetheha, ho latela Li-Centers for Disease Control and Prevention (CDC), osteoarthritis e ama karolo ea 13,9 lekholong ea batho ba baholo ba lilemo li 25 le ho feta le karolo ea 33,6 lekholong ea batho ba baholo ba 65 le ho feta. Ke mofuta o tloaelehileng haholo oa ramatiki. Mangole , matsoho , maoto , letheka le mokokotlo ke manonyeletso a atisang ho ameha ke lefu la osteoarthritis.
Batho ba nang le matšoao a lefu la masapo a hlokahalang ba hloka phekolo e atlehang ho laola bohloko bo kopanetsoeng, ho tiea, ho ruruha le matšoao a mang.
Lipakane tse ling tsa phekolo li kenyelletsa ho boloka kapa ho ntlafatsa mosebetsi o kopanetsoeng, ho fokotsa bokooa le ho ntlafatsa boleng ba bophelo.
Hangata batho ba nang le lefu lena ba ferekanngoa ke mekhoa e mengata ea kalafo-'me ka botšepehi, ba rata ho tlōla se sa sebetseng le ho lebisa tlhokomelo ho seo. Ha ho na tharollo e le 'ngoe bakeng sa motho e mong le e mong, empa bafuputsi ba hlahisitse tataiso bakeng sa phekolo ea lefu la osteoarthritis.
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Ho na le dikgetho tsa kalafo tse sa sebeliseng lithethefatsi bakeng sa phekolo ea osteoarthritis, phekolo ea moriana (lithethefatsi), meriana ea lihlooho tsa meriana, liente tsa intra-articular, liphetoho tsa mokhoa oa bophelo-le ho qetela, ho buuoa.
Ka 2012, American College of Rheumatology (ACR), e phatlalalitsoe ke litlhahiso tsa phekolo ea meriana le li-non-pharmacologic ka letsoho, hip le mangole. Lekala la litsebi tsa litsebi tsa meriana li fana ka khothatso e matla, khothatso e nang le meeli, kapa khothalletso ea letho bakeng sa dikgetho tse khethehileng tsa phekolo. E le ho nkoa e le khothaletso e matla, boleng bo holimo bopaki bo ne bo hlokeha, hammoho le bopaki bo matlafatsang haholo melemo leha e le efe e amanang le phekolo.
Khothaletso e tiisitsoeng e ne e amahanngoa le ho haelloa ke boleng ba boleng bo holimo bopaki kapa bopaki bo neng bo sa khetholle ha ho lekanngoa melemo ho latela likotsi. Haeba ho ne ho se khothatso e fanoang, ho na le data e sa lekaneng kapa ha ho na lintlha tse tsoang litsing tsa kliniki tse laoloang ke randomized.
Letsoho (Pharmacologic Treatment Options)
Ha ho litlhahiso tse matla tse entsoeng ke litsebi tse amanang le ACR sehlopheng sena sa phekolo. Litsebi li ile tsa khothalletsa hore ho sebelisoe e 'ngoe kapa tse ling tsa tse latelang tsa phekolo:
- capiaicin ea lihlooho
- li-NSAID tsa li-topical , tse akarelletsang trolamine salicylate
- NSAID ea molomo, ho akarelletsa le COX-2 inhibitors
- Ultram (tramadol)
Setsi sa setsebi se ile sa etsa tlhahiso ea hore se latelang se se ke sa sebelisoa:
- mekhoa ea phekolo ea mantlha
- meriana ea li -opioid lipilisi
Hape, ho ne ho buelloa ka mokhoa oa hore batho ba nang le lefu la masapo a nang le lefu la masapo le nang le lilemo tse 75 ba ka lokela ho sebelisa li-NSAID tsa li-topical ho e-na le li-NSAID tsa molomo.
Letsoho (e seng la Pharmacologic Treatment Options)
Ho ne ho se na bopaki bo lekaneng bo fumanehang bakeng sa ho fana ka likeletso tse matla molemong ona oa phekolo, empa ho ile ha etsoa liphuputso tse 'maloa tse lumelloang.
The ACR boemo bo khothalletsang hore litsebi tsa bophelo bo botle (mofani oa tlhokomelo ea mantlha, setsebi sa 'mele kapa setsebi sa mosebetsi) se lokela ho:
- hlahloba matla a mokuli a ho etsa mesebetsi ea letsatsi le letsatsi
- fana ka taeo ka mekhoa ea ho sireletsa hammoho
- fana ka lisebelisoa tsa thuso ho sebelisoa mesebetsing ea bophelo ba letsatsi le letsatsi
- fana ka litaelo bakeng sa tšebeliso ea mekhoa e chesang (ie, mocheso le serame)
- ho fana ka liphahlo bakeng sa batho ba nang le lefuba la masapo a methapo ea methapo ea methapo ea methapo ea methapo ea moriana
Hip (Pharmacologic Treatment Options)
Ha ho na dikgothaletso tse matla bakeng sa dikgetho tse qalang tsa pharmacologic ho phekola osteoarthritis ya hip. Lipholisiso tsa maemo a kenyeletsang li sebelisa meriana e latelang bakeng sa phekolo ea pele:
- acetaminophen
- NSAID ea molomo
- tramadol
- liente tsa corticosteroid tsa intra-articular
Litsebi li etsa tlhahiso ea hore mefuta e latelang ea phekolo e se ke ea sebelisoa bakeng sa lefuba la masapo:
Ha ho tlhahiso e entsoeng mabapi le tšebeliso ea:
- NSAID ea lihlooho
- li- injection tsa hyaluronate tse ka hare-hare
- Cymbalta (duloxetine)
- meriana ea li-opioid lipilisi
Hip (e seng Pharmacologic Treatment Options)
Litsebi li khothaletsa ka tieo hore batho ba nang le lefuba la ostoarthritis le hip:
- kenya letsoho mosebetsing oa ho ikoetlisa oa pelo kapa oa ho hanyetsa mobu, kapa ka bobeli
- kenya letsoho ho ikoetlisa ka metsing
- ho theola boima ba 'mele, haeba ho feta boima ba' mele
Litsebi li fana ka maikutlo a hore batho ba tšoeroeng ke lefuba la opaoarthritis:
- kenya letsoho lenaneong la ho itlhokomela
- fumana therapy (ho silila) hammoho le boikoetliso bo tsamaisitsoeng
- fumana litšebelisano tsa kelello
- fumana taeo mabapi le tšebeliso ea mekhoa e chesang ea metsi
- amohela le ho sebelisa lithuso tse tsamaeang , joalo ka ha ho hlokahala
Litsebi ha lia ka tsa fana ka keletso mabapi le likhetho tse latelang tsa phekolo:
- ho ikoetlisa ka tsela e leka-lekaneng, ho le mong kapa ho kopantsoe le ho ikoetlisa ka matla
- tai chi
- phekolo ea bongaka feela
Knee (Pharmacologic Treatment Options)
Ha ho na dikgothaletso tse matla bakeng sa phekolo ea pele ea moriana oa masapo o entsoeng ka lengole. Litsebi li etsa tlhahiso ea hore e 'ngoe ea tse latelang e sebelisoe:
- acetaminophen
- NSAID ea molomo
- NSAID ea lihlooho
- tramadol
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- liente tsa corticosteroid tsa intra-articular
Litsebi li fana ka maikutlo a hore batho ba nang le masapo a mabeli a lengole ha ba sebelise:
- chondroitin sulfate
- glucosamine
- capiaicin ea lihlooho
Ha ho tlhahiso e entsoeng bakeng sa tšebeliso ea li-hyaluronate tsa intra-articular, duloxetine, kapa tsa opioid analgesic.
Knee (Non-Pharmacologic Treatment Options)
Litsebi li khothaletsa ka matla lits'ebetsong tse latelang tsa phekolo ea batho ba nang le lefu la masapo:
- ikoetlisa ho ikoetlisa kapa ho ikoetlisa ka mobu, kapa ka bobeli
- kenya letsoho ho ikoetlisa ka metsing
- ho theola boima ba 'mele, haeba ho feta boima ba' mele
Litsebi li fana ka maikutlo a hore batho ba nang le lefu la masapo a mangole:
- kenya letsoho lenaneong la ho itlhokomela
- fumana phekolo ea meriana hammoho le boikoetliso bo hlophisitsoeng
- fumana litšebelisano tsa kelello
- sebelisa mokhoa o sebelisoang ka nakoana oa ho bapala
- ho apara insoles ka nakoana (haeba ho hlahlojoa ke lateral compartment osteoarthritis)
- apara li-insoles tse kenngoeng ka morao-rao ka morao-rao (haeba ho hlahlojoa ke mokokotlo oa likarolo tsa osteoarthritis)
- fumana taeo mabapi le tšebeliso ea mekhoa e chesang ea metsi
- ho amohela le ho sebelisa lithuso tsa ho tsamaea, ha ho bontšoa
- kenya letsoho lenaneong la tai
Ha ho tlhahiso e fanoeng bakeng sa:
- ho ikoetlisa, ho le mong kapa ho kopantsoe le ho ikoetlisa
- ho apara insoles hamorao
- ho amohela therapy feela
- ho apara mangole
- e sebelisang patellar e tsamaisoang hamorao
Hape ho ne ho e-na le mekhoa e 'meli ea kalafo e ileng ea buelloa ka boeena feela bakeng sa batho ba nang le lefu la masapo a mabeli ba nang le lefuba le sa foleng' me ba batla ho buuoa ka makhetlo a mangata empa ba sa batle kapa ba sa khone ho etsa joalo:
- ho fetoleloa ha Sechaena
- motlakase oa motlakase oa transcutaneous
Phekolo ea Lihlopha Tse Ling
Le hoja maoto le mokokotlo, hammoho le manonyeletso a mang, li sa kenyelletsoa litlhakisong tsa phekolo tse tsoang ho American College of Rheumatology, mekhoa e mengata ea tataiso e sebetsa ho mang kapa mang ea amehileng-haholo-holo litlhahiso tsa pharmacologic. Osteoarthritis ea mokokotlo e etsahala ha ho na le ho senyeha ha li-disk pakeng tsa li-vertebrae. Batho ba bangata ba nang le mathata a sesebelisoa a senyehang ha ba hloke ho buuoa 'me ba thusoa ka phekolo e nepahetseng ea phekolo. Leha ho le joalo, haeba mehato ea ho itokolla e sa hlōlehe, mekhoa ea ho buoa e ka kenyelletsa laminectomy e nyenyane, discectomy, kapa fusion ea mokokotlo .
Joalo ka lihlopha tse ling, phekolo ea maoto a osteoarthritis e lebisa tlhokomelo ea matšoao. Ho roala li-orthote kapa tšehetso ea maoto ho ka ba molemo. Ho lahleheloa ke boima haeba ho feteletseng ho tlōla ho tla thusa maqhama ohle a boima. Haeba mekhoa ea phekolo e hlokang tlhokomelo e hlōleha ho hlahisa karabo e lekaneng, ho buuoa ho ka nkoa e le khetho ea ho qetela. Arthroscopy , arthrodesis (fusion), kapa arthroplasty (motsoako o kopanetsoeng) o ka nkoa, ho latela motsoako o amehang maoto kapa maoto. Sepheo sa ho buuoa ka maoto ke ho kokobetsa bohloko le ho ntlafatsa mosebetsi o kopanetsoeng.
Lentsoe le Tsoang ho
Sekolo sa American College of Rheumatology se ele hloko bakeng sa ho phekoloa ha letsoho, letheka le maotong a masapo li thehiloe bopaking bo neng bo fumaneha ka 2010. Lenane la litsebi le ne le akarelletsa lingaka tsa tlhokomelo ea mantlha, li-physiatrists, li-geriatricians, rheumatologists , ngaka ea masapo, hammoho le litsebi tsa 'mele le litsebi tsa mosebetsi. Palo e kopaneng e ile ea fana ka pono ea meriana e mengata ea ho hlahloba ka botlalo bopaki.
Litlhahiso ke tsa bohlokoa hobane ho na le dikgetho tse ngata tsa phekolo bakeng sa lefu la osteoarthritis-le tlhahiso mabapi le hore na o qala hokae. Batho ba bangata ba fumanoeng ba e-na le lefu la osteoarthritis ba sebelisa mefuta e meng ea phekolo ea pharmacologic le ea se-pharmacologic.
o fane ka tokomane ena ea litokomane hobane ho bonolo ho e utloisisa mme e tla u lumella hore u buisane ka ngaka ea hau kalafo ea hau ea pele. Haeba karabo ea hau e sa lekane, u ka boela ua bona mekhoa e meng ea hau. Hape, bakeng sa mekhoa e khethehileng ea phekolo, ho na le lihlopha tse fanang ka lintlha tse ngata haholo.
> Mehloli:
> Hochberg MC, Altman RD, April KT, le al. K'holejini ea Amerika ea Rheumatology 2012 Litlhahiso tsa Tšebeliso ea Meriana ea Boipheliso le ea Pharmacologic ea Osteoarthritis ea Hand, Hip le Knee. Tlhokomelo ea Ramatiki le Lipatlisiso . 2012; Vol. 64 No. 4, maq. 465-474.
> Kalunian KC. Tlhahlobo ea Pharmacologic Therapy of Osteoarthritis. E maemong. E hlalositsoe ka la 19 May, 2016.
> Moskowitz RW, le al. Osteoarthritis - Tlhahlobo le Tlhahlobo ea Bongaka / Bophelo. Khatiso ea bone. LWW.