OSTEOATHRITIS (OA)yog ib hom kab mob sib koom ua ke uas ua rau lub nra hnyav rau cov neeg mob, tsev neeg thiab zej zog.Kev kuaj mob OA tus qauv thiab kev kho mob yog qhov tseem ceeb rau kev ua haujlwm kho mob thiab kev txhim kho kev sib raug zoo.Phau ntawv hloov tshiab tau coj los ntawm Tuam Tshoj Medical Society's Orthopedic Science ceg, pawg kws kho mob orthopedic ntawm Orthopedician ceg ntawm Tuam Tshoj Medical Association, National Elderly Disease Clinical Medicine Research Center (Xiangya Hospital) thiab cov editorial department ntawm Suav Orthopedic Magazine.Granding of Recommentations Assessment, Development and Evaluation (Grade) grading system thiab thoob ntiaj teb cov lus qhia siv tswv yim (REPORTING ITEMS In Healthca) RE, RIGHT) Xaiv 15 cov teeb meem kho mob uas orthopedics txhawj xeeb tshaj plaws txog, Thaum kawg, 30 pov thawj-raws li kev pom zoo kho mob raug tsim los txhim kho kev tshawb fawb ntawm OA kev kuaj mob thiab thaum kawg txhim kho cov kev pabcuam kho mob zoo rau cov neeg mob.
Qhia meej txog kev kuaj mob thiab kev ntsuam xyuas dav dav: OA kev kuaj mob thiab kev soj ntsuam ntsig txog cov lus pom zoo
OA feem ntau tshwm sim rau cov neeg muaj hnub nyoog ≥40 xyoo, poj niam, rog rog (los yog rog dhau), lossis keeb kwm ntawm kev raug mob.Cov tsos mob tshwm sim feem ntau yog mob pob qij txha thiab kev sib koom ua ke.Kev nthuav qhia qhov kev kuaj mob yog qhov tseem ceeb ua ntej rau kev tsim cov phiaj xwm kho kab mob.Rau cov neeg mob uas xav tias OA, cov lus qhia raug pom zoo kom nyiam X-ray kuaj.Yog tias tsim nyog, CT, MRI, thiab ultrasound tuaj yeem ua kom paub meej qhov chaw degeneration thiab qib ntawm degeneration thiab ua qhov kev kuaj mob sib txawv.Nws kuj tau taw qhia tias cov kab mob uas yuav tsum tau txheeb xyuas nrog OA suav nrog: mob caj dab, mob caj dab, mob caj dab, gout, pseudo-gout, thiab kev sib koom tes raug mob ntawm cov kab mob autoimmune. Kev kuaj mob tsis yog lub hauv paus tsim nyog rau kev kuaj mob OA, tab sis yog tias tus neeg mob kho mob. Kev tshwm sim tsis zoo los yog tsis tuaj yeem tshem tawm lwm qhov kev kuaj mob, koj tuaj yeem txiav txim siab xaiv qhov kev kuaj xyuas tsim nyog los txheeb xyuas qhov kev kuaj mob.
Tom qab kuaj pom OA, yuav tsum tau ua qhov kev ntsuam xyuas mob dav dav ntawm cov neeg mob txhawm rau txhawm rau tsim cov phiaj xwm kho mob rau cov neeg mob.Phau ntawv qhia tau hais tias qhov kev ntsuam xyuas kab mob ntawm OA cov neeg mob yuav tsum muaj ntau yam kab mob, qhov mob degree, thiab kev sib koom ua ke cov kab mob.Nws tsis yooj yim pom los ntawm OA kev kuaj mob thiab kev ntsuas ntsuas ntws.Kev kuaj pom tseeb thiab kev ntsuam xyuas dav dav yog qhov tseem ceeb ua ntej rau kev kho OA.
Kauj ruam, kev kho tus kheej: OA cov lus pom zoo txog kev kho mob
Hais txog kev kho mob, cov lus qhia tias kev kho mob ntawm OA yuav tsum ua raws li cov hauv paus ntsiab lus ntawm ladderization thiab kev kho tus kheej kom ua tiav lub hom phiaj ntawm kev txo qhov mob, txhim kho lossis rov ua haujlwm sib koom ua ke, txhim kho lub neej zoo ntawm cov neeg mob, ncua kev kis kab mob, thiab kho malformations.Kev kho tshwj xeeb suav nrog kev kho mob yooj yim, kev kho tshuaj, kho thiab kho dua tshiab.
1) Kev kho mob yooj yim
Hauv OA txoj kev kho mob, phau ntawv qhia pom zoo rau kev kho mob yooj yim.Piv txwv li, kev kawm txog kev noj qab haus huv, kev kho mob qoj ib ce, kev kho lub cev thiab kev pab cuam.
Hauv kev kho kev tawm dag zog, kev tawm dag zog aerobic thiab kev tawm dag zog dej tuaj yeem txhim kho cov tsos mob thiab lub cev ua haujlwm ntawm cov neeg mob hauv caug thiab lub duav sib koom OA;Kev tawm dag zog ntawm tes tuaj yeem txo qhov mob thiab sib koom ua ke ntawm cov neeg mob OA cov neeg mob.Lub hauv caug sib koom OA tuaj yeem txiav txim siab siv lub cev kho mob xws li cuam tshuam tam sim no hluav taws xob stimulation therapy thiab pulse ultrasound therapy los txo cov neeg mob uas muaj mob.
2) Kev kho tshuaj
Hauv zos cov tshuaj uas tsis yog-steroidal anti-inflammatory tshuaj (NSAIDS) tuaj yeem siv los ua thawj kab tshuaj kho mob rau lub hauv caug OA mob, tshwj xeeb tshaj yog rau cov neeg mob uas muaj kab mob hauv plab, kab mob plawv lossis qaug zog.Cov neeg mob uas muaj cov tsos mob tsis tu ncua ntawm qhov mob lossis qhov hnyav OA qhov hnyav tau pom zoo kom noj NSAIDS hauv qhov ncauj, tab sis lawv yuav tsum tau ceev faj txog lawv txoj kev mob plab thiab mob plawv.
Cov lus qhia tau hais tias OA tsis pom zoo kom siv cov tshuaj opioid muaj zog, thiab yuav tsum siv cov tshuaj tsis muaj zog opioid xws li Qu Maodo.Rau cov neeg mob uas muaj lub sijhawm ntev, mob ntev, mob hnyav thiab (lossis), cov neeg mob uas muaj kev nyuaj siab tuaj yeem siv tshuaj tiv thaiv kev ntxhov siab xws li Rostein.Piv nrog rau kev kho mob ntawm glucocorticoids hauv qhov sib koom ua ke, cov tshuaj sodium ntawm kev txhaj tshuaj arthrine tsuas tuaj yeem txo qhov mob hauv lub sijhawm luv luv, tab sis kev nyab xeeb yog siab, thiab cov lus qhia raug pom zoo raws li qhov tsim nyog.Tsis tas li ntawd, suav tshuaj thiab acupuncture kuj tuaj yeem siv los kho OA.
Kev ua tau zoo ntawm kev txhaj tshuaj sib koom ua ke
Cov ntaub ntawv pov thawj: Glucocorticoids tsim nyog rau kev mob hnyav ntawm lub hauv caug, tshwj xeeb tshaj yog cov neeg mob hauv caug OA nrog effusion.Nws cov nyhuv yog ceev ceev, lub sij hawm luv luv relieving qhov mob yog qhov tseem ceeb, tab sis lub sij hawm ntev kev txhim kho ntawm qhov mob thiab kev ua haujlwm ntawm qhov mob thiab kev ua haujlwm tsis pom tseeb, thiab rov ua dua qhov kev pheej hmoo ntawm kev ua kom poob ntawm pob txha mos hauv daim ntawv thov. tshuaj hormones.Nws raug nquahu kom siv cov tshuaj txhaj tshuaj glucocorticoids hauv qhov sib koom ua ke.Thiab tsis pub ntau tshaj 2 mus rau 3 zaug hauv ib xyoos, thiab lub sijhawm txhaj tshuaj yuav tsum tsis txhob luv dua 3 mus rau 6 lub hlis.Tsis tas li ntawd, tshwj tsis yog rau cov neeg mob OA cov neeg mob uas mob hnyav ntawm cov ntiv tes, cov pob qij txha ntawm cov pob qij txha feem ntau tsis suav tias yog kho OA tes.Rau cov neeg mob ntshav qab zib, tshwj xeeb tshaj yog cov uas tswj ntshav qabzib tsis zoo, lawv yuav tsum qhia txog kev txhaj tshuaj ntawm cov kab mob sib koom ua ke ntawm glucocorticoids kom ua rau muaj kev pheej hmoo ntawm cov ntshav qab zib ib ntus, thiab nws pom zoo kom cov neeg mob saib xyuas cov ntshav qab zib hauv 3 d tom qab txhaj tshuaj.
Sodium iav tuaj yeem txhim kho kev sib koom tes ua haujlwm, luv luv txo qhov mob thiab txo cov tshuaj analgesic, thiab muaj kev nyab xeeb siab.Nws yog qhov tsim nyog rau OA cov neeg mob uas muaj kab mob plab hnyuv thiab (lossis) cov kab mob plawv, tab sis nws yog nyob rau hauv lub luag haujlwm ntawm kev tiv thaiv pob txha mos thiab ncua tus kab mob no tseem muaj teeb meem.Nws raug nquahu kom thov raws li qhov tsim nyog raws li tus neeg mob tus neeg mob.Kev loj hlob thiab platelet plasma tuaj yeem txhim kho cov lus teb hauv zos, tab sis nws cov txheej txheem, kev ua tau zoo, thiab kev nyab xeeb yuav tsum tau ua raws li lub sijhawm ntev, kev ntsuam xyuas zoo random (RCT) los muab cov pov thawj ntxiv.Tsis tas li ntawd, cov kev sim tshuaj ntawm cov qia cell kho OA kuj tau ua nyob rau hauv Suav teb.
3) Kho
Hais txog kev kho cov kev kho mob, ua ntej ntawm tag nrho cov, nws yuav tsum tau to taub hais tias arthroscopy phais yog zoo nyob rau hauv lub hauv caug sib koom tes OA nrog tsuas yog cov tsos mob ntawm tus mob, thiab tsis muaj qhov sib txawv tseem ceeb ntawm qhov nruab nrab thiab ntev-ntev kev ua tau zoo thiab kev saib xyuas kev kho mob.Lub hauv caug sib koom ua ke OA nrog cov tsos mob ntawm twisted locks yuav siv tau los txhim kho cov tsos mob ntawm arthroscopy cleansing;Lwm yam kev cuam tshuam kev ntsuas tsis raug, thiab cov neeg mob lub xub pwg pob qij txha vim muaj hnub nyoog, kev ua si lossis kev xav ntawm tus kheej tsis haum rau pob qij txha.Daim iav Qingli.
Tsis tas li ntawd, tibia Tshuag chav OA nrog lub hauv caug tsis zoo, tshwj xeeb tshaj yog cov neeg mob uas muaj cov hluas thiab nruab nrab-hnub nyoog thiab kev ua haujlwm loj, tuaj yeem xaiv tibial siab-theem pob txha cuam tshuam, femoral pob txha txiav, los yog fibula proximal pob txha interception phais;Lub pob txha mos OA tshwm sim los ntawm dysplasia ntawm acetabular acetic tuaj yeem xaiv tau.
4) Kev tsim kho dua tshiab
Kev hloov pauv sib koom ua ke yog tsim rau cov neeg mob OA hnyav nrog kev ua tau zoo ntawm lwm yam kev cuam tshuam.Txawm li cas los xij, qhov xwm txheej tshwj xeeb, kev txaus siab thiab kev cia siab ntawm tus neeg mob yuav tsum tau xav txog.
Lwm qhov yooj yim ntawm cov pob qij txha ntawm cov pob qij txha ntawm cov duab sib koom ntawm lwm yam kev kho mob, cov lus qhia kev pom zoo xaiv cov pob qij txha ntawm cov khoom sib koom;lub tibia Tshuag ib chav OA thiab lub zog kab ntawm 5 ° ~ 10 °, ua tiav ligament, lub flexion thiab contracture ntawm lub flexion tsis tshaj 15 °, nws yog pom zoo kom yuav tsum tau xaiv ib tug daws teeb meem hloov.
OA, raws li tus kab mob sib koom ua ke, muaj feem ntau ntawm thawj OA ntawm cov neeg muaj hnub nyoog 40 xyoo hauv kuv lub teb chaws.Thiab nrog kev siv zog ntawm kev laus, qhov tshwm sim ntawm OA tseem muaj kev nce siab.Hauv qhov no, lub koom haum kho mob tau tshaj tawm ntau cov lus qhia / cov kws tshaj lij pom zoo nyob rau xyoo tas los no, suav nrog "Cov Kws Tshaj Lij Pom Zoo ntawm Kev Kho Tshuaj Kho Mob ntawm orthopedic mob caj dab" thiab "Cov Lus Qhia rau Cov Kws Tswj Xyuas Cov Kab Mob Hlwb ntawm osteoarthritis" los qhia thiab ua qauv kuaj mob. thiab kev kho mob.Nrog kev tso tawm ntau cov lus qhia thiab kev tshawb fawb, kuv vam tias yuav txhim kho kev noj qab haus huv ntawm OA cov neeg mob ntau dua.
Rau cov neeg mob OA, nyob rau hauv qhov kev kuaj pom tseeb, kev ntsuas kab mob tseem yuav tsum tau ua.Raws li lub hauv paus ntsiab lus ntawm theem-theem thiab kev kho tus kheej, kev kho mob yooj yim, ua ke nrog kev kho lub cev, kho thiab kho dua tshiab, thiab lwm yam kev npaj.
(Cov ntsiab lus ntawm tsab xov xwm no tau luam tawm dua, thiab peb tsis muab ib qho kev qhia lossis kev lees paub rau qhov raug, kev ntseeg tau lossis ua tiav ntawm cov ntsiab lus muaj nyob rau hauv tsab xov xwm no, thiab tsis muaj lub luag haujlwm rau cov kev xav ntawm tsab xov xwm no, thov nkag siab.)
Post lub sij hawm: May-11-2023