Samathambo Arthritis: Iimpawu, diagnosis, unyango kunye namachiza abantwana nabantu abadala

ukukrala okondeleyo kwizicwili, ethi ichaphazele amalungu kuthiwa onaso samathambo. Iimpawu, isifo kwaye afumane unyango lwesi sifo kuya kuxoxwa ngazo izinto kweli nqaku.

Yintoni isifo samathambo?

Oku kunika umdla kakhulu sisifo esibi ukuba nje kwiminyaka embalwa ungalucima onempilo ngokugqithisileyo a ayisebenzi ibuthathaka. Yinto eyaziwayo ukuba isifo uhlobo samathambo zichongwe izifo sokuhlasela. Yena liphuhlise iskimu elula. Iintlobo ngeentlobo zeeseli zegazi ezimhlophe ngenxa utyhileko izinto ezithile aqalile ukutshabalalisa ngokukhawuleza laphu amalungu zabo. Bathi aludumbanga, yaye emva kwexesha elithile kukho ukhukhuliseko. Kangangoko sincinane kuchaphazela imisipha kunye nemisipha. Sam intlala sonakele ngokupheleleyo.

Le ngezifo luphawulwa ukudumba esinganyangekiyo ngcembe synovia. Kwiimeko ezininzi, le nkqubo usebenza iinyawo, amadolo, iinyonga namalungu izandla. Njengoko esi sifo ithambo intlala abachaphazelekayo kunye namalungu baba zikhubazekile. Obubonakala kakhulu systemic zingenzeka ukoyiswa ngaxeshanye imithambo yegazi, ulusu, izihlunu kunye nentliziyo.

ulwazi zembali

Isifo samathambo samathambo kuye kwaziwa ukususela kumaxesha amandulo. Rheuma liguqulelwe ngokusuka kwisiGrike lithetha "flow". Izizathu ukusetyenziswa ngekota, kukho iinguqulelo ezininzi. Abanye abaphengululi bakholelwa ukuba izifo ezinxulumene ne kokuphela yencindi, ngokuthe ngcembe yande ebuchotsheni. Abanye uchaze intsingiselo yawo yohlobo iintlungu, zenzeka lonke ixesha uhlasela. Ekuhambeni kwexesha, kwaye kwacaca ukuba akukho flow nto kwaye akukho samathambo, kodwa wagqiba ukuba igama.

Esi sifo sichaphazela kwezona ndawo abalondolozwa umzimba womntu - amathambo. Ngexesha ngabembi lokuhlaliswa oosonzululwazi bafumanisa uphawu samathambo samathambo ubunzima iintsalela skeletal. Zonyango iincwadi reference uyakwazi ukufumana amagama ambalwa esi sifo: rheumatism esingapheliyo esosulelayo, deformans samathambo, isifo umlwelwe, kodwa ligama wanamathela.

Okokuqala, igama elithi "isifo samathambo" yaphakanyiswa ngo-1858 A. Garro ngonyaka. Noko ke, inkcazelo eneenkcukacha sifo wachazwa kwangethuba njengoko 1800 m Augustine Bove. Kokukuqwalasela oku enye iindidi sifo. Ngowe-1892, uHarry wazisa umahluko phakathi kwala magama mabini.

Izinto ezibangela isifo samathambo

Ukuba uyazi izizathu ekuphuhliseni isifo samathambo, uxilongo, unyango kunye nothintelo ngokuqhelekileyo akubangeli nzima kakhulu. Ngaphezu koko, le nkcazelo na ukuthintela engaphezulu ukuqhubeka kwesifo kunye namanye amathuba. ukuthintelwa kwalo, njengokuba umthetho, isekelwe phezu lokuphelisa isenzo yeemeko ingqondo.

I-umyalezo we esi sifo ayiqondwa ngokupheleleyo. Iingcali ichonge izizathu, kunye kungabangela uphuhliso sifo. Eyona ndima ephambili idlalwa sifuze amafa. Ngokuqhelekileyo, leukocytes kufuneka ukubulala izinto ezingaqhelekanga. Ezi ziquka iibhaktheriya, iintsholongwane, iiseli umhlaza. Ukuba kukho isiphako xa amajoni omzimba kumgangatho yemfuza, ngokuthe ngcembe iiseli ezimhlophe zegazi balahlekelwe Ukukwazi ukuqaphela izinto "ezilungileyo" "nezingalunganga". Kwelinye icala, litshintsha kwi zofuzo banoxanduva ukusebenza kweentlobo ezithile leukocytes, ekhokelela ukuphazamiseka weseli ratio. Oku kuya kuqala inkqubo kwiintetho ezikralayo, ukuba ayikho zokumisa kwangethuba kwaye lube ezingapheliyo. Ngoko kancane kancane isifo samathambo. Iimpawu, isifo kwaye afumane unyango - imibuzo embalwa ukuba wonke umntu kufuneka azi umntu emngciphekweni isenzeko kwesi sifo.

Xa izihlobo close isasazeka akanguye sifo, kwaye susceptibility nokuphazanyiswa amajoni omzimba njengoko kuchaziwe apha ngasentla. Oku kubonakala ngokohlobo esi sifo. Amathuba isahlakalo isifo samathambo kuxhomekeke kumlinganiselo phakathi kweentsapho, kwakunye nefuthe yeemeko ezithile ubomi. Le yokugqibela ziquka:

• Ukutshaya. Umdibaniso phakathi lo mkhuba kanye samathambo, izazinzulu baye baqaphela kwi-imi- 70 kwinkulungwane yokugqibela. Ukutshaya yecuba-25 ngosuku (kwiminyaka engama-20) ixesha elide kwandisa ubungozi sifo. Iinxalenye umsi wecuba kuchaphazela iiseli zomzimba, okubangela ekuqaleni yokugqibela ukuvelisa autoantibodies.
• Isini kunye nobudala. Oku kubonakaliswa ukuba besini intle ezithandwa ukuba isifo samathambo. Isigulo bayiveze nangaliphi na ubudala, kodwa kaninzi kwenzeka ngeenxa iminyaka 40-50.
• Gciwane. Izigulane isifo samathambo ungaqaphela zisiba nesifo emva kutshanje bajamelene SARS.
• izifo hormone. Izazinzulu lubonise ukuba zokucwangcisa yomlomo kunciphisa kakhulu isehlo isifo samathambo. Ukukhulelwa amabhinqa ngesi sifo kubangela uxolelo kunye nabasebenzi, phezu koko, igalelo okubi.

Phantsi yesenzo iiseli zamajoni omzimba iimeko ezichazwe aqalise ukuhlasela kweqokobhe eziqalelo edibeneyo, apho bekuhleli komtshiso oko kubo. Ulusu kummandla ochaphazelekayo kuba shushu, ibe buhlungu. imiphumela emibi iiseli zamajoni omzimba ukwasebenza imithambo yegazi, echaza wabonakala extra-articular kwesi sifo.

picture clinical

Kunye nezinye izinto ezimbi efanayo ayikwazi asingosinga samathambo zakudala samathambo. Iimpawu zokuqala sifo ziqala ukuba avele phakathi kwiiveki ezimbalwa, kude komtshiso akuthethi ziyacaca. Ekuqaleni, esi sifo sichaphazela izalathiso neminwe phakathi ngesandla. Kulo mzekelo, kukho nangokurhala, kukho ukufukuka okuncinci kwamalunga metacarpophalangeal. Bona zibekwe emazantsi neminwe. A uphawu uphawu esi sifo ukutshatyalaliswa ngaxeshanye namalungu kwelinye icala. Iintlungu syndrome kunokwenzeka ukusuka kwiinyanga ezimbalwa ukuya kunyaka omnye. Le kuyaphela ngokuqhelekileyo kwenzeka kusasa kwaye sihlala kwada kwasemini, waza ke ingena ukwehla. Emva kokuba umsebenzi okanye umthambo abapasileyo iintlungu.

Ngokunxuseneyo nenkqubo zophendlo lwezifo azimanye amalungu amancinane iinyawo, ezo zibekwe emazantsi neminwe. Izigulane ingxelo intlungu phantsi kwamagqabi xa sicinezelweyo. Njengoko ukuqhubela phambili kwesifo kunokutshiseka onke amalungu enkulu (iqatha, idolo negxalaba).

Ezinye iimpawu ziquka maqhuqhuva samathambo kunye kusasa ukuqina syndrome. Izigulane bathi ukuqaleka kuvela emva ubuthongo. La maqhuqhuva ekuthiwa-samathambo akhiwa kule ndawo ngezantsi nje engqinibeni, iinyawo nezandla. Kwimeko ke zinikwa zemali omzimba angqonge kwisiza nyama.

Kwezinye izigulane, umfanekiso lwezonyango yi zincediswe ukuvuthuluka imeko jikelele. Ubushushu, ebuthongweni babo kunye onombilini. isifo samathambo neminwe e-advanced nqanaba luphawulwa iibhrashi deformation. Le meko kunye ekuthiwa ulnar kuphambuka, nokushukumisa amalungu ebegqwese lifinyele. Xa onamathele amalungu inkqubo vertebral kwiintetho ezikralayo, eyethisa kakhulu kwi entanyeni kunye Nape.

Isigaba isifo

Chonga iindlela eziliqela ngawo umntu ngokuchanileyo Cazulula ibakala isifo samathambo. Eyona ulwazi zezo ezisekelwe kwiziphumo ze-X-reyi.

Zahlula-hlulwe ngokweendidi ezine:

• Ngelo isanda, imiqondiso yokuqala lwavela ngayo wokuhla kwamathambo. Le nokubonakaliswa kuphela esi sifo, leyo kumiselwa radiographs. izicwili Soft kancane zilinganisiwe. Ngamanye amaxesha ithambo ungahlula iindawo ukukhanya. Oku njalo kuxokwa-cysts. Ukuba izithuba ntsebenziswano emxinwa, uyakwazi ukuthetha malunga nophuhliso ngokukhawuleza esi sifo, yaye kungekudala lenguqu kwakhe ukuya kwinqanaba elilandelayo. A isici esasenza kweli nqanaba sifo bolulelwa akukho zimpawu zibonakala clinical. Isigulane Kungenzeka ungawuboni iingxaki zempilo, ngoko musa ukukhawuleza ukuya kwagqirha.
• Inqanaba lesibini luphawulwa uphuhliso ngakumbi inkqubo zophendlo lwezifo kunye nokubandakanyeka emathanjeni akhe. Owokuqala ubunzima ezandleni kwindawo iingalo nezihlahla. Ukuba ukhukuliseko yenzelwe kufutshane intlala kule ndawo na ukuhamba elinganiselwe. Kulo mzekelo, ijwabu intlala ngokwayo lunokuhlala luhleli, kodwa izihlunu sele eqala yoma. Bursa kalanga kunye asha kancinane. Izigulane e yondele ngokuqhelekileyo ezikhala namahlaba.
• Xa isifo samathambo, iqonga yesithathu mfanekiso wazilanda yoma kwezihlunu kunye deformation welungu. Ukuba Ityuwa ambona lokuqala sifo, kukho ngokucacileyo calcification distinguishable kwi x-reyi.
• Xa Isigaba sesine iba ukuphazamiseka ithambo. Kwi X-ray ibonisa ngokucacileyo osteoporosis, erosions ezininzi kunye cysts. Ilunga ngokupheleleyo izihlunu likhubazeke kwaye atrophied ngeenxa zonke.

Nokusindlekwa isifo samathambo kuvumela ukuba ukhethe uthomalaliso kakhulu, kwaye ukuthintela iingxaki kunokwenzeka.

iimviwo Medical

isifo samathambo ibekwe kuluhlu lwezifo ezingapheliyo of umyalezo ongaziwayo, ngoko ubhaqo lwalo kudla ngokuba nzima. Ngowe-1997, i-American College of zamathambo ecetywayo iindlela eziliqela ngenxa uxilongo le ngezifo aseleyo ezifanelekileyo unanamhla. Nge ezine izinto ezisixhenxe uluhlu iimpawu uxilongo ingaqwalaselwa njengemeleyo.

1. Morning ukuqina.
2. maqhuqhuva omzimba.
3. Hlula amalungu ngaphezulu kwesithathu.
4. into Positive omzimba.
5. Ekubulaleni esihlahleni.
6. utshintsho Radiographic.
7. isifo twatsa ngokuhlangeneyo.

Ngelishwa, ezi mpawu zingentla kungabonwa kuphela akumanqanaba kamva zophuhliso sifo. Yiyo loo nto xa kusasa ukuqina kunye neentlungu amalungu kufuneka uye esibhedlele. Xa kwafunyaniswa ukuba isifo samathambo, iimpawu, uxilongo, unyango kunye amanyathelo othintelo kwesi sifo kufuneka yaziwe wonke ugqirha.

Ukuba uyayazi imbangela bokuphela isigulana amisele mandatory x-reyi izandla neenyawo, uvavanyo igazi ngenxa ekufumanekeni factor samathambo kunye nokuvavanywa ESR. Emva kokuba uviwo, ugqirha ikhetha unyango olufanelekileyo. Ngokuqhelekileyo, sinzima kwaye iqulathe izigaba ezininzi. On ngobuwena ngamnye uchaze ngezantsi.

unyango olusisiseko

Ukuze ukuphelisa "isiseko lwesifo" lisetyenziswa unyango olusisiseko isifo samathambo. Iziyobisi amiselwe ngugqirha, musa ukuphelisa intlungu kunye nezinye iimpawu zesi sifo. Ezi nkundla ke zenzelwe ukuba ukuphazamisa uphuhliso ngakumbi esi sifo. Imiphumo emihle amachiza iba oqaphelekayo kuphela emva kweenyanga zonyango.

amalungiselelo Gold ukuphelisa esi sifo ziye zasetyenziswa phantse ikhulu leminyaka. isenzo sabo ingakumbi ngempumelelo nisaqala sifo ngeentlungu kakhulu kwi ekuhlanganeni kwengubo maqhuqhuva samathambo. Phakathi iziphumo ebezingalindelekanga kunokwenzeka ziquka isahlakalo "yegolide" dermatitis kunye mucositis.

Amachiza Immunosuppressive nazo esisetyenziswa ngokubanzi kwi unyango ( "MTX", "Azathioprine"). La machiza ukuba isifo samathambo ajoliswe ingcinezelo ngumntu yeendlela zokuzikhusela zomzimba. Ngenxa yokuba ke kokufuduselwa ngumhlaza, abaninzi bayoyika ukuzisebenzisa. Nangona kunjalo, oku kukoyika lobuxoki. Kuba unyango lwe samathambo usebenzisa iidosi asezantsi, emibi kakhulu zinqabile kakhulu.

Kwezinye iimeko, izigulane sulfonamides ezimiselweyo. Oku amachiza antibacterial, leyo zinqanda ukukhula eziphilayo izifo. Ngenene ingenzeka kweziganeko ezibi liphantsi kakhulu. ukusebenza yabo lingaphantsi kancinane xa kuthelekiswa kwiziyobisi immunosuppressive kunye negolide. Dynamics ezincumisayo le zonyango xa izigulane unesifo 'isifo samathambo neminwe, "waphawula kuphela emva kweenyanga ezintandathu zonyango enjalo.

amachiza anti-ukudumba

amachiza Nonsteroidal anti-ukudumba (NSAIDs) zibe nefuthe iintlungu kwaye antipyretic ( "meloxicam" "Diclofenac"). Bona ezimiselweyo lumngcungcuthekise kwamalunga. La machiza kakhulu ngcono imeko yomguli. Kuyimfuneko ukuba ziyeke ukuthatha kubo izifo nangoko wabuya. NSAIDs abakwazi ukoyisa ngokupheleleyo esi sifo, abasusa iimpawu ezingathandekiyo kuphela. Phantse yonke imithi Izimo, ngoko ngaphambi kokuba ikhosi unyango Kucetyiswa ukuba udibane nogqirha.

amachiza ikhetha ukuba isifo samathambo zisetyenziswa hayi kudala. Eli ligama entsha yezonyango mihla. Amachiza ezinjalo eyilelwe ukunciphisa kakhulu inani ziziphumo ebezingalindelekanga, ngokuba zisebenza kuphela kwi site nangokurhala, musa kuchaphazela ezinye iinkqubo omzimba. iziyobisi uyakhetha emane zinqanda imveliso arhente ukudumba kwindawo intlala ngokuhlangeneyo. Iziyobisi zibe lula ukuyisebenzisa. ukushiyeka kunokwenzeka kufuneka kuqwalaselwe nefuthe ukwanda ekunqandeni egazini. Oku, kunokubangela isifo sentliziyo okanye istroke.

Corticosteroids ( "prednisolone", "Dexamethasone") zisetyenziselwa ukulwa isifo samathambo. Oku amachiza hormone eyilelwe ukunciphisa intlungu yaye kusasa ukuqina kwamalunga. Umlinganiselo oogqirha umbuzo wokusetyenziswa corticosteroids antsonkothileyo. Abanye zikholisa ukusetyenziswa ukunyanga izifo iihomoni, abanye - nxamnye. Zakutshanje bechaza iintlobo zazo iimbono yeziphumo ebezingalindelekanga. Hormone, ukongeza impembelelo emzimbeni, kunganyusa amaqondo eswekile yegazi, ukunciphisa amajoni omzimba, kubangela uxinzelelo oluphezulu lwegazi. Kungenxa yoko le nto phambi emisela unyango, ugqirha uyawulinganisela "kwizazi" kunye "bawo."

unyango Local of isifo samathambo

Amalungiselelo ezichazwe ngasentla ayifanelekanga ukuba isetyenziselwe zonke izigulane. Kwezinye kukho isici ukuba yinxalenye amacandelo, abanye anayenza nemiphumo emihle nezinyangayo. Ngoko ke, kwezinye iimeko, oogqirha babuyelayo kunyango mlonyeni.

Ngexesha isifo esinganyangekiyo usebenzisa laser zokukhanya. Olu nyango unika isiphumo onomoya anti-ukudumba. Malunga nama-80% yezigulane waphawula uphuculo imeko ngokubanzi.

Enye indlela unyango na cryotherapy. Ngexesha inkqubo, ingcaphephe kuchaphazela kobubi ngokunzulu namalungu achaphazelekayo. Cryotherapy ukuba ingozi kakhulu kwaye akukho Izimo.

Ukusebenzisa namafutha aqholiweyo nezithambiso ezahlukeneyo kuthoba kuphela okwexeshana. Le nto ukuba ulusu akakuphosi ngaphezu kwe-7% yazo izithako ezisebenzayo. Oku akwanelanga ukuba ufumane isiphumo ozinzileyo nezinyangayo. Nakuba iintlobo ngeentlobo izibonelelo zonyango kunye namafutha aqholiweyo, uncedo lwabo kwiimeko ezingaqhelekanga.

ukuyifundisa

Emva ukususwa uhlobo zale sifo ingasetyenziswa yokuthanjiswa kwakunye nezinye iindlela ukuyifundisa. Eyona nto kukuba le unyango kunempembelelo umdla yaye inceda ukwehlisa komtshiso yasekuhlaleni. Ezi amayeza ngcono igazi kuqukuqela amalungu abachaphazelekayo kwaye ngaxeshanye landisa ukuba abantu bangazinzi zabo. In yezonyango namhlanje ngenkuthalo kusetyenziswa iparafini, UHF, phonophoresis, kwakunye infrared.

nesondlo esifanelekileyo

Ukubambelela ukutya engqongqo lubonise ukuba izigulane unesifo "isifo samathambo". Iimpawu, isifo kunye ikhondo esi sifo sikwazi ukufumanisa unobangela ukwenzeka. Noko ke, kungakhathaliseki ukuba ezi zinto, uhlengahlengiso ukutya kufundisa zonke izigulane.

Oogqirha bakholelwa ukuba ukudla ezithile igalelo ukudumba emzimbeni. Ezi ziquka yehagu, zonke iziqhamo citrus, ingqolowa kunye rye, iimveliso zobisi, ngokunjalo ingqolowa. Oogqirha Sicebisa utya intlanzi, nerhasi kunye buckwheat, amaqanda. A indawo ekhethekileyo kwizidlo kufuneka babe iziqhamo kunye nemifuno aneevithamini. Kuba ikhondo unyango Kucetyiswa ukuba ngaphandle okunamafutha kunye nokutya eqhotsiweyo. Products kufuneka iyabiliswa, kwaye atye kancinci, atye rhoqo. Kunye yonyango utshintsho kweziyobisi yokudla kunempembelelo entle Dynamics kwakhona.

Juvenile samathambo Arthritis

Iimpawu, unyango, ekufumaniseni kwesi sifo abantwana musani kwahluke ngale khosi kunye nonyango kwizigulane abadala. Samathambo yesifo lolutsha uhlobo iphawulwa ekhawulezayo yobhekiso phambili. 100 amawaka abantwana esi sifo kwenzeka kuzo zonke izigulane-15.

Isifo kwenzeka ubukhulu becala ngaphantsi kweminyaka eli-16 ubudala kwaye kuqhubeka iminyaka eliqela. uphuhliso yawo idla ziziphumo iindidi iimpembelelo, ukusukela izifo ezosulelayo nawokugqiba kunye uvakalelo esiba kwizinto ezithile zokusingqongileyo.

Uphawu ephambili samathambo samathambo ebantwaneni yintlungu omnye okanye ngaphezulu amalungu ngaxeshanye. Xa usibona deformation yabo waphawula ukuba esizibonakalisa ekuqaleni ngokwalo njengoko ukudumba. Ngokuthe ngcembe, ukusebenza namalungu lifinyele. Kwezinye iimeko izigulane abaselula anda iindawo nkovu, nomkhuhlane.

Uthomalaliso kubandakanya ukusetyenziswa NSAIDs ( "Ortofen" "Brufen") kunye neetyuwa ngegolide immunosuppressants. Xa unyango kwisibhedlele isifo esikwinqanaba engasebenziyo kuyanconywa abantwana, apho ngamanyathelo zempilo ezahlukeneyo uyasilela bunjani umsebenzi weentshukumo.

Musa ukushiya ngaphandle ingqalelo namantshontsho isifo samathambo. Iimpawu, unyango, ekufumaniseni kwesi sifo izigulane abaselula kufuna indlela abanezakhono. Ukuba ixesha lokuthatha onke amanyathelo zonyango eziyimfuneko ukuphelisa esi sifo, kunokwenzeka ukuba siphephe uphuhliso iingxaki ezinzulu. Ukongeza, unyango ezikumgangatho ophezulu xa usaqala aluchaphazeli ubomi elizayo umntu oselula.

ukuvimbela

izigulane ezininzi uyazibuza ukuba ukunyanga ukuba isifo samathambo. Uxilongo Koyikisa, kodwa akukho mfuneko ukuba woyike. Ngelishwa, le unyango ngenxa yesi sifo akakho. Yinkqubo esinganyangekiyo kaninzi kufuna unyango lobomi. Eyona nto ibalulekileyo - ukuqala kwangoko.

Namhlanje, iingcali ezivela ehlabathini lonke befuna rhoqo iindlela ezintsha zonyango ezo ezingahambi iziphumo ebezingalindelekanga. Ingakumbi kubaluleke lo mba kwabasetyhini kwisikhundla ophethwe isifo samathambo. Enyanisweni, kwimeko enjalo, ulwamkelo iziyobisi ezininzi kuyathintelwa.

Abantu abaninzi bayavuma ukuba unyango ilungileyo nayiphi sifo - luthintelo kwayo ngexesha elifanelekileyo. Ukuze ukukhusela amalungu oogqirha bacebisa ukuba agcine indlela yokuphila esempilweni. Libhekisela nokungasetyenziswa yonke imikhwa emibi, ukutya okunezondlo, ukuzilolonga eyaneleyo. Hayi indima lokugqibela idlalwa ekomelezeni kwamajoni omzimba kwaye ulwe utyebile.

Ngoku uyazi oko yayingako imiqondiso kunye isifo samathambo. Iimpawu, isifo kwaye afumane unyango lwesifo - ngemiba embalwa ezalanayo efuna indlela abanezakhono kakhulu. isifo samathambo ibizwa kudidi kwezifo kunye abane olihlwempu. Ukuba ixesha lokuba athathe onke amanyathelo ukuphelisa inkqubo kwiintetho ezikralayo, ngokungqongqo ulandele iingcebiso kagqirha, ungenza ukuguqulela ngezifo bezifo.