I-OARSI Ranks Iingcebiso zoNyango lwe-Knee ne-Hip Osteoarthritis
Iinkonzo ezahlukeneyo ze- osteoarthritis ziyacetyiswa kwizigulane ezineentlungu ezidityanisiweyo, ukuqina, ukuvuvukala kunye nezinye iimpawu ze-osteoarthritis . Izigulane zivame ukudideka ngamanyathelo amaninzi kunyango-kwaye ngokunyanisekileyo, bayathanda ukunqumla into engasebenzi kwaye igxininise kwintoni. Ziziphi iindlela zokwelapha i-osteoarthritis ezilungileyo?
I-Osteoarthritis Research Society International (i-OARSI) yakha ikomiti (11 i-rheumatologists, 2 oogqirha bokunakekelwa kweprayimari, oogqirha be-orthopedic, kunye neengcali ezi-2 kwiicawa ezisekelwe kubungqina abavela kumazwe angama-6) abenze uhlolo oluhlelekile lwemiyalelo yezokhuseleko ebekho ukususela ngo-1945 ukuya kuJanuwari 2006 ngamadolo kunye ne- osteoarthritis .
Ukususela ekukhangekeni, ikomiti yafumanisa izikhokelo zonyango ezingama-23 zokulawulwa kwamadolo kunye ne-hip osteoarthritis - 6 zaziyi-opinion based based, ezi-5 zazikho ubungqina-obusekelwe kulo, kwaye ezi-12 zisekelwe kwimbono yobugcisa kunye novavanyo lophando. Ngenkqubo ekhutshiweyo eyayibandakanya ukuhlolwa okubalulekileyo kwezikhokelo ezikhoyo, ukuhlaziywa ngokuchanekileyo kobungqina bwakutshanje, kunye nokusebenzisa ukuvelisa iziphakamiso zokuvumelana - ekugqibeleni iipilisi ezingama-25 zazishunyayelwa "isethi esinye seziphakamiso ezifikeleleko."
Ngonyango olunye lwacetywayo lwabelwa i-SOR (amandla okuncoma) amanqaku. I-SOR nganye yonyango isekelwe kwiingcamango zekomiti ekhokelayo emva kokuqwalasela ubungqina bophando malunga nokukhuseleko, ukusebenza, kunye neendleko-mpu melelo. Ubungcali beklinikhi yamalungu ekomiti banceda ekufakela i-SOR kwakhona, kubandakanya izinto ezinjengeembono zabo zokunyamezela isigulane kunyango. I-SOR ibonakaliswe njengepesenti emela umyinge wamanqaku e-komiti yee-komiti ze-SOR kwisiphakamiso ngasinye, apho i-0% ibuthathaka kwaye i-100% yomeleleyo.
Ngokomzekelo, i -OR ye-97% ibonisa ukuba ikomiti, ngokwemyinge, icinga ukuba ukusebenza, ukhuseleko, kunye neendleko-mpu melelo zonyango ziphezulu kakhulu.
I-OARSI igxininisa ukuba unyango oluphezulu lwe-osteoarthritis luquka zombini i-pharmacologic (iziyobisi) kunye neyeza ezingezizo-pharmacologic (ezingezizobisi). Le yilona ngcebiso yokuqala yokuqala.
Ezinye iziphakamiso ezingama-24 zahlula iindidi ezintathu-i-nonpharmacologic, i-pharmacologic, kunye nokugqitywa. Emva kolunye unyango olusicetywayo yiphesenti ye-SOR.
11 Iimpawu zonyango ze-Nonpharmacologic Treatment ye-Osteoarthritis
- imfundo malunga neenjongo zonyango kunye nokulawulwa ngokwabo ngokuguqula indlela yokuphila (97%)
- u-aerobic, ukuqiniswa kwemizimba, kunye nokusetyenziswa kwamanzi (96%)
- ukunciphisa ubunzima (96%)
- ezincedisayo zokuhamba (90%)
- ukuthunyelwa kwiphilisi yomzimba (89%)
- i-footware kunye ne- insoles (77%)
- amabhonti amadolo (76%)
- qha ga mshelwano (66%)
- iindlela zokushushu / ukushisa (64%)
- i-acupuncture (59%)
- Ukuvuselela kombane (58%)
I-Pharmacologic Treatment ye-Osteoarthritis
- IiNSAID zomlomo (93%)
- i-acetaminophen (92%)
- ii-NSAID kunye ne- capsaicin (85%)
- ii- opioids ezinobuthakathaka kunye nama- analgesics e- narcotic ukwenzela intlungu yokukhankanya (ukuxhatshazelwa kwonyango oluqhelekileyo) (82%)
- i-intraarticular (kwi-joint) i -corticosteroids (78%)
- ii -hyaluronan (64%)
- i-glucosamine kunye / okanye i- chondroitin sulfate yokunceda impawu (63%)
- i-glucosamine sulfate , i- chondroitin sulfate , kunye / okanye i- diacerein ukwenzela ukuphuculwa kwimiba kunye nezakhiwo ezizungezile (41%)
5 Utyando lwe-Osteoarthritis
- Ukutshintshwa kwegama lokuguqula idolo (76%)
- i-osteotomy kunye nezinye iindlela zokugada ukugcina amajoyina (75%)
- ukuxuba okuhlangeneyo emva kokutshintshwa okuhlangeneyo kuye kwahluleka (69%)
- ukuhlamba ngokuhlangeneyo (ukuhlamba) kunye ne- arthroscopic disridement kwi-knee osteoarthritis (60%)
Izikhokelo ezindala zonyango lwe-osteoarthritis zaphuhliswa phambi kokuba ii-NSAID zihlolwe ingozi yeentliziyo (ukuhlaselwa kwintliziyo kunye nokushaya kwesifo). Ukubambisana kwezithintelo zesisu kunye nezingozi zentliziyo kuye kwabangela ukuba ii-NSAID zisetyenziswe ngaphantsi. Amalungu ekomiti ye-OARSI akholelwa ukuba ii-NSAID ziyingozi ezichasene nezidakamizwa kwaye ukusetyenziswa kwexesha elifutshane kunokufanelekileyo-xa kuqwalaselwe ngomntu ngamnye.
I-OARSI ayicebisi ii-NSAID ukusetyenziswa kwexesha elide ngaphandle kokuqwalasela imbali yesigulane.
Ngokubanzi, kukho ukulinganiselwa kwenkqubo yokuphuhliswa ngu-OARSI. Omnye unokubonisa ukungalingani koogqirha kwikomiti - kunye nabagqirha bamazinyo kunye noogqirha abazinyamekelayo. Ngokuqinisekileyo umntu unokubonisa ukuthobeka okukhulu okwakubandakanyeka ekuphuhliseni isivumelwano. Kodwa nangona kunjalo, kukho ukubaluleka kwezikhokelo ezintsha, ngokukodwa kwizigulane, ezingenakho ukufikelela kuzo zonke izikhokelo zangaphambili eziye zaqwalaselwa yikomiti.
Imithombo:
> I-Osteoarthritis: Ziyiphi i-Treatments Work and What? I-Osteoarthritis Research Society International (OARSI). Fe bruwari 15, 2008.
http://www.oarsi.org/pdfs/pr_080215_guidelines.pdf
> Iingcebiso ze-OARSI zolawulo lwe-hip kunye ne-knee osteoarthritis, Icandelo II: I-OARSI-based based-based, ingqungquthela yezivumelwano. I-Osteoarthritis kunye neKartilage. W. Zhang et al. Fe bruwari 2008.