Psoriasis yog kab mob ntawm daim tawv nqaij uas muaj ntau heev. Muaj ntau hom txheej txheem pathological no. Scale lichen (lwm lub npe rau tus kab mob) raug cais raws li kev kho mob tshwj xeeb, thaj chaw, thiab qhov hnyav. Arthropathic psoriasis (psoriatic mob caj dab) yog ib daim ntawv ntawm daim tawv nqaij psoriasis, nrog rau ib tug inflammatory txheej txheem ntawm connective cov ntaub so ntswg thiab movable kev twb kev txuas ntawm cov pob txha (pob txha). Hom kab mob ntawm daim tawv nqaij no cuam tshuam txog 15% ntawm tag nrho cov neeg mob ntawm scaly lichen.
Kev piav qhia ntawm pathology
Arthropathic daim ntawv ntawm psoriasis yog tus cwj pwm los ntawm qhov mob hauv pob qij txha thiab txha nraub qaum, muaj cov tawv nqaij plaques, mob siab rau cov leeg vim hypertonicity ntawm cov leeg nqaij. Tus kab mob tuaj yeem cuam tshuam rau cov pob qij txha hauv plab, tab sis feem ntau yog nyob rau ntawm qhov chaw phalanges ntawm cov ntiv tes ntawm sab sauv thiab sab qis.
Tus kab mob tuaj yeem cuam tshuam rau cov txheej txheem uas txuas rau scapula thiab collarbone (acromion), sternoclavicular leeg. Cov mob hnyav ntawm psoriatic mob caj dab muaj xws liKev puas tsuaj loj rau ntawm daim tawv nqaij, txha nraub qaum thiab lub paj hlwb, qaug zog heev ntawm lub cev.
Kev kho mob tau ua tiav ntev thiab ua haujlwm, tso cai rau koj kom ua tiav qhov kev pab ib ntus thiab txo qis tus kab mob nce ntxiv.
Type of arthropathic psoriasis
Tus kab mob tau faib raws qhov chaw thiab daim ntawv ntawm cov txheej txheem kho mob. Muaj tsib yam tseem ceeb ntawm psoriatic arthropathy.
- Oligoarthritis yog ib yam kab mob uas 2 lossis 3 pob qij txha cuam tshuam ib txhij. Tsis pub dhau 6 lub hlis, tus kab mob tuaj yeem rhuav tshem txog li kaum lub pob qij txha. Vim lub fact tias cov txheej txheem inflammatory cuam tshuam rau ob peb pob qij txha ib zaug, nws tsis muaj peev xwm tiv nrog tus kab mob tam sim ntawd. Qhov nyuaj kuj yog nyob rau hauv qhov tseeb tias tsis muaj cov tsos mob ntawm tus kab mob; nws muaj peev xwm txiav txim siab qhov pib ntawm oligoarthritis nkaus xwb nrog kev pab ntawm X-rays.
- Interphalangeal deforming osteoarthritis yog ib qho kab mob cuam tshuam rau cov pob qij txha maculophalangeal, cov pob qij txha ntawm cov ntiv tes thiab cov ntiv taw. Kev sib koom ua ke dystrophy feem ntau tshwm sim rau cov poj niam tom qab lub cev tsis muaj zog.
- Psoriatic symmetrical polyarthritis yog ib yam kab mob uas tsim tawm tsam keeb kwm ntawm kev txhoj puab heev psoriasis. Tus kab mob no tshwm sim los ntawm ob sab qhov txhab ntawm cov pob qij txha ntawm tes thiab ko taw.
- Amityl mob caj dab yog ib qho kev puas tsuaj uas cuam tshuam tsis tau rov qab los ntawm kev puas tsuaj ntawm cov pob txha taub hau, pob txha cov ntaub so ntswg, kev puas tsuaj thiab txiav cov ntiv tes.
- Psoriatic spondylitis yog kev puas tsuaj ntawm lub cev vertebral, ua rau muaj qhov curvature ntawm qaum. Tus kab mob no tshwm sim hauv cov neeg mob psoriasis rau ntau tshaj 5 xyoos. Qhov chaw -vesicular formations ntawm daim tawv nqaij.
Muaj cov kab mob phem ntawm cov kab mob sib kis, tab sis lawv tshwm sim tsis tshua muaj.
Txoj kev hloov pauv, ntxiv rau cov ntawv, tau muab faib ua theem: nce qib, nyob ruaj khov, rov ua dua. Hauv qab daim duab - arthropathic psoriasis (exacerbation stage).
Yog vim li cas thiaj tsim
Txoj yam uas tsis muaj qhov pathology yuav tsis muaj kev txhim kho yog tsis paub. Xav txog cov laj thawj uas tuaj yeem ua rau qhov pib ntawm psoriatic mob caj dab.
- YGenetic predisposition. Hauv 40% ntawm cov neeg mob uas muaj tus kab mob no, tom ntej ntawm cov txheeb ze raug kev txom nyem los ntawm psoriatic o ntawm cov pob qij txha.
- Kev siv tshuaj tsis siv tshuaj los kho cov kab mob dermatosis cuam tshuam rau ntawm daim tawv nqaij. Kev kho tshuaj tsis raug cais tawm ua rau qhov rhiab heev ntawm epidermis, thiab cov tshuaj tsis ua haujlwm.
- Metabolic ntshawv siab. Cov kab mob metabolic feem ntau ua rau rog rog. Qhov hnyav tshaj yog qhov hnyav ntxiv ntawm cov pob qij txha. Nrog ntau lub cev hnyav thiab sawv ua haujlwm, arthropathic psoriasis sai sai.
- Neurological kab mob.
- Kev ntxhov siab ntau dhau, kev ntxhov siab.
- kis kab mob thiab kab mob.
- Kev siv tsis pom zoo ntawm corticosteroids, tshuaj uas thaiv beta-adrenergic receptors.
Yuav ua li cas thiaj paub cov tsos mob
Feem ntau, kab lusCov tsos mob tshwm sim tom qab lub dermatological tshwm sim ntawm tus kab mob uas cuam tshuam rau ntawm daim tawv nqaij. Cov tsos mob ntawm arthropathic psoriasis tuaj yeem tshwm sim los yog sai sai.
- Ntxig sawv ntxov. Qee zaum kev rov zoo tag nrho tshwm sim thaum yav tav su.
- Mob pob qij txha, mob heev thaum hmo ntuj. Cov kev xav tsis zoo ua ntej tshwm sim ib ntus, maj mam nce hauv lub sijhawm thiab lub zog.
- o thiab hnyuv ntxwm zoo li tus ntiv tes.
- daim tawv nqaij ntawm cov pob qij txha tig liab liab ua ntej thiab tom qab ntawd xiav xiav.
- Kev tsis sib haum xeeb ntawm cov pob qij txha thiab cov ntiv tes sib txuas ntawm cov ntiv tes.
- mob hauv cov leeg thiab cov fascia uas nyob ib sab.
Kuv yuav tsum hu rau tus kws tshwj xeeb twg?
Yog tias koj muaj cov tsos mob saum toj no (ib lossis ntau dua), koj yuav tsum sab laj nrog kws kho mob dermatovenereologist, kws kho mob caj dab lossis tus kws kho mob rheumatologist. Ib tus kws tshaj lij uas paub txog, tom qab kuaj pom thiab anamnesis, yuav muab qhov kev txiav txim siab zoo.
Txhawm rau kom paub meej qhov kev kuaj mob, nws yog ib qho tsim nyog yuav tsum tau ua cov txheej txheem kuaj mob. Yog tias cov txiaj ntsig ntawm kev kuaj pom zoo, tus neeg mob tau sau npe thiab sau cov txheej txheem kho mob.
Raws li ICD-10, tus kab mob no txawv raws li ib hom kab sib txawv. Tus kws kho mob hauv keeb kwm ntawm tus kab mob xaiv arthropathic psoriasis nrog tus lej tshwj xeeb - L40.5.
Diagnosis
Txoj hauv kev tseem ceeb ntawm kev lees paub qhov kev kuaj mob yog radiography. Yeej, lawv thaij duab ntawm sacro-air sib koom ua ke, pob qij txha ntawm ko taw, tes, sternoclavicular sib koom. Nyob ntawmcov duab qhia qhov tsis xws luag hauv cov pob txha mos thiab cov pob txha ntawm cov pob txha, axial txav ntawm cov pob txha puas. Ntxiv nrog rau kev tshawb fawb tsis muaj kev cuam tshuam ntawm cov qauv ntawm cov pob qij txha siv x-rays, tus neeg mob tau sau ntau cov txheej txheem ntxiv:
- Tau suav suav.
- Rheumatoid factor test.
- Kev kuaj xyuas cov kua dej synovial.
- Kev txiav txim siab ntawm lub cev tiv thaiv kab mob - kev tshuaj xyuas kom muaj nuj nqis rau antigens thiab immunoglobulins.
- kuaj ultrasound ntawm pob qij txha.
- MRI ntawm kev txav pob qij txha.
- Arthroscopy yog ib qho kev kuaj mob me me thiab kev kho mob uas tso cai siv lub arthroscope los txheeb xyuas thiab kho cov kab mob orthopedic.
- Kev sib tsoo.
Tom qab ua tiav tag nrho cov kev ntsuas tsim nyog, kev kuaj mob tau tsim thiab kho mob arthropathic psoriasis.
Txoj Kev Kho Mob
Kev kho mob nyuaj thiab yog tsom rau txo cov txheej txheem inflammatory, mob, tshem tawm qhov poob ntawm kev sib koom ua haujlwm. Lub luag haujlwm ntawm kev kho mob yog txhawm rau txo qhov kub ntxhov, tiv thaiv kom tsis txhob muaj cov tsos mob tshwm sim, thiab tswj kev tshem tawm.
Cov hau kev tseem ceeb yog: noj tshuaj, kho lub cev, ua raws li cov cai ntawm kev noj zaub mov.
Tshuaj:
- Cov tshuaj tseem ceeb siv los kho mob caj dab psoriatic yog cov tshuaj uas tsis yog-steroidal anti-inflammatory tshuaj: "Indomethacin","Diclofenac", "Ibuprofen", "No-Shpa". Nyob rau hauv cov ntaub ntawv ntawm cov teeb meem ntawm lub digestive system los yog ib tug neeg intolerance, xaiv cyclooxygenase-2 inhibitors yog muab: Celecoxib, Refocoxib, Nimesulide.
- Miorelaxants - tshuaj uas txo cov leeg leeg. Cov no suav nrog: Baclofen, Mydocalm, Sirdalud.
- Cov khoom siv rau sab nraud. Txhawm rau txo qhov o, mob mob, txhawm rau tiv thaiv mycelium, ntau yam tshuaj pleev yog siv: "Advantan", "Nizoral", "Ultrafastin"
Kev kho lub cev yog sau thaum tsis muaj contraindications thiab thaum lub sijhawm tshem tawm ntawm kev tawm tsam ntawm tus kabmob:
- PUVA txoj kev kho yog ib txoj hauv kev los ua ke UVA thiab cov neeg ua haujlwm photosynthetic.
- Magnetotherapy.
- Phonophoresis nrog glucocorticoids.
Nws yog ib qho tseem ceeb kom nkag siab tias tsuas yog nrhiav kev kho mob raws sij hawm tuaj yeem lav qhov txiaj ntsig ntawm kev kho mob. Nrog kev kho tus kheej lossis qib siab ntawm arthropathic psoriasis, kev tsis taus yog lav feem ntau.
Kev noj qab haus huv
Txhua yam kev kho mob ua rau muaj txiaj ntsig zoo dua yog tias koj ua raws li niaj hnub ua thiab saib xyuas kev noj haus. Los ntawm kev noj haus, nws yog ib qho tsim nyog yuav tsum tsis suav nrog qee yam khoom noj uas tuaj yeem ua rau muaj mob:
- yuav haus dej cawv.
- kas fes thiab tshuaj yej, tsuas yog ntsuab.
- Cov zaub mov ua rau ua xua: citrus txiv hmab txiv ntoo, zib ntab, txiv hmab txiv ntoo liab, qe.
- Fried thiab smoked.
- Txhua yam khoom noj ceev.
Nrog arthropathic psoriasis, koj yuav tsum nojfeem ntau, tab sis me ntsis los ntawm me ntsis. Qhov tseem ceeb yuav tsum yog cov khoom siv mis nyuj, nyoos thiab steamed zaub. Kev noj nqaij yuav tsum txwv, nws yog qhov zoo dua kom tsis suav nrog nqaij npuas.
zoo heev li kev kho mob nrog rau kev noj zaub mov muaj ntau yam kev tawm dag zog tshwj xeeb thiab gymnastics.
Kev kho neeg pej xeem rau kev kho mob psoriatic arthropathy
Lwm yam tshuaj tuaj yeem yog qhov zoo ntxiv rau cov tshuaj ib txwm muaj. Ua ntej siv cov tshuaj pej xeem, nws raug nquahu kom tau txais kev pom zoo los ntawm tus kws tshaj lij.
Decoctions thiab tshuaj yej los ntawm cov tshuaj ntsuab, da dej nrog celandine, compresses thiab lotions pab txo qhov mob.
Vim kev paub tsis zoo ntawm etiology ntawm arthropathic psoriasis, nws tsis tuaj yeem tiv thaiv tus kab mob. Tab sis hu rau tus kws kho mob nyob rau theem pib ntawm tus kab mob thiab kev kho kom zoo tuaj yeem ua tiav qhov kev txo qis thiab kev kho kom ruaj khov.
