Cov kab mob suav nrog hauv pab pawg mob caj dab tsis tshua muaj rau cov menyuam yaus. Yeej, cov no yog complex rheumatic pathologies uas tshwm sim nrog inflammatory kev puas tsuaj rau pob txha mos thiab pob qij txha. Tus kab mob no tshwm sim los ntawm kev hloov pauv hauv ib qho chaw sib cais, qhov tseeb hauv cheeb tsam. Hyperemia, o thiab mob hauv cov cheeb tsam cuam tshuam, kev sib koom ua ke tsis muaj zog yog cov tsos mob ntawm kev mob caj dab hauv cov menyuam yaus, qhov ua rau thiab kev kho mob uas yuav txawv ntawm txhua kis.
Hauv kev nkag siab ntawm peb feem ntau, mob caj dab yog ib qho "muaj hnub nyoog" kab mob uas tau kuaj pom feem ntau hauv cov neeg laus. Yog li ntawd, cov kab lus "mob caj dab nyob rau hauv ib tug me nyuam ntawm 2 xyoos" thaum xub thawj siab ib muag zoo li absurd. Tab sis hmoov tsis, cov ntaub ntawv txheeb cais qhia tias txhua txhiab tus menyuam raug mob los ntawm cov pob qij txha. Pediatrics thiab pediatric rheumatology hais txog kev mob caj dab hauv cov menyuam yauspawg ntawm cov kab mob tseem ceeb hauv zej zog, feem ntau ua rau muaj kev tsis taus ntawm cov neeg mob hluas. Yog tias tsis tsim nyog thiab kho raws sijhawm, tus menyuam txoj kev noj qab haus huv tuaj yeem cuam tshuam loj heev.
Ntau hom mob caj dab thaum ntxov
Cov hom kab mob sib koom ua ke hauv cov menyuam yaus feem ntau yog:
- rheumatic;
- reactive;
- kis;
- menyuam yaus rheumatoid;
- menyuam yaus ankylosing.
Txhua tus kab mob no muaj nws tus yam ntxwv, cov tsos mob tshwj xeeb thiab ua rau. Kev mob caj dab hauv cov menyuam yaus feem ntau tshwm sim nrog kev nce hauv lub cev kub, txo qis hauv kev ua si, uas ua rau lawv txwv tsis pub txav mus los. Qhov kev kuaj mob no yog tsim los ntawm cov ntaub ntawv keeb kwm kho mob ntxaws, cov txiaj ntsig ntawm kev kuaj thiab ntsuas ntsuas (ultrasound, radiography, CT, MRI ntawm cov pob qij txha).
Ua ntej kho mob caj dab hauv tus menyuam, nws yog ib qho tseem ceeb kom txiav txim siab qhov tseeb etiology ntawm tus kab mob. Hauv cov menyuam yaus, cov kab mob zoo li no tsis tshua muaj kev ywj pheej, feem ntau lawv tshwm sim tawm tsam keeb kwm ntawm kis kab mob. Cov hauv paus ntsiab lus ntawm kev kho mob caj dab hauv cov neeg laus thiab menyuam yaus tsis muaj qhov sib txawv loj. Feem ntau, kev kho mob nyuaj yog ua tiav, uas tsis yog siv cov tshuaj xwb, tab sis kuj tseem kho lub cev kho mob, zaws, thiab lwm yam tshuaj.
qhov sib txawv tseem ceeb
Rheumatoid mob caj dab yog ib qho tshwm sim ntawm rheumatism hauv cov menyuam yaus, tib yam li kab mob rheumatic, chorea, erythema annulare. Qhov tshwm sim ntawm daim ntawv no ntawm tus kab mob yog txuam nrog cov kis streptococcalkab mob.
Kev mob caj dab hauv cov menyuam yaus yog cov kab mob ntawm cov pob qij txha uas tshwm sim los ntawm kev kis tus kab mob, kab mob, kab mob, kab mob fungal. Qee zaum tus kab mob tuaj yeem tshwm sim raws li qhov teeb meem ntawm zuam-borne borreliosis. Cov kab mob nkag mus nrog rau cov qog ntshav thiab cov ntshav ntws ncaj qha mus rau hauv cov kab mob sib koom ua ke los ntawm qhov qhib qhov txhab ntawm lub cev.
Cov pab pawg ua haujlwm muaj xws li post-enterocolitis thiab urogenital lesions. Reiter's syndrome yog lwm hom kev mob caj dab thaum yau.
Cov menyuam yaus rheumatoid mob caj dab yog tus cwj pwm los ntawm kev mob ntev ntawm cov pob qij txha. Nyob rau tib lub sijhawm, me ntsis paub txog qhov ua rau ntawm pathology. Feem ntau, cov menyuam yaus mob caj dab hauv cov menyuam yaus tshwm sim ua ntej hnub nyoog 16 xyoo. Tus kab mob no sai heev, thiab nyob rau hauv cov mob hnyav, cov kab mob hauv nruab nrog cev tau koom nrog cov txheej txheem pathological - peb tab tom tham txog hom articular-visceral, cuam tshuam rau lub plawv, ntsws, thiab cov ntaub so ntswg microphages. Feem ntau, cov menyuam yaus rheumatoid mob caj dab tshwm sim ib txhij nrog vasculitis, uveitis, polyserositis.
Qhov txawv ntawm spondyloarthritis, tsis muaj tsawg lub npe hu ua ankylosing spondylitis, yog qhov chaw ntawm qhov txhab. Hauv cov menyuam yaus ankylosing mob caj dab, tus txha nraub qaum thiab peripheral pob qij txha raug kev txom nyem. Yuav luag ib feem peb ntawm tag nrho cov kab mob Bechterew tshwm sim hauv cov neeg mob hnub nyoog qis dua 14.
Ua rau menyuam yaus cov kab mob sib kis
Cov laj thawj rau qhov pib mob caj dab thaum ntxov tuaj yeem muab faib ua ob pawg. Thawj yog qaug zogkev tiv thaiv kab mob thiab kev tsis zoo ntawm kev sib raug zoo uas ua rau muaj kev txhim kho ntawm cov kab mob sib koom ua ke:
- tsis huv;
- tsis huv hauv chav;
- siab av thiab dampness;
- nquag hypothermia.
Muaj qee yam ua rau txhua hom kab mob. Piv txwv li, reactive arthritis nyob rau hauv cov me nyuam nyob rau hauv tej rooj plaub yog tshwm sim los ntawm txoj hnyuv los yog genitourinary kab mob:
- salmonellosis;
- mob plab;
- yersiniosis;
- chlamydial urethritis lossis cystitis.
qeb ntawm cov kab mob sib kis ntawm cov pob qij txha yog qhov dav dua, vim tias txhua yam kab mob etiologically cuam tshuam nrog cov kab mob ntawm tus kab mob rubella, kab mob adenovirus, mumps, kab mob siab thiab mob khaub thuas. Cov kab mob sib koom tuaj yeem tshwm sim los ntawm kev txhaj tshuaj tiv thaiv, nrog rau cov mob tonsillitis, sinusitis, pharyngitis. Kev mob caj dab feem ntau dhau los ua qhov tshwm sim ntawm tuberculosis, gonorrhea, fungal kab mob.
Yog tias txhua yam pom tseeb nrog cov etiology ntawm kev sib kis thiab mob caj dab, ces me ntsis paub txog keeb kwm ntawm cov menyuam yaus rheumatoid daim ntawv. Ntawm cov iab liam ua rau tus kab mob no, caj ces predisposition thiab cuam tshuam ntawm ib tug xov tooj ntawm lwm yam yog xam. Vim yog exogenous irritation nyob rau hauv cov ntshav, muaj ib tug ntse tso tawm ntawm immunoglobulins, uas yuav pom tau los ntawm cov me nyuam txoj kev tiv thaiv raws li autoantigens. Hauv kev teb, lub cev pib tsim cov tshuaj tiv thaiv, uas, thaum cuam tshuam nrog autoantigen, tsim cov tshuaj tiv thaiv kab mob.complexes. Tom qab tag nrho, nyob rau hauv lem, muaj peev xwm ua puas lub connective cov ntaub so ntswg thiab lub synovial membrane ntawm lub pob qij txha, tshwj xeeb tshaj yog. Yog li ntawd, qhov tsis sib haum xeeb ntawm autoantigens thiab cov tshuaj tiv thaiv kab mob ua rau muaj kev sib koom ua ke ntev.
Spondyloarthritis yog suav hais tias yog kab mob multifactorial, qhov tseem ceeb hauv kev loj hlob uas yog los ntawm kev tsim thiab kev cuam tshuam ntawm cov kab mob sib kis (tshwj xeeb yog enterobacteria).
Kev nthuav qhia ntawm rheumatoid mob caj dab
Hauv cov menyuam yaus, daim ntawv no mob, cuam tshuam ib lossis ntau pob qij txha tib lub sijhawm. Yeej, cov tsos mob ntawm tus kab mob tshwm sim symmetrically - cov pob qij txha ntawm ob sab o, daim tawv nqaij hloov liab, ib tug kov rau lawv tej zaum yuav nrog los ntawm tsis kaj siab kev xav. Feem ntau, lub hauv caug, pob taws, lub luj tshib thiab dab teg pob qij txha tau koom nrog hauv cov txheej txheem pathological, cov pob qij txha interphalangeal thiab metatarsophalangeal raug kev txom nyem ntau dua. Nrog rau kev mob caj dab hauv cov menyuam yaus, thaum sawv ntxov nruj hauv kev txav, pom kev hloov pauv. Vim muaj tus kab mob no, kev ua ntawm cov menyuam yaus hnub nyoog qis dua ob xyoos raug txo qis, qee zaum lawv tsis kam txav mus los ntawm nws tus kheej.
Daim ntawv mob hnyav feem ntau ua rau lub cev kub nce mus txog 39 ° C. Cov menyuam yaus rheumatoid mob caj dab, uas ua raws li hom articular-visceral, yuav luag ib txwm nyuaj los ntawm arthralgia, lymphadenopathy, thiab hepatosplenomegaly. Hauv cov menyuam yaus uas muaj daim ntawv no ntawm kev sib koom ua ke, pom muaj mob febrile tsis tu ncua, ua pob liab liab tshwm sim.
SwiftKev loj hlob ntawm tus kab mob ua rau deformation ntawm cov pob qij txha, txwv kev txav mus los. Qee cov tsos mob ntawm rheumatoid mob caj dab hauv cov menyuam yaus tuaj yeem tshwm sim los ntawm cov protein metabolism tsis zoo. Nws yog lawv uas feem ntau ua rau tsim thiab tso tawm hauv cov ntaub so ntswg ntawm amyloid - ib qho tshwj xeeb protein-polysaccharide complex. Amyloidosis tuaj yeem tshwm sim hauv cov leeg nqaij, ob lub raum, siab, hnyuv. Yog tsis muaj kev kho kom raug, tus kab mob no yuav ua rau muaj kev tsis taus.
Nyob rau hauv cov mob hnyav, yuav tsum tau mus pw hauv tsev kho mob ceev ntawm tus menyuam yaus uas muaj mob caj dab me me. Cov tsos mob hauv cov menyuam yaus uas qhia tias muaj teeb meem ntawm tus kab mob muaj xws li cov tsos mob ntawm myocarditis (ua tsis taus pa, mob hauv siab, tsis muaj zog, lub plawv dhia tsis zoo), qhov loj ntawm daim siab thiab tus po, palpable.
Spondyloarthritis tsos mob
Kev tshwm sim ntawm tus kab mob tsis tuaj yeem nkag siab nrog cov cim qhia ntawm kev mob caj dab ntawm lwm hom. Cov neeg mob tsim articular syndrome. Cov tsos mob ntxiv ntawm cov kab mob spondyloarthritis tshwm sim feem ntau hauv cov neeg mob seropositive, yog li tus kab mob pib nrog kev ua haujlwm siab. Qhov no pathology tshwm sim los ntawm lwm yam tshwm sim. Cov menyuam yaus uas muaj spondyloarthritis muaj:
- tsis muaj zog;
- malaise;
- poob phaus;
- nephropathy;
- kidney amyloidosis;
- subfebrile fever.
Enthesopathy, Achilles bursitis, thiab txhav ntawm tus txha caj qaum tuaj yeem hu ua tus cwj pwm rau cov kab mob no. Tus kab mob no maj mam thiab nyuaj kho. Cov tsos mob ntawm kev mob caj dab hauv cov menyuam yaus tau piav qhia saum toj no yog ib qho teeb meem rau kev ceevmus ntsib kws kho mob. Yog tsis muaj kev kho kom raug, ankylosis ntawm vertebrae thiab intervertebral discs tsim, thiab cov pob qij txha raug cuam tshuam.
How reactive arthritis manifests
Kab mob sib koom ua rau 1-3 lub lis piam tom qab muaj kab mob hauv plab hnyuv lossis cov kab mob genitourinary. Cov kab mob tshwm sim los ntawm o ntawm cov pob qij txha, mob hnyav, tshwj xeeb tshaj yog aggravated los ntawm kev siv lub cev me ntsis. Ib qho kev hloov ntawm cov xim ntawm cov epidermis hla cov pob qij txha ua pom kev pom, uas tau txais cov xim liab lossis xiav.
Nrog rau cov pob qij txha, cov mob caj dab reactive tuaj yeem ua rau cov tsos mob ntxiv vim yog qhov txhab:
- qhov muag (conjunctivitis, iridocyclitis);
- mucous daim nyias nyias ntawm qhov ncauj kab noj hniav thiab tus nplaig (yaig, glossitis);
- genitals (balanoposthitis, vaginitis);
- hearts (extrasystole, myocarditis, pericarditis, aortitis).
Cov menyuam yaus uas muaj mob caj dab feem ntau tsim cov leeg nqaij thiab ntshav ntshav. Feem ntau, tus kab mob no teb zoo rau kev kho mob. Txawm li cas los xij, nws tsis tsim nyog ncua kev kho mob, vim qhov teeb meem feem ntau ntawm kev mob caj dab ntev yog lub raum amyloidosis, glomerulonephritis, thiab polyneuritis. Kev hloov pauv mus rau ib daim ntawv ntev yuav qhia tau los ntawm cov tawv nqaij daj ntseg ntawm qhov sib koom ua ke thiab cov tsos ntawm fistulas nrog dawb paug.
Txoj kev ntawm daim ntawv kis kab mob
Raws li nrog mob rheumatoid hauv cov menyuam yaus, kev kho mob yuav tsum tsis txhob tso tseg tom qab. Cov tsos mob ntawm tus kab mob no tshwm sim nyob rau ntawm lub teeb nrawm. kab mob sib kisetiology cuam tshuam rau tus me nyuam txoj kev mob, ua rau kub taub hau, mob taub hau, tsis muaj zog, tsis qab los noj mov. Qhov cuam tshuam sib koom ua ke nce hauv ntim, daim tawv nqaij hauv qhov chaw no yuav kub dua li lwm qhov ntawm lub cev. Nrog rau kev mob caj dab, qhov mob tau hnov txog thaum so, tab sis tsis xis nyob nce nrog kev txav mus los.
Yuav ua li cas kho cov kab mob sib koom ua ke hauv tus menyuam
Kev kho mob caj dab hauv cov menyuam yaus yuav tsum muaj kev sib koom ua ke. Tau hnov qhov kev kuaj mob, koj yuav tsum tau npaj rau qhov tseeb tias kev kho mob tuaj yeem siv sijhawm li ob peb lub hlis. Yog tias kev kho mob pib rau theem siab, ces tib neeg feem ntau yuav tsum tau tawm tsam tus kab mob ntau tshaj ib xyoos.
Txhua yam tshuaj yog muab los ntawm cov kws kho mob tshwj xeeb, thiab nws yog ib qho tseem ceeb kom nkag siab tias tsis muaj ib qho kev kho mob. Txhua qhov kev npaj yog xaiv rau cov menyuam yaus ib tus zuj zus. Ntawm cov tshuaj uas siv los tiv thaiv kev mob caj dab ntawm cov pob qij txha hauv cov menyuam yaus, immunomodulators, tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob feem ntau yog siv.
Tshuaj kho pob qij txha
Thaum lub sijhawm mob hnyav, tus menyuam tau muab tshuaj nrog glucocorticosteroid Cheebtsam. Nws yog ib qho tsim nyog yuav tsum siv cov tshuaj uas muaj cov tshuaj hormones hauv zos, tshwj xeeb tshaj yog thaum yau, nrog kev ceev faj heev, vim lawv sai sai thiab muaj kev phiv ntau heev. Tsis muaj teeb meem koj yuav tsum kho tus menyuam ntawm koj tus kheej, siv cov tshuaj raws li kev pom zoo ntawm cov neeg paub, cov txheeb ze, cov phooj ywg raug mob caj dab. Cov tshuaj uas tsim nyog rau cov neeg laus tej zaum yuav muaj qhov nruj tshaj plaws contraindications.rau ib tug me nyuam. Kev xaiv cov tshuaj yog ib qho teeb meem tshwj xeeb rau kev muaj peev xwm ntawm tus kws tshaj lij thiab yuav tsum tau coj mus rau hauv tus account tus yam ntxwv ntawm tus neeg mob.
Rau cov tsos mob ntawm kev mob caj dab ntawm cov pob qij txha hauv cov menyuam yaus, siv cov tshuaj hauv qab no:
- "Indomethacin". Ib qho tshuaj los ntawm pab pawg NSAIDs, uas muaj cov nyhuv analgesic thiab antipyretic. Tsis tas li ntawd, cov cuab yeej no zoo kawg nkaus ua kom pom nws cov khoom tiv thaiv edematous. "Indomethacin" rov qab mus rau cov pob qij txha cuam tshuam, tab sis nrog kev siv ntev, cov kev mob tshwm sim tuaj yeem ua tau (kev cuam tshuam hauv plab hnyuv, hlawv, khaus).
- "Naproxen". Ntawm cov lus qhia rau kev siv cov tshuaj tiv thaiv kab mob no yog rheumatoid mob caj dab, nrog rau cov menyuam yaus. "Naproxen" sai sai muaj cov nyhuv kho: ob peb hnub tom qab pib siv, thaum sawv ntxov nruj me ntsis, qhov mob ploj mus, o ntawm pob qij txha ploj. Muab "Naproxen" nyob rau hauv ib koob tshuaj txhua hnub tsis pub tshaj 10 mg rau 1 kg ntawm qhov hnyav. Nws yog ib qho tsim nyog yuav tau noj cov tshuaj hauv ob koob tshuaj nrog 12-teev ntu. Naproxen yog contraindicated rau cov menyuam yaus hnub nyoog qis dua 10 xyoo.
- "Aspirin". Cov tshuaj, uas muaj acetylsalicylic acid, pab txo qhov mob, ua npaws, thiab tshem tawm qhov mob. Qhov zoo ntawm cov tshuaj no suav nrog nws qhov kev ua haujlwm sai, tab sis nws yog txwv tsis pub siv rau cov ntshav txhaws.
Physiotherapy
Raws li koj paub, lub sijhawm ntawm kev siv tshuajmuaj kev txwv. Nws yog tsis yooj yim sua kom noj cov tshuaj tiv thaiv kab mob tas li, vim qhov no tuaj yeem ua rau muaj kev cuam tshuam tsis zoo. Txhawm rau txhim kho cov txiaj ntsig ntawm kev kho mob, cov tshuaj tau hloov pauv los ntawm cov txheej txheem kho lub cev:
- Electrophoresis. Nrog kev mob caj dab ntawm lub hauv caug sib koom hauv cov menyuam yaus, kev kho mob feem ntau pib nrog kev siv hluav taws xob tam sim no. Lub teeb nqi, dhau mus rau hauv cov txheej txheem sib sib zog nqus ntawm cov epidermis, txhim kho cov nyhuv ntawm cov tshuaj.
- Magnetotherapy. Txhua qhov kev sib tham cuam tshuam txog kev cuam tshuam ntawm lub zog ntawm thaj chaw cuam tshuam, vim tias cov txheej txheem metabolic txhim kho, vascular tone rov zoo li qub, thiab o.
- Ultrasound. Lub hauv paus ntsiab lus ntawm no physiotherapy yog raws li qhov kev tso tawm ntawm cov tshuaj mus rau hauv cov ntaub so ntswg nyob rau hauv lub zog ntawm high-frequency ultrasonic tsis. Nrog rau txhua tus txheej txheem, cov txheej txheem metabolic tau hloov kho hauv cov pob qij txha. Kev kho mob Ultrasound yog tshwj xeeb tshaj yog pab tau thaum ntxov ntawm kev mob caj dab.
massage
Qhov no tsis yog txoj kev kho mob tsawg dua, tab sis nws tsuas yog siv tau thaum tshem tus kab mob. Txhawm rau kom ua tiav qhov kev xav tau ntawm kev kho mob, nws yog ib qho tseem ceeb uas yuav tsum tau ua cov txheej txheem zaws txhua hnub, tsis tas yuav ploj mus ib hnub. Kev zaws yuav tsum tau ua los ntawm kws kho mob. Lub sijhawm ntawm txhua txoj haujlwm feem ntau tsis tshaj li ib nrab teev.
Nyob rau hauv thawj zaj lus qhia, nws yog ib qho tsim nyog kom ua tiav qhov kev so siab tshaj plaws ntawm cov leeg, yog li qhov saum npoo tsuas yog stroked thiab maj mam rubbed. Nrog rau txhua theem, cov txheej txheem zaws yuav khaus, tab sis nyob rau hauv cov ntaub ntawv ntawm kev mob caj dab, tsis muaj teeb meem koj yuav tsum cuam tshuam.quab yuam, nyem, kais, twist lub pob qij txha.
Ua tsaug rau kev zaws, qhov mob sib koom ua ke txo qis, kev ua si thiab kev txav ntawm cov ceg ceg cuam tshuam rov pib dua. Cov chav kawm tiav ntawm cov kev sib tham yuav yog ib qho kev tiv thaiv zoo ntawm ntsev deposition thiab nqaij atrophy. Kev zaws pab tshem tawm cov kua dej ntau dhau ntawm lub hnab sib koom ua ke thiab txhim kho cov ntshav ncig hauv cov ntaub so ntswg.
Txoj kev ua neeg
Koj tuaj yeem ntxiv cov txiaj ntsig ntawm kev kho tshuaj thiab kho lub cev nrog kev pab ntawm lwm cov tshuaj. Daim ntawv qhia nrov tshaj plaws:
Mustard plasters. Ib txoj hauv kev pheej yig, ntuj tsim los tiv thaiv kev mob caj dab, txawm rau menyuam yaus
- da dej coniferous. Ob peb ceg ntoo spruce yog brewed nrog boiling dej, insisted, tom qab uas strained infusion yog poured rau hauv da dej.
- Compresses nrog av nplaum. Cov tshuaj no pab txo qhov o. Av nplaum yog diluted nrog dej kom txog thaum ib tug mushy loj yog tau thiab thov mus rau qhov chaw muaj kab mob ntawm lub cev rau ob peb teev, nruj nreem kho nrog ib tug ntaub so ntswg bandage.
- qhwv nrog thistle decoction. Haum rau cov menyuam yaus hnub nyoog qis dua 6 xyoo. Rau 1st. l. qhuav tshuaj noj ib khob ntawm boiling dej. Muab sib tov rau ntawm hluav taws, ces boil rau li ib nrab ib teev. Thaum lub broth txias lawm, nws yuav tsum tau lim, thiab cov ntaub qhwv ntaub qhwv nyob rau hauv nws yuav tsum tau siv rau kev sib koom tes.
Ua ntej yuav siv lwm txoj kev kho mob, nco ntsoov nrog koj tus kws kho mob tham. Nrog rau kev nkag mus rau cov kws tshwj xeeb raws sijhawm, tus menyuam yuav muaj peev xwm ua tau tag nrho lub neej yam tsis nco qab txog tus kab mob.
