Rheumatism ntawm cov pob qij txha yog ib qho kev sib haum xeeb. Tus kab mob no muaj ntau cov tsos mob tsis zoo uas tuaj yeem txo qis tus neeg mob lub neej zoo, tab sis kuj txwv nws lub cev ua si.
cov ntaub ntawv dav dav
Rheumatism ntawm pob qij txha yog kab mob autoimmune. Feem ntau lawv raug kev txom nyem los ntawm cov poj niam (kwv yees li 75% ntawm tag nrho cov neeg mob). Tus kab mob no feem ntau tshwm sim thaum muaj hnub nyoog 35 txog 60.
Feem ntau, cov txheej txheem autoimmune no pib tsim tom qab muaj kab mob sib kis los ntawm pawg A beta-hemolytic streptococcus. Thaum lub sijhawm tus kab mob no, lub cev tsim cov tshuaj tiv thaiv los tua cov kab mob. Hmoov tsis zoo, lawv tuaj yeem cuam tshuam tsis tsuas yog cov kab mob sib kis, tab sis kuj yog cov ntaub so ntswg uas muaj cov qauv protein zoo sib xws. Lub hom phiaj tshaj plaws rau cov tshuaj tiv thaiv no yog cov pob qij txha thiab lub plawv.
Txoj kev sib cav
Muaj ntau yamua rau txoj kev loj hlob ntawm tus kab mob no. Rheumatism ntawm cov pob qij txha tshwm sim ntau zaus hauv cov xwm txheej hauv qab no:
- Cov txheeb ze ze ntawm tus neeg raug kev txom nyem los ntawm kab mob no.
- Keeb kwm ntawm cov kab mob xws li rubella, kab mob siab B, herpes.
- Qhov muaj collagen hom 2, 9, 10 thiab 11 hauv cov ntaub so ntswg.
- Kev nyuaj siab ntxhov plawv.
- Taumatic pob qij txha.
- Kev txhim kho menopause ntawm cov poj niam.
- nquag tshwm sim ntawm kev tsis haum tshuaj.
Kev pheej hmoo ntawm kev tsim mob rheumatism ntawm cov pob qij txha yog siab dua, qhov ua rau muaj kev cuam tshuam ntau rau tib neeg lub cev.
daim duab kho mob
Cov tsos mob ntawm kev sib koom tes rheumatism nyob rau hauv chav kawm classical ntawm pathology yog qhov txawv me ntsis ntawm qhov tshwm sim ntawm lwm yam kab mob uas cuam tshuam rau thaj chaw anatomical zoo sib xws. Lub tsev kho mob ntawm tus kab mob no muaj xws li:
- mob pob qij txha;
- mob nqaij ntuag;
- kev nce hauv lub cev kub txog 37.5 ºС;
- kev qaug zog;
- tag kis sawv ntxov.
Thaum txheeb xyuas thawj cov tsos mob ntawm rheumatism ntawm cov pob qij txha, koj yuav tsum sab laj nrog kws kho mob tam sim ntawd. Kev ntsuas kho sai sai tau pib, qhov tsawg tus neeg mob lub neej zoo yuav raug txo rau yav tom ntej.
Tus yam ntxwv mob
Kev swb ntawm pob qij txha hauv rheumatism yog tshwm sim los ntawm qhov mob. Nyob rau tib lub sijhawm, nws pib cuam tshuam tus neeg mob thaum hmo ntuj lossissawv ntxov teev. Mob yuav ua tau heev pronounced. Raws li qhov tshwm sim ntawm nws lub xub ntiag, tus neeg mob muaj kev txwv tsis pub txav mus los. Tom qab ntawd, qhov mob thiab qhov hnyav thaum sawv ntxov maj mam txo.
Diagnosis
Koj yuav tsum sab laj nrog kws kho mob tam sim ntawd tom qab thawj cov tsos mob ntawm tus kab mob no tshwm sim. Rheumatism ntawm cov pob qij txha tuaj yeem muaj kev kawm nrawm nrawm nrog kev txhim kho ntawm kev txwv lub cev muaj zog. Nrog rau kev kuaj mob raws sij hawm thiab kev kho mob, tus neeg mob muaj lub sijhawm kom tsis txhob muaj teeb meem. Txhawm rau txheeb xyuas qhov kev kuaj mob no, tus kws kho mob ua cov kev tshawb fawb hauv qab no:
- radiography ntawm cov pob qij txha cuam tshuam;
- suav ntshav tag;
- kuaj ntshav biochemical;
- kev sib koom tes nrog kev tshuaj xyuas ntxiv ntawm cov kua dej synovial;
- tshuaj tiv thaiv kab mob tiv thaiv kab mob.
X-ray ntawm cov pob qij txha cuam tshuam tso cai rau koj los qhia meej qhov xwm txheej ntawm thaj chaw no. Nyob rau hauv cov ntaub ntawv ntawm rheumatism, nqaim ntawm qhov sib koom ua ke, proliferation ntawm osteophytes tuaj yeem pom. Cov kev hloov pauv no yuav ua rau muaj kev txwv ntawm tus neeg mob lub cev muaj zog ua haujlwm.
Cov kev hloov hauv qab no tuaj yeem pom hauv kev kuaj ntshav dav dav rau rheumatism ntawm cov pob qij txha:
- tshaj qib ntawm leukocytes: siab dua 9.0109 / l;
- nce hauv erythrocyte sedimentation tus nqi: ntau dua 10 mm / h hauv cov txiv neej thiab ntau dua 15 mm / h hauv cov poj niam;
- nce platelet suav: ntau dua 420109 / L;
- txo cov qe ntshav liab: tsawg dua 3.51012 / L.
Los ntawm lawv tus kheej, xws li kev hloov pauv hauv kev kuaj ntshav dav dav tsis yog qhov tshwj xeeb, thiab nws tsis tuaj yeem txiav txim siab qhov muaj mob rheumatism nkaus xwb.
Ib txoj kev qhia ncaj ncees ntawm kev tshawb fawb nyob rau hauv rooj plaub ntawm cov kab mob no yog kuaj ntshav biochemical. Ua tsaug rau nws, nws muaj peev xwm txiav txim siab muaj C-reactive protein thiab rheumatoid yam hauv cov ntshav. Thaum ob ntawm cov tshuaj no raug kuaj pom ib zaug, qhov kev kuaj mob tau tsim nyob rau hauv feem coob ntawm cov neeg mob. Nyob rau tib lub sijhawm, raws li cov txiaj ntsig tsis zoo ntawm kev tshuaj xyuas rau rheumatism ntawm cov pob qij txha, ib tus tsis tuaj yeem hais tias tus neeg mob tsis muaj tus kabmob no.
Kev sib koom tes nrog kev xav tias mob rheumatism yog ua tsis tshua muaj. Txoj kev kuaj mob no tsuas yog siv thaum cov kws kho mob muaj teeb meem ua qhov kev kuaj pom tseeb. Nrog rheumatism, ntau cov protein, leukocytes thiab granulocytes tau pom nyob rau hauv cov kua synovial los ntawm kev sib koom ua ke. Tsis tas li ntawd, nws yog huab, thiab nws cov viscosity qis dua li qub.
Kev kuaj pom muaj cov tshuaj tiv thaiv kab mob anticitrulline tso cai rau qhov muaj txiaj ntsig zoo los tsim kom muaj kev mob rheumatism ntawm cov pob qij txha ntawm ob txhais ceg thiab tes. Qhov tsis zoo ntawm txoj kev tshawb fawb no yog nws tus nqi siab heev.
ntsuas ntsuas
Yog tias qhov kev kuaj mob no tau tsim, tus neeg mob yuav tsum pib kho tam sim ntawd. Muaj ib tus kws kho mob tshwj xeeb uas paub meej tias yuav kho rheumatism li cas. Qhov no yog rheumatologist. Hauv cov chaw kho mob zoo tib yam ntawm tus kws kho mob tshwj xeeb no, nrhiavyuav luag tsis yooj yim sua. Txhawm rau kom tau txais kev saib xyuas zoo, koj yuav tsum tau hu rau lub chaw kho mob ntiag tug lossis ntau lub chaw saib xyuas kev noj qab haus huv loj. Kev xa mus rau tus kws kho mob rheumatologist tom qab kuaj qhov tsim nyog yuav raug muab los ntawm tus kws kho mob hauv zos lossis tus kws kho mob.
Tam sim no kev kho mob rau rheumatism ntawm cov pob qij txha muaj xws li:
- tsis yog-steroidal tshuaj tiv thaiv kab mob;
- glucocorticosteroids;
- cytostatics;
- tshuaj tua kab mob;
- kub npaj;
- Yaminoquinolones;
- mercaptocarboxylic acid derivatives;
- xaiv cov tshuaj tiv thaiv kab mob;
- tshuaj tiv thaiv kab mob enzyme;
- siv lub cev kho mob;
- kev ua kom lub cev kho mob.
Ib txwm, tus neeg mob tsis tau sau ib txhij rau tag nrho cov tshuaj no thiab ntsuas kev kho mob. Ib qho kev kho mob tshwj xeeb yog tsim los ntawm tus kws kho mob tshwj xeeb, nyob ntawm qhov hnyav thiab ceev ntawm kev txhim kho cov txheej txheem pathological.
Nonsteroidal tshuaj tiv thaiv kab mob
Tshuaj los ntawm pab pawg kws tshuaj no yog siv los kho cov mob rheumatism hauv yuav luag txhua tus neeg mob. Qhov no yog vim lub fact tias lawv ib txhij muaj anti-inflammatory thiab analgesic nyhuv. Cov tshuaj tseem ceeb ntawm pab pawg no siv rau rheumatism yog raws li hauv qab no:
- "Nimesulide".
- "Ketoralac".
- Y"Diclofenac".
- Ibuprofen
- "Meloxicam".
Raws li Meloxicam, nws kuj muaj cov leeg nqaij so. Tag nrho cov tshuaj uas tsis yog-steroidal anti-inflammatory siv tshuaj muaj kev phiv loj heev - kev puas tsuaj rau lub plab mucosa. Yog vim li cas tus kws kho mob tshwj xeeb yuav tsum qhia koj yuav ua li cas kho rheumatism nrog kev pab ntawm cov tshuaj no. Hauv feem ntau ntawm cov xwm txheej, tsis hais cov tshuaj tshwj xeeb, lawv tau muab 1 tab. 2-3 zaug ib hnub tom qab noj mov.
YGlucocorticosteroids
Cov tshuaj no siv tsawg dua li cov tshuaj uas tsis yog-steroidal anti-inflammatory. Cov neeg sawv cev hauv qab no ntawm pawg kws tshuaj no tau siv ntau dua:
- "Prednisolone".
- "Methylprednisolone".
- "Dexamethasone."
Txhua yam tshuaj no muaj ib qho kev phiv loj heev - lawv ua rau cov ntshav siab nce ntxiv. Yog li ntawd, nrog ceev faj heev, lawv yuav tsum tau muab tshuaj rau cov neeg mob hypertensive. Tam sim no, glucocorticosteroids feem ntau pom zoo rau cov neeg mob tsuas yog thaum lub sij hawm exacerbation ntawm pathological txheej txheem los yog nyob rau hauv ib tug hnyav zuj zus mus.
YCytostatics
Cov tshuaj no tuaj yeem ua rau muaj kev phom sij loj rau lub cev. Tias yog vim li cas lawv tsis siv nyob rau hauv feem ntau cov neeg mob. Lawv tsuas yog siv rau hauv cov xwm txheej ntawm rheumatism ntawm cov pob qij txha, thaum muaj kev loj hlob zuj zus thiab qhov hnyav hnyav.cov tsos mob ntawm tus kab mob. Tsis tas li ntawd, cytostatics yog siv thaum lwm yam tshuaj tsis zoo. Cov tshuaj tseem ceeb hauv pab pawg no yog:
- "Methotrexate".
- "Azathioprine".
Y"Cyclophosphamide".
Thaum noj cytostatics, nws yog ib qho tseem ceeb kom ua raws li tag nrho cov lus pom zoo ntawm tus kws kho mob tshwj xeeb. Yog tias koj ntsib kev mob tshwm sim, koj yuav tsum sab laj nrog nws tam sim.
Tshuaj tua kab mob
Nrog rheumatism ntawm cov pob qij txha, lawv tsis siv ntau zaus. Raws li txoj cai, tsuas yog nyob rau hauv cov ntaub ntawv ntawm tus kab mob exacerbation, nrog rau kev nce hauv lub cev kub thiab leukocytosis hauv kev kuaj ntshav. Hauv qhov no, cov tshuaj tua kab mob los ntawm pawg cephalosporins (Ceftriaxone, Cefazolin), macrolides (Azithromycin, Erythromycin) lossis tshuaj tiv thaiv penicillins (Amoxiclav) feem ntau yog siv. Cov tshuaj no tsuas yog yuav tsum tau noj thaum tus kws kho mob tshwj xeeb thiab tom qab noj mov.
Physiotherapeutic effect
Muaj ntau cov tswv yim kho lub cev uas siv rau rheumatism ntawm cov pob qij txha. Cov tseem ceeb yog:
- Magnetotherapy.
- raug rau hluav taws xob ntau zaus.
- Electrophoresis nrog novocaine.
- Kev raug hluav taws xob infrared.
- Ozokerite applications.
- daim ntawv thov Paraffin.
Magnetotherapy zoo dua rau kev kho mob hauv caug rheumatismpob qij txha. Electrophoresis nrog novocaine yuav tsum tau muab tshuaj tsuas yog tom qab kuaj xyuas tus neeg mob cov keeb kwm tsis haum, vim tias feem ntau cov lus teb anaphylactic tau pom zoo rau nws siv. Hauv qhov no, tus neeg mob yuav xav tau kev kho mob xwm txheej ceev.
Kev kho lub cev tsis tuaj yeem ua haujlwm tseem ceeb rau tus kab mob no. Qhov kev ua tau zoo tshaj plaws ntawm nws tuaj yeem ua tiav nrog kev noj tshuaj raws li lub tswv yim tsim nyog los ntawm kws kho mob tshwj xeeb.
kho mob qoj ib ce
Ib qho kev tawm dag zog tshwj xeeb tuaj yeem txhim kho kev ua haujlwm ntawm tus neeg mob. Ua tsaug rau lawv, nws yuav muaj peev xwm kov yeej thaum sawv ntxov nruj thiab nce kev txav mus los ntawm kev sib koom ua ke. Nyob rau tib lub sijhawm, nws yog ib qho tseem ceeb heev uas tus kws kho mob tshwj xeeb tsim cov kev pab cuam ntawm kev kho lub cev. Nws yuav xaiv cov kev tawm dag zog uas yuav pab tau rau txhua kis.
Kev kho mob ib ce, zoo li kev kho lub cev, raws li cov txheej txheem ywj pheej tsis ua lub luag haujlwm txiav txim siab. Nws ua haujlwm tsuas yog tiv thaiv keeb kwm yav dhau los ntawm kev kho tshuaj muaj txiaj ntsig.
Kev Tiv Thaiv
Qhov kev tiv thaiv tseem ceeb los txo qis qhov tshwm sim ntawm kev txhim kho rheumatism ntawm cov pob qij txha yog kev kho mob ntawm txhua tus kab mob sib kis uas tus neeg raug kev txom nyem hauv nws lub neej. Rau qhov no, nws yog ib qho tsim nyog yuav tau siv cov tshuaj uas tau muab los ntawm kws kho mob tshwj xeeb thiab, qhov tseem ceeb tshaj, cov tshuaj tua kab mob. Hypothermia kuj yuav tsum tau zamsib koom raug mob.
