Izigulane emadolweni kunye ne-arthrosis: iziyobisi. Ukukhetha, inkcazo, imiyalelo

-Nzulu Greek enkulu Aristotle wathi: "Le intshukumo - oku ubomi." Kodwa ke, ngelishwa, asingabo bonke abantu bangakonwabela oko ukuba ngokupheleleyo. Omnye kubantu ezilishumi kule planethi luhlangabezana intlungu emva kokuba umsebenzi emzimbeni, egramza kwi amalungu ngumkhinkqi engaphakathi, ezehlisa kakhulu umgangatho wobomi. Ngoko kubonakala Iimpawu zokuqala arthrosis. Kwinqaku, xa kuyimfuneko ukunika ziinaliti ukuya entlanganweni amadolo kunye osteoarthritis, amalungiselelo afunekayo ezi nkqubo.

Zintoni izinto ezibangela osteoarthritis kunye

Ukudleka - a oko kuboniswa intshabalalo okuthe intra-articular intlala isifo esinganyangekiyo. Njengoko umthetho, esi sifo kubonakala kubantu abadala ngenxa yenkqubo yendalo ukuguga izicwili lomzimba, kodwa kwiminyaka yakutshanje amadoda namabhinqa angaphezu kwamashumi amane abafunyenwe ngokugqithisileyo ngazo esi sifo.

Oku kungenxa yokuba umsebenzi ebonakalayo yabantu sele lehlile kakhulu: Umsebenzi ungenzi nto, ukusetyenziswa kwezithuthi zikawonke nezithuthi zabucala, esingangqinelaniyo inala - ngenxa yoko, ndandityebe ngokugqithiseleyo kwandisa umthwalo emalungwini. Njengoko unyango oogqirha bacebisa iinaliti ukuya entlanganweni kwedolo. Xa imithi zilawulwa osteoarthritis ubukhulu becala ngaphakathi ezidibeneyo.

Izinto ezibangela osteoarthritis zasesekondari kunokuba ukulimala (nemivumbo, komsipha, kwizaphuko), umthwalo omkhulu kakhulu leembaleki kunye nabasebenzi bawo kwisigaba lomsebenzi inxulunyaniswa yabasebenzi emzimbeni enzima. Ukongeza, ezi imiqathango ukwenzela uphuhliso sifo ukudala, kunye nezinye izinto, ezifana izifo samathambo, iinkqubo ezidlulileyo esosulelayo kwaye ukudumba, yofuzo, izifo inkqubo yonyango, iinkqubo, ukuphazamiseka yokucolwa kunye nabanye.

Njengoko intlala uqhawuka

Onke amalungu emzimbeni womntu twatse kwisakhiwo - ezimbini okanye ngaphezulu umphezulu articular, ngokufulelwa intlala, lwamalunga zifakwe apha engxoweni imixholo kulwelo synovia. intlala Hyaline yi elastic kwaye isakhiwo egudileyo, nto leyo evumela ukuba ukukhuhlana ngexesha intshukumo. replacement Meal lwenziwa yi kulwelo lwamalunga, ngenxa nempahla yaso ngegazi asikwazanga.

Lo mhlaba kwenza intlala sesichengeni. Ngenxa yenkqubo exchange akaphumeleli okanye hyaline intlala utshintsho sisiba mandundu ezinkulu kakhulu umthwalo articular unokujongana, xa lingekho okanye ubonelelo zaneleyo Kwezixa yokuyikhangela kunye ngokutsha kwenzeka ngokucothayo kakhulu. Thinning of the intlala interlayer hyaline kukhokelela ekubeni ukwanda zochuku kwi joint ngexesha intshukumo, nto leyo ekhokelela entshabalalweni olukhawulezisiweyo of intlala kwaye ikhuthaze uphuhliso neenkqubo arhabaxa. Xa abantu, le nkqubo ubonisa intlungu, ukuqina, ukuhamba elilinganiselweyo. Kweli nqanaba, i uncedo ukuze beze ziinaliti ukuya entlanganweni kwedolo. iingcali Izimvo kunye nezigulane malunga ezi nkqubo ibonisa impumelelo yabo.

Inyathelo lokugqibela lale nkqubo intlala zophendlo lwezifo ibhuqiwe kwaye endaweni ngokukhulisa inyama ezinezikhondo nokuqina. Ngenxa tshintsho kwi joint yi likhubazeke yaye ingasakwazi ukwenza imisebenzi yazo. Ukuze uphephe oku, isicelo hondroprotektory. Ixabiso lisezantsi kwaye ikuvumela ukuba usebenzise kubo kakhulu ngokubanzi.

Ngelishwa, zisebenza kuphela ukuba sikwinqanaba lokuqala ukutshatyalaliswa intlala kwaye ukuvelisa yifuna kwimeko yenkqubo ukubaleka. Ukongeza, ukuthatha la machiza kufuneka ixesha elide, zingadlulanga iinyanga ezintathu ukuya kwezintandathu, kwaye kwezinye iimeko ngabanye, yaye ukuya kutsho kwiminyaka enye enesiqingatha, kuba intlala regenerates ngokucothayo kakhulu. Nelo lokuqhubeka kwekhosi, imo ukwamkelwa, leyo iinaliti ukuya entlanganweni kwedolo, yaye yintoni iidosi ungeniselo - konke oku uchaza nesinika ugqirha ukuba isigulane ngamnye, ngokusekelwe isimo sokuqala kunye ukugcina utshintsho apha ekuhambeni unyango.

Iindlela kwaye unyango

unyango arthritis kuba konyango,. treatment Surgical kuthetha yi athile omzimba - replacement hip.

Eyona njongo iphambili iyeza osteoarthritis - ukunqanda ngakumbi ukutshatyalaliswa intlala inyama nokulondoloza umsebenzi ngokubambisana.

Ukuba unyango ibe neziphumo ezihle, kufuneka ibhekiswe nokususwa ukudumba, iintlungu ukubuyisela intlala. Ukulungiselela le njongo:

• arhente antiinflammatory nonsteroidal;
• intra-articular ziphene iziyobisi;
• kuthetha isenzo warming wengingqi ukuphucula igazi flow kummandla ochaphazelekayo (ngokohlobo namafutha aqholiweyo, ijel nezithambiso);
• hondroprotektory.

arhente Non-steroidal anti-ukudumba

Iziyobisi hlobo ukunciphisa nangokurhala, ukudumba, abe neziphumo antipyretic kunye iintlungu.

Kuba ukuchazwa kakhulu intshukumo iintlungu zezi: "ibuprofen" "Diclofenac isodium" ( "Voltaren"). NSAIDs musa kunokubangela imincili, ukozela, habituation, ukuxhomekeka iziyobisi, kodwa ukusetyenziswa ixesha elide iziphumo zazo ezonakalisayo inwebu kwiinwebu esiswini. Ngoko ke mabaqeshe "Diclofenac" (kuqhume) ukulungiselela uncedo ahlekise. Ixabiso ampoules abahlanu iphakheji malunga namakhulu amabini engange. Isicelo: intramuscularly for two - iintsuku ezintlanu kwaye ke idluliselwe azipilisi iziyobisi (ukuba kuyimfuneko).

Unako ukusebenzisa "Ketonala" - izitofu intramuscularly okanye butofelwe, ngokunjalo iindlela injectable "Flamaksa", "Artrozilena". Xa kulawulwa yegazi, ekhefu phakathi unyango kufuneka iiyure eziyi-8.

corticosteroids hormone hondroprotektory

Ixabiso uba kangako ukuba iintlungu obunamandla, amafutha okanye izithambiso akukho lusasebenza. Xa samathambo egqitha nqanaba etsolo, iba corticosteroids ezifanelekileyo hormone. La machiza zikhuthaza ingcinezelo ngokukhawuleza nangempumelelo inkqubo kwiintetho ezikralayo, kodwa ukusetyenziswa ixesha elide esa entshabalalweni ngokudibeneyo kwaye kaninzi baxabane ezibi.

Ngoko ke, koogqirha amisele corticosteroids amayeza intraarticular "Diprospan" "Kenalog", "Hydrocortisone" ngohlobo lwezitofu oko kunciphisa amathuba okuba ukuba kuya kuba neziphumo ezibi kakhulu ubuncinane.

Chondroprotectors - it amayeza kunye neziyobisi, sikhetha ukuyilwa components ezintsha ngokupheleleyo noshowo intlala kwithishyu. Bathi kutsha nje nokuthintela ukutshatyalaliswa ngakumbi.

Le chondroprotectors Isakhiwo iquka amacandelo ezimbini eziphambili: glucosamine kunye chondroitin sulfate. Ezi izinto eziyimfuneko ukuze kwakhiwe ulwelo lwamalunga, kwaye umzimba womntu ngokuqhelekileyo uvelisa kubo ngokwakhe.

kunikezelo

Okwangoku, iinkampani ezixuba amayeza ukuvelisa iziyobisi chondroitin kunye glucosamine kule fom zilandelayo:

• izisombululo ukuze emigodini;
• izithambiso, namafutha aqholiweyo, ziwe;
• njengezingxobo, Ithatyathwe emigutyeni ngenxa ulawulo ngomlomo, amacwecwe.

Kukho izizukulwana ezintathu chondroprotectors:

1. Lokuqala - koqoqobo kwesilwanyana. Ngaba ngokuqhelekileyo ukunyamezeleka kakuhle, isiphumo uza ngokukhawuleza, kodwa zinokubangela ukuba komzimba. Kule ntlobo ziquka iziyobisi ezifana 'rumalon "yaye" Alflutop ".
2. Okwesibini - amalungiselelo zokwenziwa of chondroitin sulfate ( "Chondroxide", "Struktum", "hondrolon", "Mukosat"), glucosamine ( "Don ',' Elbona", "Sustilak") kunye acid-hyaluronic ( "Fermatron", "Synvisc ' "Hyaluron", "hyalgan")
3. amachiza ezihlangeneyo (combined) eziquka imidibaniso ezahlukeneyo chondroitin kunye glucosamine ( "Artra", "Teraflex") - Okwesithathu.

Ukuhlelwa iindlela zolawulo

Ukuhlelwa Chondroprotectors isekelwe kwiindlela ezahlukeneyo wolawulo:

1. Intra-articular inaliti - indlela kakhulu, kuba isiphumo kuphuhliswa ngokukhawuleza kwaye ihlala ixesha elide ngokwaneleyo. Phinda ezi zazo kufuneka kuphela izihlandlo ezimbalwa ngonyaka. Kufanelekile ukuba nemixube eziqulathe hyaluronic acid, ezifana "hyalgan", "Fermatron". Ububi le ndlela zibandakanya isibakala sokuba inaliti kwi amalungu ukuba izakhi zonyango kwaye kuqhutywa kwindawo esibhedlele. Kwiimeko ezininzi, ulawulo chondroprotective ukusebenza kwamalungu idolo.
2. Inaliti Intramuscular - indlela elula kwaye isetyenziswa ngokubanzi ukungenisa chondroprotectors. Ngale ndlela elawulwa "Alflutop", "hondrolon", "Artradol", "Hondrogard" kunye namanye amalungiselelo amaninzi intramuscular. Ifanele kwizigulane ngenxa yezizathu ezahlukeneyo akanako ukuginya cwecwe okanye philisi, okanye isifo kakhulu sezintso.
3. Njengezingxobo kunye tablets - ezazisetyenziswa ngokubanzi kwaye ethandwa indlela kulawulo iziyobisi. Akudingi iimeko aseptic, ungenelelo abasebenzi abaqeqeshiweyo ngokukodwa, ifanele self-zolawulo. Noko ke, ububi kule ndlela nayo iye: ikhosi elide unyango, ipilisi umthwalo omkhulu ophezu kwesibindi kunye nezintso.
4. ukusetyenziswa lwangaphandle njengoko izithambiso, amafutha okanye gel - indlela ulungile ukongeza kulawulo ngomlomo, kodwa hayi nje monotherapy. Hyaluronic acid kunye chondroitin kuphantse ukungena ngesikhumba ukuya entlanganweni, kodwa zidityaniswe ngeendlela physiotherapeutic permeability ezi zinto lungandiswa. Njengoko obezbolevayuschego zingasetyenziswa "Diclofenac '" (kuqhume). Ixabiso kweziyobisi baqonde ngaphakathi 200-600 engange.

Le mithi kakhulu ngempumelelo

Naimbolee olusebenzayo iindlela njenge "Alflutop» (SC Biotehnos, SA, Romania). Isiseko sokulungiselela sisicatshulwa esithathwe eziphilayo zaselwandle ngeentlobo ezine. Lo mxube defatted ezingcwalisile ukungcola kunye neeproteni. Isiphumo iphambili ichiza ejoliswe nokulawulwa kweenkqubo pathways kwi ijwabu intlala.

Ngokufanayo isenzo amachiza afana "Chondroxide", "hondrolon", "Struktum", "Don." Isicelo: intramuscularly, nzulu, 1 ml imihla kangangeeveki ezintathu.

Ngokuthatha inxaxheba kwinkqubo amalungu elikhulu lolawulo intraarticular yi ngeemililitha omnye okanye emibini joint nganye abachaphazelekayo kanye ngeentsuku ezintathu okanye ezine (total lwezitofu ezintlanu okanye ezintandathu), yaye emva koko - isitofu intramuscular, oluqhutywa iintsuku ezingamashumi amabini. Izinga phindaphindo kuyimfuneko ku tirhisa isiqingatha sonyaka.

Imali zifumaneka ezineengqayi ezilishumi odnomillimetrovyh okanye lweephakheji ampoules ezintlanu ml ezimbini.

ixabiso elithelekelelwayo ezikhemisti - 3300 engange pack nganye.

Ichiza "rumalon"

Kwelinye ichiza olusebenzayo ithathwa njenge "rumalon" (Cjsc "Bryntsalov A", Russia). Oku kuquka yinxalenye isicatshulwa ingqondo kunye namathole intlala noqhoqhoqho.

Isicelo: kuphela anzongonzongo inaliti intramuscular. Kuba abadala, iidosi 1 ml kathathu ngeveki amaxesha, okanye ml 2 dvzhdy ngeveki. Imiphumo emihle yale unyango sele olubonakalayo isibini iiveki zonyango. Le khosi unyango epheleleyo ali-25 isitofu 1 ml nganye, okanye 15, kodwa ml-2 (iiveki 6-8). uluhlu lwezitofu kufuneka kuphindwa ubuncinane kabini ngonyaka, okanye ngokuphindwe kane ngonyaka yi ingxaki ngexesha sifo kwisithuba seminyaka eliqela.

Iveliswe ku upakisho of ampoules ezilishumi elinye milliliter yezisombululo uzilungiselele.

ixabiso elithelekelelwayo ezikhemisti - evela engange 1100 pack nganye.

Amalungiselelo kunye glucosamine kunye chondroitin

Classical kwaye isetyenziswa ngokubanzi labo arhente:

1. "Don '- kuqulunqo glucosamine yinto olungumgubo isisombululo yomlomo kwaye ikulungele zitofu e ampoules. Iveliswe yinkampani Italian Rottapharm. ixabiso Package ukusuka engange-900 ukuya 1600.
2. "Artradol" - ukulungiselela chondroitin ukuba isitofu intramuscular zokukhokhela inkampani Russian "Trivium". Le phakeji yokufunda isenokuba-5 okanye 10 ampoules ze ml-2. Ixabiso ngeenxa engange 700-1000 pack nganye.
3. "Hondrolon" - solution sulfate chondroitin kwi ampules ziveliswe eRashiya. Enye ixabiso phakheji ukusuka engange 1000 ukuya 1300 iqulethe ezineengqayi ezilishumi.
4. "Struktum" - nokulungiselela njengezingxobo chondroitin sulfate, eveliswe yi bumabumela French Pierre Fabre Medicament Production. Kuyinto ifumaneka iidosi ezimbini - 500 kunye mg 250. Ixabiso ezikhemisti - malunga 700 - 1500 engange pack nganye.

Ukudibana glucosamine kunye chondroitin

arhente luhlangene therapeutic:

1. "Artra" - tablets. Iveliswe yinkampani American UNIPHARM. Ziquka glucosamine hydrochloride kwi umthamo 500 mg sodium chondroitin sulfate kunye 500 mg, phantse akukho iziphumo ebezingalindelekanga. Ubume - yeCwecwe, 30-120 iiPC. kwiphakheji, ixabiso yahluka ukusuka engange 500 ukuya 1900, ngokuxhomekeke inani labo.
2. "Teraflex" - ukulungiselela American ngokuqinileyo entsonkothileyo Sagmel, iqulathe 400 mg chondroitin kunye glucosamine 500 mg, iza ngohlobo izithambiso kunye njengezingxobo. Iphekhi enye iqulathe 30-120 njengezingxobo, ixabiso kuxhomekeka kwinani njengezingxobo ngu 550-1850 engange.
3. Kukho kwakhona i formula lokuwandisa ichiza - "Teraflex Advanced". Yohluka ukusuka phambi classical kwi ukwakhiwa non-steroidal nechiza elichasene-ukudumba - ibuprofen. Ngokubambisana njengezingxobo ngomlomo Kucetyiswa ukuba basebenzise amalungiselelo chondroitin kunye glucosamine ngokwemixholo ( "Teraflex" ngokohlobo a cream).

Iinaliti ukuya edolweni arthrosis joint: hyaluronic acid

Amalungiselelo zixhaphakileyo acid hyaluronic ezikhemisti ngoku:

1. "Ostenil", "Sinokrom" yaye "Sinokrom Forte" - evela Austria eJamani, "Fermatron" - ukusuka UK, "Suplazin" - evela Ireland.
2. Hayi njalo, kodwa kukho iziyobisi ezifana "viscos" (Germany) kunye 'ViskoPlyus "(Sweden), i-Italian" hyalgan "," Gialyuks "(South Korea), US' Synvisc" yaye "Dyuralan Es Jay."
3. Imveliso Russian iziyobisi bodwa "Intradzhekt Gialuform" ( "Toskani" eMoscow) kunye "Giastat" (Tula).

inaliti acid hyaluronic kungena ezingamadlelane kuveliswe imveliso ogqityiweyo e iisirinji ezilahlwayo, kananjalo kube lula kakhulu ukuba isetyenziswe.

Intra-articular iinaliti ukuya entlanganweni amadolo kunye osteoarthritis, ngokusekelwe ngamalungiselelo hyaluronate kuchaphazela organ enesifo ngeendlela ezintathu:

• ukukhuhlana nokwandisa uphelelo ngenxa yokuba kwenani kolwelo lwamalunga kunye viscosity yayo;
• ngokunzima kondla cells intlala zomzimba, ngaloo ndlela zivuse nokuhlaziya ngokutsa hyaline intlala;
• ethintela iinkqubo ukudumba kwaye kunciphisa nobukhali iimpawu zazo.

isiphelo

Kokuba kuchazwe ukuba isitofu of hyaluronic acid ukuya entlanganweni idolo ilunyango mihla ukuba izifo ezinxulumene kwindlela musculoskeletal. ichiza lubanesiphumo engaqhelekanga kwaye ikuvumela ukuba umlibale malunga izenzo osteoarthritis sikwinqanaba lokuqala. Le uyofaka ulwelo ekhuselekileyo kunciphisa kakhulu umthwalo kwi joint, intlala izinto izondlo kwaye yenza a (zendalo) afakelweyo zendalo, ekufuphi kakhulu kumafa kolwelo synovia zabantu.

Kwakhona arhente abaphumelelayo iimveliso eziqulathe glucosamine kunye chondroitin.

ulawulo intra-articular kwala machiza kunempembelelo olukhawulezayo ixesha elide.