Zowonongeka Villonodular Synovitis (PVNS)

Zamkati

• Nchiyani chimayambitsa PVNS?
• Komwe mthupi mumapezeka
• Zizindikiro
• Chithandizo
• Opaleshoni yojambulajambula
• Opaleshoni yotseguka
• Olowa m'malo
• Kukonza matendon
• Mafunde
• Mankhwala
• Nthawi yochira opaleshoni
• Zosintha m'moyo
• Tengera kwina

Chidule

Synovium ndi kansalu kakang'ono kamene kamagwirizana. Zimapanganso madzi kuti afewetse mafupa.

Mu pigmented villonodular synovitis (PVNS), synovium imakulitsa, ndikupanga kukula kotchedwa chotupa.

PVNS si khansa. Sichingafalikire mbali zina za thupi, koma chimatha kukula mpaka kukawononga mafupa apafupi ndipo pamapeto pake chimayambitsa nyamakazi. Kukula kwakukulu kwa cholumikizira kumayambitsanso kupweteka, kuuma, ndi zizindikilo zina.

PVNS ndi gawo la zotupa zopanda khansa zomwe zimakhudza mafupa, otchedwa tenosynovial giant cell tumors (TGCTs). Pali mitundu iwiri ya PVNS:

• PVNS yakomweko kapena yam'mutu imakhudza gawo limodzi lokhalo kapena ma tendon okha omwe amathandizira kulumikizana.
• Kusokoneza PVNS kumaphatikizapo kulumikizana kwathunthu. Kungakhale kovuta kuchiza kuposa PVNS yakomweko.

PVNS ndichikhalidwe chosowa kwambiri. Zimakhudza za.

Nchiyani chimayambitsa PVNS?

Madokotala sakudziwa chomwe chimayambitsa vutoli. Pakhoza kukhala kulumikizana pakati pa PVNS ndi kuvulala posachedwa. Chibadwa chomwe chimakhudza kukula kwa maselo olowa chitha kuthandizanso.

PVNS ikhoza kukhala matenda otupa, ofanana ndi nyamakazi. apeza zikwangwani zotupa monga C-reactive protein (CRP) mwa anthu omwe ali ndi vutoli. Kapenanso, mwina zimayamba chifukwa cha kukula kosasunthika kwa maselo, ofanana ndi khansa.

Ngakhale kuti PVNS imatha kuyambira msinkhu uliwonse, imakonda kukhudza anthu azaka za 30 ndi 40s. Amayi amakhala othekera pang'ono kutengera vutoli kuposa amuna.

Komwe mthupi mumapezeka

Pafupifupi 80 peresenti ya nthawiyo, PVNS ili pa bondo. Tsamba lachiwiri lofala kwambiri ndi mchiuno.

PVNS ingakhudzenso:

• phewa
• chigongono
• dzanja
• bondo
• nsagwada (kawirikawiri)

Si zachilendo kuti PVNS ikhale mgulu limodzi.

Zizindikiro

Pamene synovium ikukula, imatulutsa kutupa palimodzi. Kutupa kumatha kuwoneka kodabwitsa, koma nthawi zambiri kumakhala kopweteka.

Zizindikiro zina ndizo:

• kuuma
• kuyenda kochepa mu mgwirizano
• kutuluka, kutseka, kapena kumva pamene mukusuntha cholumikizira
• kutentha kapena kukoma pamfundo
• kufooka mu mgwirizano

Zizindikirozi zimatha kuwonekera kwakanthawi kenako kuzimiririka. Matendawa akamakula, amatha kuyambitsa nyamakazi.

Chithandizo

Chotupacho chidzapitilira kukula. Idasiya kusachiritsidwa, idzawononga fupa lapafupi. Chithandizo chachikulu cha TGCT ndi opaleshoni yochotsa kukula. Opaleshoni imatha kuchitidwa m'njira zosiyanasiyana.

Opaleshoni yojambulajambula

Njira yowonongekayi imagwiritsa ntchito tinthu ting'onoting'ono tating'ono. Dokotalayo amaika kachetechete, kamayaka kamamera kudzera pachimodzi mwa zomwe zidachitikazo. Zida zing'onozing'ono zimalowa m'malo ena.

Dokotalayo amatha kuwona mkati mwa cholumikizira pakuwunika kanema. Pochita izi, dokotalayo amachotsa chotupacho komanso malo owonongeka olowa.

Opaleshoni yotseguka

Nthawi zina zocheka zing'onozing'ono sizimamupatsa dotolo malo okwanira kuti athetse chotupa chonsecho. Pazochitikazi, opareshoni imachitika ngati njira yotseguka kudzera pachombo chimodzi chachikulu. Izi zimapangitsa dokotala kuwona gawo lonse lolumikizana, lomwe nthawi zambiri limafunikira zotupa kutsogolo kapena kumbuyo kwa bondo.

Nthawi zina, ochita opaleshoni amagwiritsa ntchito njira zingapo zotseguka komanso zomata panjira yomweyo.

Olowa m'malo

Ngati nyamakazi yawononga cholumikizira chomwe sichingakonzedwenso, dokotalayo amatha kutenga zonsezo kapena gawo lake. Madera owonongeka akachotsedwa, mbali zina zopangidwa ndi chitsulo, pulasitiki, kapena ceramic zimayikidwa. Zotupa nthawi zambiri sizibwerera pambuyo poti mulowe m'malo.

Kukonza matendon

PVNS ikhoza kuwononga tendon yolumikizana. Izi zikachitika, mutha kukhala ndi njira yosokera kumapeto kwa tendon.

Mafunde

Kuchita opaleshoni sikumachita bwino nthawi zonse kuchotsa chotupa chonse. Anthu ena siabwino ofuna kuchitidwa opaleshoni, kapena sakonda kukhala nawo. Pazochitikazi, ma radiation atha kukhala mwayi.

Poizoniyu amagwiritsa ntchito mafunde amphamvu kuti awononge chotupacho. M'mbuyomu, chithandizo cha radiation chinachokera ku makina kunja kwa thupi.

Mowonjezerekawonjezereka, madokotala akugwiritsa ntchito cheza cha intra-articular, chomwe chimalowetsa madzimadzi otulutsa mphamvu mu olowa.

Mankhwala

Ofufuzawa akuphunzira mankhwala ochepa a PVNS m'mayesero azachipatala. Gulu la mankhwala a biologic lingathandize kuteteza maselo kuti asatengere limodzi ndikupanga zotupa. Mankhwalawa ndi awa:

• kutuloji
• emactuzumab
• imatinib mesylate (Gleevec)
• alirezatalischi (Tasigna)
• pexidartinib

Nthawi yochira opaleshoni

Zimatenga nthawi yayitali bwanji kuti mupeze bwino zikudalira momwe mwakhalira kale. Zitha kutenga miyezi ingapo kuti muchiritse pambuyo pochitidwa opaleshoni yotseguka kwathunthu. Nthawi zambiri, opaleshoni ya arthroscopic imabweretsa nthawi yochira mwachangu kwamasabata angapo kapena ochepera.

Thandizo lamthupi ndilofunika kuti mupulumuke mwachangu. Munthawi yamagawo awa, muphunzira zolimbitsa thupi kuti mulimbitsenso ndikusintha kusinthasintha kwa olowa.

Zosintha m'moyo

Ndikofunika kupumula olumikizidwa omwe akhudzidwa ngati akupweteka, komanso mutachitidwa opaleshoni. Tengani zolumikizira zolumikizira zolemera ngati bondo ndi chiuno posakhala pamapazi anu ndikugwiritsa ntchito ndodo mukamayenda.

Kuchita masewera olimbitsa thupi nthawi zonse kumatha kukuthandizani kuti musasunthike polumikizana komanso kupewa kuuma. Katswiri wazakuthupi angakuwonetseni zomwe muyenera kuchita, ndi momwe mungachitire mosamala komanso moyenera.

Kuti muchepetse kutupa ndi kupweteka, gwirani ayezi kulumikizidwe lomwe lakhudzidwa kwa mphindi 15 mpaka 20 nthawi, kangapo patsiku. Mangani ayezi mu thaulo kuti isawotche khungu lanu.

Tengera kwina

Opaleshoni nthawi zambiri imachita bwino kwambiri pochiza PVNS, makamaka mtundu wakomweko. Pakati pa 10 peresenti ndi 30 peresenti ya zotupa zomwe zimafalikira zimayambiranso pambuyo pochitidwa opaleshoni. Mudzawona dokotala yemwe adakuchitirani zaka zingapo mutatha opaleshoni kuti muwonetsetse kuti chotupacho sichinabwerere.