ICD 10. samathambo, isifo sokuqaqamba kwamalunga: Izimpawu kanye Ukwelashwa

ICD 10 samathambo libhekisela isigaba M: polyarthropathies ukuvuvukala. Ngaphezu ke, nazi JRA (Juvenile noma sokuqaqamba kwamalunga engamahlongandlebe rheumatoid), sifo nezinye. Izimbangela lokhu sifo akukaqondwa ngokugcwele. Kunemibono eminingana mayelana nentuthuko yayo, kodwa ukuvumelana ongakabi sekukhona. Kukholakala ukuthi ukutheleleka kubangela ukuphazamiseka ukulawulwa izivikeli mzimba e abantu beyizidlova. Ngenxa yalokho kwetinhlavu molecule ukubhubhisa izicubu ngokuhlanganyela. Ukukhombisa ukuphikisana nalokhu mbono rheumatoid arthritis (i ikhodi ICD - 10 M05), kahle baphathwe izidakamizwa elwa namagciwane.

Umlando isifo

Rheumatoid arthritis - lesi sifo lasendulo. Amacala lokuqala ke, kuye kwatholakala ekutadisheni amathambo amaNdiya, ogama ubudala waba kungathi izinkulungwane ezine nengxenye edlule. Esikhathini izincwadi, incazelo Armenia ihlangabezana iminyaka 123 ezitholakala kule nkathi yethu. Abantu nge ejwayelekile izimpawu zesifo bachazwa ku zabalingiswa Rubens.

Njengoba amayunithi nosologic samathambo owokuqala owachaza lesi udokotela landrum-Beauvais ekuqaleni kwekhulu nesishiyagalolunye wawuqamba "sifo asthenic." ngegama lalo lamanje lesi sifo has kamuva isigamu sekhulu leminyaka ngo-1859, ngesikhathi kukhulunywa ngo indatshana ubunjalo kanye nokwelashwa sifo rheumatism. ukuhlonza kanye amacala ayisihlanu, iningi labo abesifazane ngamunye abantu abayizinkulungwane ezingamakhulu. Ngu-2010, abantu abangaphezulu kuka-amane nesishiyagalolunye namakhulu eRiphabhlikhi Armenia emhlabeni.

Etiology futhi pathogenesis

RA - ukugula ezivame kangaka ukuthi kunikela isahluko e-ICD 10. Isifo samathambo, kanye nezinye izifo ngisho namalungu, kubangelwa lezi zinto ezilandelayo:

1. Ufuzo:

- ukuthambekela izifo sokuhlasela kwamasosha omzimba emkhayeni;

- khona isigaba ezithile histocompatibility amasosha omzimba.

2. ezithathelana:

- isimungumungwane, mumps (mumps), zokuphefumula ukutheleleka syncytial;

- ukusha kwesibindi kohlobo B,

- wonke umndeni herpes amagciwane, CMV (cytomegalovirus), Epstein-Barr igciwane;

- retrovirus.

3. Trigger izici:

- hypothermia;

- ukudakwa;

- ukucindezeleka, imithi, ukuphazamiseka kwama-hormone.

I pathogenesis lesi sifo kuyinto okungavamile izivikeli mzimba impendulo yokubakhona antigen amangqamuzana. Ama-lymphocyte ukukhiqiza immunoglobulin, ayisiza ngokumelene izicubu emzimbeni, hhayi ebulalayo amagciwane noma ama-virus.

umtholampilo

Ngokwe-ICD-10, i-rheumatoid arthritis eba ngezigaba ezintathu. Ngo esigabeni sokuqala edema waphawula amaphilisi ngokuhlanganyela, elibangela ubuhlungu, imfiva kanye kushintsha ukuma emalungeni. In the isinyathelo sesibili amaseli izicubu, ehlanganisa ingaphakathi joint baqale ngokushesha sokuhlukanisa. Ngakho-ke, i-synovium iba obukhulu futhi kube lukhuni. In the isinyathelo sesithathu amaseli ukuvuvukala ukukhulula enzyme ukuthi ababhubhise izicubu ngokuhlanganyela. Lokhu kubangela ubunzima ukunyakaza yokuzithandela futhi kuholela ukukhubazeka ngokomzimba.

rheumatoid arthritis (ICD10 - M05) has a kuqala kancane kancane. Izimpawu avele kancane kancane, kungase kuthathe izinyanga. Ezimweni ezingavamile kakhulu, inqubo usungaqala oyingozi noma subacute. Iqiniso ukuthi articular syndrome (ubuhlungu, defiguratsiya nowasekhaya lokushisa rise) akuyona uphawu pathognomonic kakhulu nzima ukuhlonza isifo. Ngokuvamile, ekuseni ukuqina (ukungakwazi ukukhiqiza ukunyakaza emalungeni) ihlala cishe ihora, futhi iyakhula lapho sizama ukunyakaza asebenzayo. A kuzalwa lesi sifo ubuhlungu bamalunga phakathi izinguquko sezulu kanye meteosensitivity jikelele.

Embodiments Yiqiniso emitholampilo

ezahlukeneyo eziningana abahlukene lesi sifo, ukuthi kufanele Orient udokotela emtholampilo.

1. Classic lapho umonakalo Ilunga kulapho ziyalingana, lesi sifo sanda kancane kancane futhi kukhona zonke kokumethemba yayo.

2. Oligoarthritis ukunqoba emalungeni esikhulu kakhulu, ngokuvamile kwedolo. Iqala kabi, futhi kuwukubonakaliswa esethola engakapheli amasonto ayisithupha ukusuka ekuthomeni lesi sifo. Kulokhu, ubuhlungu emalungeni kukhona oluyingozi ngokwemvelo, kwi-radiograph akukho izinguquko sokugembula kanye nokwelashwa ama-NSAID (non-steroidal izidakamizwa eqeda ukuvuvukala) nethonya elihle.

3. Felty sifo sitholakale lapho isifo emalungeni wahlanganyela kweNdikimba nobuntu ubende igazi isithombe izinguquko.

4. Juvenile rheumatoid arthritis (i ikhodi ye-ICD-10 - M08). Sici sici ukuthi esizithinta ngayo izingane kuze kube iminyaka engu-16. Hlukanisa izinhlobo ezimbili isifo:

- ne allergosepticheskim syndrome;

- ngokubambisana kanye ifomu visceral okuhlanganisa vasculitis (ukuvuvukala emalungeni), valvular isifo senhliziyo, izinso kanye ipheshana wokugaya ukudla, futhi ethukile izinkinga ohlelweni.

ngezigaba

Njengasendabeni yabase yezinye izinhlangano isifo eyaziwako ICD-10, i-rheumatoid arthritis has ngeengaba eziningana.

1. ukubonakaliswa Clinical:

- zibekwa lapho izimpawu kuhlale sikhatsi lesingaba tinyanga letisitfupha;

- ekuseni, uma isifo ihlala kufika unyaka;

- enemininingwane - izinyanga 24;

- ngasekupheleni - nge ubude ukugula ngemva kweminyaka engaphezu kwemibili.

2. Radiographic esiteji:

- Okokuqala. Kukhona ukuqina futhi compaction we izicubu zomzimba ezithambile we ngokuhlanganyela, emaphaketheni angawodwa kwamathambo.

- Okwesibili. inqubo kwamathambo esiqukethe zonke ithambo epiphysis, ngokuhlanganyela isikhala ukuvaleka, ivele ku uqwanga ukuguguleka;

- Okwesithathu. Deformation ithambo epiphysis, dislocations komkhuba kanye subluxations;

- Okwesine. Ankylosis (sokungabi nhlobo isikhala ngokuhlanganyela).

3. kwebalingisi Immunological:

Ukuze isici rheumatoid:

- seropositive-rheumatoid arthritis (ICD10 - M05.0). Lokhu kusho ukuthi isiguli itholwa egazini isici samathambo.

- seronegative-rheumatoid arthritis.

Ukuze amasosha omzimba eyindilinga tsitrullinovomu peptide (anti-CCP):

- seropositive samathambo;

- seronegative samathambo (ICD10 - M06).

4. Isigaba Functional:

• Eyokuqala - ukulondoloza zonke izinhlobo zemisebenzi.
• Okwesibili - wephule umsebenzi okhokhelwayo.
• Okwesithathu - agcinwayo ikhono self-service.
• Okwesine - wephule zonke izinhlobo zemisebenzi.

rheumatoid arthritis ezinganeni

Juvenile rheumatoid arthritis ICD 10 njengoba wodwana - njengenhlangano isifo sokuhlasela kwamasosha omzimba kwezingane ezincane. Ngokuvamile, izingane ukugula ngemva igciwane ezisindayo, ngomgomo noma ukuhlukumezeka amalunga omzimba. I synovium ekuthuthukiseni ukuvuvukala aseptic okuholela ekuqongeleleni ngokweqile uketshezi emalungeni ingaphakathi, ubuhlungu, futhi ekugcineni - ku odongeni ukuqina egobolondweni lelunga futhi sinamathele yona uqwanga. Ngemva kwesikhathi esithile, uqwanga uyabhujiswa, kepha ingane iba ekhubazekile.

Umtholampilo ukuhlukanisa mono -, oligo - futhi polyarthritis. Lapho ehlaselwa ngokuhlanganyela eyodwa kuphela, it is, ngokulandelana, monoarthritis. Uma izinguquko sokugembula angaphansi emalungeni afika kwamane, ke oligoarthritis. Polyarthritis banalesi kokunqotshwa cishe wonke amalunga omzimba. Behlukene njengoba letindzala samathambo, futhi lapho kuthinta nezinye izitho ngaphandle skeleton.

ukuhlola

Ukuze lokwenza ukuxilongwa, kudingeka kahle futhi ngokugcwele ukuqoqa anamnesis, ukuqhuba ukuhlolwa kwegazi kwamakhemikhali, x-ray ukuze babone ukwenza amalunga serodiagnosis.

Ukuhlolwa kwegazi udokotela uyazinaka le-erythrocyte sedimentation isilinganiso, i-rheumatoid isici, inani egazi. Athuthukisiwe kakhulu okwamanje iyona ukuthola anti-CCP, okuyinto ahlukanisa ngo-2005. Kuyinto Inkomba ethize kakhulu, okuyinto cishe ngaso sonke isikhathi igazi iziguli, ngokungafani kuya isici samathambo.

ukwelashwa

Uma isiguli wahlupheka ngegciwane noma yena ngawo ugcwaliseka ngokugcwele, ubonisa yokwelapha ethile antibiotic. Uma ukhetha imithi unaka kobukhulu articular syndrome. Njengomthetho, iqala izidakamizwa nonsteroidal eqeda ukuvuvukala futhi ngesikhathi esifanayo naphakathi-articular corticosteroids ephathwa ngayo. Ngaphezu kwalokho, njengoba RA - isifo sokuhlasela kwamasosha omzimba, isiguli udinga plasmapheresis ukuqeda zonke izakhiwo okuzivikela umzimba.

Ukwelashwa ngokuvamile eside futhi zingase zephuze iminyaka. Lokhu kungenxa yokuthi izidakamizwa baye emisipheni. Omunye izikhathi ayisihluthulelo yokuyelapha ekwelapheni kwamathambo. Ukuze wenze lokhu, isiguli uyabuzwa ukuhlonipha olukhethekile lokudla ngokuqukethwe eliphezulu calcium (nemikhiqizo yobisi, nama-alimondi, walnuts, hazelnuts), futhi ukuthatha calcium kavithamini D.