ICD 10. nyamakazi: Zizindikiro ndi Chithandizo

ICD 10 nyamakazi amatanthauza gulu la M: yotupa polyarthropathies. Kuwonjezera izo, pano ali JRA (Ana kapena zaumbanda nyamakazi), gout ndi zina. Zimayambitsa matenda akadali asanamvetsetse. Pali ziphunzitso zambiri zokhudza chitukuko, koma kugwirizana sanabadwe anatuluka. Akukhulupirira kuti matenda amayambitsa chisokonezo mu lamulo la chitetezo cha m'thupi mwa anthu amene predisposed kwa izo. Chifukwa cha mapangidwe tinthu kuti awononge minofu olowa. Against mfundo imeneyi zikusonyeza kuti nyamakazi (malamulo ICD - 10 M05), bwino ankachitira ndi mankhwala antibacterial.

Mbiri ya matenda

Nyamakazi - matenda akale. Milandu loyamba izo zapezeka mu kuphunzira kwa mafupa a Amwenye, amene zaka anali anayi ndi theka zaka chikwi. Mu mabuku, ikulongosola za Armenia likukwaniritsa zaka 123 a m'nthawi yathu ino. Anthu ndi zizindikiro zikusonyeza matenda Buku la zojambula za Rubens.

Monga mayunitsi nosologic nyamakazi loyamba dokotala Landrum-Beauvais m'zaka za m'ma chakhumi ndi chisanu ndi chinayi ndi dzina "asthenic gout." Dzinali pano matendawa ali theka patapita zaka, mu 1859, pamene kutchulidwa mu ndemanga pa chikhalidwe ndi mankhwalawa gout enaake ophwanya. kuzindikira ndi milandu makumi asanu, ambiri a iwo akazi pa anthu zikwi zana. Ndi 2010, chinapha anthu oposa makumi asanu ndi anayi zikwi ku Republic of Armenia mu dziko.

Etiology ndi pathogenesis

RA - matenda ambiri kuti iye anathandiza mutu mu ICD 10. nyamakazi, komanso matenda ena zimfundo ndi chifukwa cha zinthu zotsatirazi:

1. chibadwa:

- chizolowezi matenda autoimmune m'banja;

- pamaso pa kalasi yeniyeni ya chitetezo histocompatibility.

2. Matenda:

- chikuku, mumps (mumps), kupuma syncytial matenda;

- chiwindi B;

- banja lonse la nsungu mavairasi, CMV (cytomegalovirus), Epstein-Barr HIV;

- retroviruses.

3. choyambitsa zinthu:

- hypothermia;

- kuledzera;

- nkhawa, mankhwala, mahomoni disruptions.

The pathogenesis matendawa ali ndi nthenda chitetezo poyankha pamaso pa antigens selo. Lymphocytes kubala immunoglobulins ndi minofu thupi, m'malo kuwononga mabakiteriya kapena mavairasi.

chipatala

Malinga ndi ICD-10, nyamakazi akufotokozera mu magawo atatu. Mu gawo loyamba la edema anati makapisozi limodzi kamene kamayambitsa kupweteka m'thupi kutentha thupi ndiponso amasintha mawonekedwe a malo. Mu ndime yachiwiri maselo minofu, lomwe lili mkati mwa olowa kuyamba mofulumira kugawa. Choncho, synovium amakhala wakuda ndi okhwima. Mu ndime yachitatu maselo yotupa kumasula michere kuti awononge minofu olowa. Izi zimapangitsa bvuto ndi kayendedwe zaufulu ndi kumabweretsa kupunduka kwa kuthupi.

Nyamakazi (ICD10 - M05) ali ndi isanayambike pang'onopang'ono. Zizindikiro kuonekera pang'onopang'ono, zingatenge miyezi. Nthawi zina kwambiri, ndondomeko akhoza kuyamba pachimake kapena subacute. Popeza kuti matenda articular (ululu, defiguratsiya ndi kuwuka m'deralo kutentha) si pathognomonic chizindikiro ali kwambiri kovuta matenda a. Childs, mmawa stiffness (kulephera kutulutsa zoyenda mu malo) kumatenga pafupi ora, ndipo nakweza pofuna kayendedwe yogwira. A nyengo yachisanu ikupita matenda ndi molumikizana mafupa pa kusintha nyengo ndi meteosensitivity ambiri.

Embodiments matenda N'zoona

mitundu angapo osiyana cha matenda, kuti oyendetsa dokotala kuchipatala.

1. Classic pamene kuwonongeka olowa ndi symmetrical, matenda pang'onopang'ono ndipo pali zonse zofunika ake.

2. Oligoarthritis kukunda mfundo zazikulu kwambiri, kawirikawiri bondo. Izo zimayambitsa mavuto, ndi mawonetseredwe onse a kusintha mkati mwa masabata asanu kuchokera isanayambike matenda. Mu nkhani iyi, kupweteka m'malo olumikizirana mafupa ndi loopsali mu chikhalidwe, pa radiograph palibe kusintha pathological ndi mankhwala a NSAIDs (sanali steroidal odana ndi yotupa mankhwala) ndi zotsatira zabwino.

3. syndrome Felty amawapeza pamene matenda zimfundo ndi anagwirizana ndi kukulitsa khalidwe la ndulu kusintha magazi chithunzi.

4. Ana nyamakazi (ICD kachidindo 10 - M08). Mbali khalidwe ndi kuti imagwira ana kwa zaka 16. Kusiyanitsa mitundu iwiri ya matenda:

- ndi matenda allergosepticheskim;

- olowa ndi mawonekedwe choipidwa womwenso vasculitis (kutupa m'malo olumikizirana mafupa a), matenda valvular mtima, impso ndi kapepala m'mimba ndi mavuto mantha dongosolo.

Gawo

Monga momwe zinalili ndi mabungwe ena matenda osonyezedwa mu ICD 10, nyamakazi ali classifications angapo.

1. chipatala mawonetseredwe:

- m'banda zizindikiro lolimba kwa miyezi isanu ndi umodzi;

- oyambirira, ngati matenda amatenga chaka;

- mwatsatanetsatane - kwa miyezi 24;

- mochedwa - ndi nthawi ya matenda a zaka zoposa ziwiri.

2. Radiographic gawo:

- Choyamba. Pali thickening ndi compaction a minofu zofewa ya olowa, matumba lakutali la kufooka kwa mafupa.

- Chachiwiri. kufooka kwa mafupa ndondomeko analanda onse epiphysis fupa, malo olowa kuchepetsa, awonekere kukokoloka chichereŵechereŵe;

- Chachitatu. Mapindikidwe fupa epiphysis, dislocations juga ndipo subluxations;

- Chachinayi. Ankylosis (kusapezeka malo olowa).

3. Immunological mapangidwe:

Pakuti chinthu rheumatoid:

- seropositive nyamakazi (ICD10 - M05.0). Izi zikutanthauza kuti wodwala wapezeka mwazi wa chinthu rheumatoid.

- seronegative nyamakazi.

Kwa chitetezo kwa ozungulira tsitrullinovomu peputayidi (wotsutsa-CCP):

- seropositive nyamakazi;

- seronegative nyamakazi (ICD10 - M06).

4. zinchito kalasi:

• The choyamba - kupulumutsa mitundu yonse ya zinthu.
• Chachiwiri - linaphwanya ntchito akatswiri.
• Chachitatu - anapitiriza luso kudzimvera utumiki.
• Chachinayi - linaphwanya mitundu yonse ya zinthu.

Nyamakazi ana

Zaumbanda nyamakazi ICD 10 monga gulu osiyana - monga matenda autoimmune wa ana. Nthawi zambiri, ana kugwa kudwala pambuyo matenda lolemera, katemera kapena kupwetekedwa mafupa. The synovium osauka aseptic kutupa imbaenda kudzikundikira kwambiri a madzimadzi mu olowa M'mimbamo ululu, ndipo kenako - khoma thickening ya kapisozi olowa ndi kum'mamatira kuti chichereŵechereŵe lapansi. Patapita nthawi, chichereŵechereŵe anawonongedwa, ndipo mwanayo amakhala olumala.

chipatala kusiyanitsa rekodi -, oligo - ndi polyarthritis. Pamene chidwi ndi olowa mmodzi, ndi, motero, monoarthritis. Ngati kusintha pathological imvera mfundo inayi, izo oligoarthritis. Polyarthritis anapezeka ndi kugonjetsedwa kwa pafupifupi onse malo. Kutalikirana monga zokhudza zonse nyamakazi, ndipo pamene amakhudza ziwalo zina kupatula mafupa a.

diagnostics

Pofuna kuti matenda, muyenera bwino ndi kwathunthu kusonkhanitsa anamnesis, kuchititsa MAGAZI amuzolengedwa, X-ray kuti zimfundo ndi serodiagnosis.

Kuyesa kwa magazi dokotala amasamalirira kwa erythrocyte mlingo sedimentation, rheumatoid chinthu, nambala ya maselo magazi. The zapamwamba kwambiri panthawi ndi kudziwika odana CCP, amene anali olekanitsidwa mu 2005. Ndi chizindikiro kwambiri yeniyeni, yomwe ndi pafupifupi zopezeka mu magazi odwala, mosiyana ndi chinthu rheumatoid.

chithandizo

Ngati wodwala zowawa ndi matenda kapena ali pachimake, amasonyeza chapadera mankhwala mankhwala. Posankha ndi mankhwala amamvetsera kuopsa kwa matenda articular. Monga ulamuliro, akuyamba ndi mankhwala nonsteroidal odana ndi yotupa ndi pa nthawi yomweyo corticosteroids kwapakati pa-articular ndi mwanayo. Komanso, monga RA - matenda autoimmune, wodwala ayenera plasmapheresis kuthetsa maofesi onse m'thupi kwa thupi.

Chithandizo kawirikawiri yaitali ndipo akhoza anachedwa kwa zaka. Ichi ndi chifukwa chakuti mankhwala osokoneza bongo atasunga zimakhala ndi. Imodzi ya mphindi chifungulo cha mankhwala ndi chithandizo cha kufooka kwa mafupa. Kuti tichite zimenezi, wodwalayo amafunsidwa kulemekeza kudya zakudya zapadera ndi okhutira mkulu kashiamu (mkaka, amondi, walnuts, hazelnuts), ndi kutenga kashiamu ndi vitamini D.