Shirin Gudanarwa Daga ACR da EULAR
An saki jagorancin kula da polymyalgia rheumatica (PMR) a cikin watan Satumba na 2015, a matsayin wani ɓangare na kokarin hadin gwiwa tsakanin Cibiyar Rheumatology na Amirka (ACR) da Ƙungiyar Turai ta Rheumatism (EULAR). Sharuɗɗa shine farkon sa na shawarwari na duniya don kulawa da kulawa da marasa lafiya tare da polymyalgia rheumatica.
Menene Polymyalgia Rheumatica?
An kiyasta cewa kimanin yara 711,000 na Amurka suna da polymyalgia rheumatica - yanayin da yakan bunkasa hankali. Duk da yake bayyanar cututtuka na iya bunkasa ba zato ba tsammani, wannan ba ya saba da polymyalgia rheumatica. Kwayoyin cututtuka sun haɗa da haɗakar ƙwayoyin ƙwayoyin cuta, tare da kwatangwalo da kafadu da dama, da kuma manyan makamai, wuyansa, da ƙananan baya. Yawancin lokaci babu kumburi daga cikin gidajen. Yana yiwuwa a samu rheumatica polymyalgia tare da wani cuta na rheumatic . Akwai bambanci mai yawa a lura da kwayar polymyalgia rheumatica, irin su lokacin da za a yi amfani da glucocorticoids ko maganin cututtuka na anti-rheumatic (DMARDs) da kuma tsawon lokacin.
Ka'idoji da shawarwari don Manajan PMR
Ka'idodin 2015 da ACR da EULAR suka bayar sun haɗa da ka'idoji masu mahimmanci da takamaiman shawarwari game da samun damar kula da lafiyar, kulawa da kwararru, biyan bukatun, da kuma hanyoyin dabarun magani.
An ba da shawarwarin musamman kamar:
- "da karfi da shawarar" lokacin da shaida ta nuna wani muhimmin amfani tare da kadan ba tare da hadarin ba
- "yanayin" lokacin da kadan ya kasance shaida mai zurfi na amfani ko kuma lokacin da amfani ba ta da muhimmanci sosai wajen rage hadari
Ka'idodi masu mahimmanci sun haɗa da:
- Tsayar da wata hanya don gano polymalgia rheumatica, tare da gwagwarmaya kimantawa game da ban da yanayin da mimic polymyalgia rheumatica.
- Kafin yin bayani, kowane shari'ar ya kamata a samu sakamakon binciken gwaje gwaje-gwaje.
- Dangane da alamu da bayyanar cututtuka, dole ne a umarci ƙarin gwaje-gwaje don ƙyale yanayin haɓaka. Dole ne a ƙaddara hadaddun abubuwa. Dole ne a yi la'akari da abubuwan haɗari na sake dawowa ko yin magani mai tsawo.
- Dole ne a ba da hankali ga mahimmin kwararru.
- Dole ne a raba magunguna da likita.
- Dole ne marasa lafiya suyi amfani da shirin magance kwayoyin halitta na polymyalgia rheumatica.
- Dole ne marasa lafiya su sami damar samun ilimi game da maganin rheumatica da kuma kulawa da polymyalgia.
- Kowane mai haƙuri da ake bi da shi don polymyalgia rheumatica ya kamata a kula ta hanyar yin la'akari da takaddama. A cikin shekarar farko, ana iya ganin marasa lafiya kowane mako 4 zuwa 8. A cikin shekara ta biyu, an yi ziyartar ziyara a kowane makonni 8-12. Kulawa ya kamata ya zama kamar yadda ake buƙata don sake dawowa ko don yin amfani da shi.
- Dole ne marasa lafiya su sami dama ga masu sana'a na kiwon lafiya suyi rahoton canje-canje, irin su fushi ko abubuwa masu ban mamaki.
Mahimman shawarwari don gudanarwa na polymyalgia rheumatica sun hada da:
- Shawarwari mai karfi don amfani da glucocorticoids maimakon NSAIDs (kwayoyin masu maganin ƙwayoyin cuta ba tare da kariya ba), sai dai wani gajeren lokaci na NSAIDs ko analgesics a marasa lafiya tare da ciwo da suka shafi sauran yanayi.
- Ƙwararriyar ƙarfafawa don ƙananan tasiri gwargwadon glucocorticoid (watau, yi amfani da miyagun ƙwayoyi don ɗan gajeren lokacin da ake buƙata don samun amsa mai dadi).
- Bayanin ka'ida don ƙananan sakamako na farko na glucocorticoids tsakanin 12.5 da 25 MG prednisone daidai yau da kullum. Zai yiwu a yi la'akari da matakin mafi girma ga wadanda ke da haɗari na haɗuwa da kuma hadarin abubuwan da suka faru. Za a iya la'akari da ƙananan kashi ga waɗanda ke da haɗuwa ko wasu abubuwa masu haɗari don sakamakon illa da suka danganci amfani da glucocorticoids. An dauki kashi na farko na 7.5 MG / rana da katsewar yanayin, kuma an fara maganin maganin 30 mg / rana.
- Ƙarfafawa mai karfi don ƙaddamar da jigilar tarwatsawa tare da saka idanu akai-akai. Shirin da aka ba da shawara don farawa ta farko shi ne ya ragu zuwa kashi na 10 na moriya na 10 mg kowace rana a cikin kwanaki 4 zuwa 8. Don sake farfasawa, maganin da ya kamata ya kamata a karu zuwa kashi wanda yayi haƙuri kafin ya sake dawowa sannan ya rage a hankali a kan makonni hudu zuwa takwas zuwa kashi wanda ya sake dawowa. Da zarar an sami gafartawa, za'a iya yin amfani da 1 MG kowane mako 4 ko kuma ta 1.25 MG ta amfani da wani lokaci na rana har sai an yanke shawarar, kuma ba za a rushe remission ba.
- Bayanin ka'ida don amfani da methylprednisolone na intramuscular maimakon ko glucocorticoids na baki.
- Bayanin ka'ida don kashi guda maimakon kashi na yau da kullum na glucocorticoids.
- Bayanin ka'ida don amfani da matakan da suka dace da glucocorticoids, musamman ga wasu marasa lafiya.
- Shawara mai karfi game da amfani da masu fashewa na TNF .
- Shawarar ka'ida don tsarin aikin motsa jiki don kula da ƙwayar tsoka da aiki, kazalika da rage haɗarin lalacewar .
- Shawara mai karfi game da amfani da shirye-shiryen kayan lambu na kasar Sin Yanghe da Biqi.
Sources:
2015 Shawarwari don Gudanar da Rhythmic Rheumatica. Dejaco C. et al. Arthritis & Rheumatology Vol. 67 A'a. 10. Oktoba 2015.
http://www.rheumatology.org/Portals/0/Files/2015%20PMR%20guidelines.pdf
Polymyalgia Rheumatica. Kwalejin Amirka na Rheumatology. Updated Yuni 2015.
http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Polymyalgia-Rheumatica