ICD 10. ramatiking e ruruhisang Ramatiki: Matšoao le Phekolo

ICD 10 ramatiki e bua ka sehlopha sa tsa M: hlabang polyarthropathies. Ho phaella ho eona, mona ke JRA (ya mike mike kapa ya mike mike ramatiki), gout le tse ling. Lisosa tsa lefu lena e ntse e sa utloisise ka ho feletseng. Ho na le likhopolo tse 'maloa mabapi le ntshetsopeleng lona, empa tumellano e-s'o hlaha. Ho lumeloa hore tšoaetso bakang tšitiso ka molao oa tsamaiso ea boitshireletso ba mmele ka batho ba ua tsoaroa ke ho eona. Ka lebaka la sebōpeho sa limolek'hule hore timetsa dinama tse nyenyane tse kopanetsoeng. Khahlanong le khopolo ena e bontša hore ramatiki (khoutu ICD - 10 M05), hampe tšoaroa ka lithethefatsi antibacterial.

Histori ea lefu lena

Ramatiki - lefu lena boholo-holo. The Maemong a pele ea ho 'nile ha fumanoa ka ho ithuta tsa lithotsela tsa Maindia a, eo lilemo e ne e le ka tse' nè le halofo lilemo tse sekete. Ka lingoliloeng, tlhaloso ya Armenia kopana le lilemo tse 123 tsa puso ea rona. Batho ba nang le matšoao a tloaelehileng tsa lefu li ne li tšoantšetsoa ka litšoantšo tsa Rubens.

Ka diyuniti nosologic ramatiki pele o ile a hlalosa ngaka Landrum-Beauvais mathoasong a lilemo ea leshome le metso e robong le e mong ea bitsoang e "asthenic gout." lebitso la eona hona joale ea lefu lena le nang le halofo lilemo tse lekholo hamorao, ka 1859 ho, nakong ea ho buuoa ka treatise ka mofuta le kalafo ea gout rheumatic. hlwaya le Maemong a mashome a mahlano, 'me boholo ba tsona basali ka batho ba makholo a likete. Ka selemo sa 2010, ea bolaea batho ba fetang mashome a mane e robong tse sekete ho tswa Republic of Armenia lefatšeng.

Etiology le pathogenesis

RA - kula atile hoo le o tlatselitse khaolo e ka ICD 10. ramatiking e ruruhisang ramatiki, hammoho le mafu a mang a manonyeletso, bakoang ke lintlha tse latelang:

1. lefutso:

- tšekamelo ea ho mafu autoimmune ka lapeng;

- ho ba teng ha ka sehlopha sa itseng tsa lisireletsi histocompatibility.

2. tšoaetso:

- maselese, mumps (mumps), ho hema syncytial tshwaetso;

- lefu la sebete B;

- ho lelapa kaofela herpes livaerase, CMV (cytomegalovirus), Epstein-Barr kokoana-hloko;

- retroviruses.

3. tsosang lintlha:

- hypothermia;

- botahoa;

- khatello ea kelello, meriana, hormonal disruptions.

The pathogenesis ya lefu lena le ke ka e sa tloaelehang sesole a arabela ho ba teng ha antigens seleng. Lymphocytes hlahisa immunoglobulins khahlanong le dinama tse nyenyane tse 'mele, ho ena le ho timetsa libaktheria kapa likokoana-hloko.

Tleliniki

Ho ea ka ICD-10, ramatiki develops ka mekhahlelo e meraro. Ka ho ba sethaleng sa pele sa edema hlokomela capsules kopanetsoeng, e leng ho ba utloisa bohloko, feberu le fetola sebopeho sa manonyeletso. Ka mohato oa bobeli lisele dinama tse nyenyane tse, e leng koahela ka hare tsa kopanetsoeng qala ho ka potlako ho arola. Ka lebaka leo, synovium fetoha teteaneng le thata. Ka mohato oa boraro lisele tse hlabang lokolla enzyme hore timetsa dinama tse nyenyane tse kopanetsoeng. Sena se etsa hore bothata ba ka mekhatlo ea boithatelo 'me ho etsa hore ka likoli tse matla' meleng.

Ramatiki (ICD10 - M05) o na le ho qala butle-butle. Matšoao a hlaha butle-butle, ho ka nka likhoeli. Maemong a sa tloaelehang haholo, tshebetso ka qala a hlobaetsang kapa subacute. 'Nete ea hore lefu articular (bohloko, defiguratsiya le phahama ea moo mocheso) hase pathognomonic letšoao ke haholo thata ho hlahloba lefu lena. Ka tloaelo ho, hoseng ho satalla (hloleha ho hlahisa tshisinyo ka manonyello a) nka ka hora, 'me e Amplified ha leka mekhatlo mafolofolo. A selelekela sa lefu lena le ke bohloko kopanetsoeng nakong liphetoho meteo le meteosensitivity kakaretso.

Embodiments tlelenike thupellong

variants 'maloa fapaneng ya lefu lena le, e le hore ba lokela ho Bochabela ngaka tliliniking ya.

1. Classic ha tšenyo e kopanetsoeng ke ditshwani, lefu lena le tsoela pele butle ebile e le ho na le tsohle tsa precursors lona.

2. Oligoarthritis ho hlōla manonyeletso kholo ka ho fetisisa, hangata lengole. E qala hampe, 'me liponahatso kaofela reversible ka hare ho libeke tse tšeletseng ho tloha qala ho ea lefu lena. Tabeng ena, ho bohloko manonyeletso li hloka botsitso linthong tsa tlhaho, ka radiograph ho na liphetoho pathological le kalafo ea NSAIDs (bao e seng steroidal-ba khahlanong le a hlabang lithethefatsi) ba le le phello e ntle.

3. lefu Felty e fumanoa ha lefu la manonyello a ikopanya ka kholiso bath ea spleen liphetoho mali setshwantsho.

4. ya mike mike ramatiki (ICD khoutu 10 - M08). A tsobotsi bath ke hore ho ama bana ba ho fihlela ho lilemo tse 16. Khetholla mefuta e 'meli ea le lefu lena:

- le lefu allergosepticheskim;

- e kopanetsoeng 'me mofuta o visceral e kenyeletsang vasculitis (ho ruruha ea manonyello a), lefu valvular pelo, liphio le pampitšana tshilong ya dijo,' me mathata a tsamaiso ea methapo.

tlhophiso

Joalokaha ke le nehile tsa mekhatlo e meng lefu, joalokaha bontšoa ke ICD 10, ramatiki e na classifications 'maloa.

1. Clinical liponahatso:

- haholo pele ha matšoao a nka ho fihlela ho likhoeli tse tšeletseng;

- pele ho nako, ha lefu lena le nka ho fihlela ho selemo;

- qaqileng - ho fihlela ho likhoeli tse 24;

- morao - ka nako ya ho kula ka lilemo tse fetang tse peli.

2. Radiographic sethaleng:

- Pele. Ho na le thickening le compaction ya dinama tse nyenyane tse bonolo tsa kopanetsoeng, lipokothong thōko sa osteoporosis.

- Ea bobeli. osteoporosis thulaganyou e hapa tsohle epiphysis lesapo, sebaka kopanetsoeng narrowing, hlaha ka khoholeho ea mobu lefufuru;

- Ea boraro. Deformation lesapo epiphysis, dislocations tloaela ho le subluxations;

- Ntlha ea bone. Ankylosis (ka ho feletseng ba sieo ha sebaka kopanetsoeng).

3. Immunological characterization:

Bakeng sa ntlha e ruruhisang:

- seropositive ramatiki (ICD10 - M05.0). Sena se bolela hore le mamello e lemoha maling a Ntlha e ruruhisang.

- seronegative ruruhisang ramatiki.

Bakeng sa lisireletsi ho cyclic tsitrullinovomu peptide (-ba khahlanong le CCP):

- seropositive ramatiki;

- seronegative ramatiki (ICD10 - M06).

4. tshebetso sehlopha sa:

• Pele - ho boloka mefuta eohle ea mesebetsi.
• Ea bobeli - hataketse mosebetsi litsebi.
• Ea boraro - bolokoa le matla a ho ho intša tšebeletso.
• Bone - hataketse mefuta eohle ea mesebetsi.

Ramatiki ka bana

Mike mike ramatiki ICD 10 ka sehlopha arohaneng - ka e le lefu le autoimmune tsa bana ba banyenyane. Hangata ka ho fetisisa, bana ba oela kula ka mor'a tshwaetso boima, ente kapa ho sithabela manonyeletso. The synovium ntseng li hōla moruong aseptic ruruha leng isang bokella ka tsela e feteletseng ea mokelikeli ka kopanetsoeng cavity, bohloko, 'me qetellong - ho leboteng thickening ea komiki e kopanetsoeng le khomarelang ho lefufuru la. Ka mor'a nako e itseng, ka lefufuru e timetsoa, 'me ngoana e ba nang le bokooa.

tleliniking khetholla mono, -, oligo - le polyarthritis. Ha a otloa ke e kopanetsoeng le 'ngoe feela, e, ka ho latellana, monoarthritis. Haeba liphetoho pathological angoa ke ho manonyeletso ho fihlela ho tse 'nè, ho oligoarthritis. Polyarthritis na le boloetse ba ho hlōloa ha hoo e ka bang tsohle manonyeletso. Isolated ka systemic ramatiki, 'me ha ama litho tsa ka hare tse ling tse ntle le masapo ea.

tlhathoba

E le ho etsa hlahloba, u lokela ho hantle le ka botlalo bokella anamnesis, tsamaisa liteko mali skeletal, X-ray ho etsa manonyello le serodiagnosis.

Teko ea mali ngaka lefang a lebisa tlhokomelo ho erythrocyte sekhahla sedimentation, ruruhisang Ntlha e, palo ea lisele tsa mali. The e tsoetseng pele ka ho fetisisa ka nako eo ke ba bonoa ba-ba khahlanong le CCP, e neng e ka thōko ka 2005. Ke pontshi haholo itseng, eo e ka hoo e ka bang kamehla o teng maling a bakuli, ho fapana ho Ntlha e ruruhisang.

kalafo

Ha mokuli a utloa bohloko e tshwaetso kapa o ka e tletseng ballon, o bontša itseng lithibela-mafu phekolo. Ha khetha meriana patala a lebisa tlhokomelo ho tiea tsa lefu articular. E le busa, e qala ka lithethefatsi nonsteroidal-ba khahlanong le a hlabang le ka nako e tšoanang corticosteroids intra-articular li tsamaisoa. Ho phaella moo, e le RA - lefu autoimmune, mokuli hloka plasmapheresis ho felisa mehahong tsohle boitshireletso le 'mele.

Phekolo ke hangata e telele le ka lieha ka lilemo. Sena ke ka ntlha ya go ha e le hantle hore lithethefatsi li bokeletseng lisele ka. E 'ngoe ea linako tse senotlolo sa phekolo ke kalafo ya osteoporosis. Ho etsa sena, ho ba le mamello e ile a botsa hore ba hlomphe le ho ja e khethehileng le dikahare tse phahameng tsa khalsiamo (lihlahisoa tsa lebese, lialmonde, walnuts, makotomane), le ho nka k'halsiamo le vithamine D.