Zithini iindlela zakho zolawulo lweentlungu ezingapheliyo?

Imfundo yezeMpilo

Ubuhlungu obungapheliyo buchazwa njengayo nayiphi na intlungu ehlala iinyanga ezintathu ukuya kwezintandathu okanye nangaphezulu. Ngokwesiqhelo, sisiphumo esithe ngqo semeko esempilweni enje ukwenzakala okudlulileyo, iingxaki zomqolo, ukonakala kwethambo, okanye i-fibromyalgia . Izibalo zibonisa ukuba umntu omnye kwabahlanu abadala eMelika bahlala nentlungu engapheliyo. Kwangelo xesha, iingxelo zibonisa ukuba kunjalo ngokuya engaphantsi unyango . Ukulawulwa kweentlungu ezingapheliyo kwizigulana ezineemeko ezininzi kunokuba nzima. Iqala ngokumisela unobangela.

Iintlobo zentlungu engapheliyo

Intlungu engapheliyo ihlala iwela kwiintlobo ezintathu zokuhlela:

• Intlungu ye-nociceptive Imele impendulo yesiqhelo yokuthukwa okanye yokwenzakala kwezicubu ezinje ngesikhumba, izihlunu, amalungu e-visceral, amalungu, imisipha, okanye amathambo. Umzekelo wentlungu ye-nociceptive yi-arthritis.
• Intlungu ye-Neuropathic yaziwa njengentlungu yentlungu. Luhlobo lweentlungu ezingapheliyo ezenzekayo xa iiseli zenkqubo ye-nervous system zenzakala okanye zonakaliswe. Intlungu yomqolo wentlungu, ilungu le-phantom (post-amputation) iintlungu, kunye ne-post-stroke yentlungu esembindini okanye i-shingles eminye yemizekelo yentlungu ye-neuropathic.
• Intlungu yokudumba sisiphumo sokwenza kusebenze kunye novakalelo lwendlela ye-nociceptive pain yendlela eyahlukeneyo yabalamli ekhutshwe kwindawo yokuvuvukala kwezicubu. Imizekelo yentlungu ebangelwa kukudumba ibandakanya i-appendicitis, isifo samathambo, isifo sokuqaqamba kwamathumbu, kunye neherpes zoster.

Kukho iintlobo ezithile zentlungu engapheliyo-njenge-fibromyalgia kunye neentloko zentloko-ezingenakukwazi ukuhlelwa ngokulula, kwaye ziwele ngaphandle kwezi ntlobo ziphambili. Ezi ndidi zibalulekile kuba uhlobo lwentlungu ludlala indima enkulu kwezona ndlela zonyango zinganyangekiyo ziya kusebenza kakhulu.

Ezinxulumene: Unyango lweShingles kunye namayeza

Amayeza aqhelekileyo okuphelisa iintlungu ezingapheliyo

Kukho inani lamayeza aqhele ukumiselwa abantu abaneentlungu ezingapheliyo, kubandakanya:

• Izidakamizwa ezichasayo ezichasayo kunye ne-acetaminophen: Zininzi iindidi zonyango lwe-nonsteroidal anti-inflammatory (NSAIDs). Ezinye zazo (ezinje nge ibuprofen ) inokufunyanwa ngaphezulu kwekhawuntari. Abanye, njengeMobic ( myoxicam ), ziyafumaneka ngugqirha.
• Amayeza entlungu Izithambiso ezingaphezulu kwekhawuntara zinganika isiqabu. Okanye, Amayeza amayeza e-lidocaine Ukufakwa kwindawo (iiyure ezili-12 kunye neeyure ezili-12) kunokunciphisa iintlungu.
• Uxinzelelo: Ezinye zeendidi ezindala zokuthintela uxinzelelo kunokuba luncedo kakhulu ekulawuleni iintlungu; Eyona nto iphambili kwi-tricyclic antidepressants. La mayeza anokuthomalalisa iintlungu kumayeza aphantsi kuneedosi ezifunekayo ukunyanga uxinzelelo.
• Anticonvulsants (anti-ukuhlutha) amayeza: La mayeza anokuba luncedo kakhulu kwezinye iintlobo zentlungu yentliziyo (njengokutshisa, ukudubula iintlungu).
• Ukuphumla kwezihlunu : La mayeza ahlala esetyenziswa kwimeko ebukhali yokuqaqanjelwa yimisipha.
• Iibhloko zemithambo-luvo: Oku kubandakanya inaliti kwisithuba se-epidural somqolo womqolo kunye nokubonelela ngolawulo lweentlungu zexesha elide, ngakumbi kwabo baneemeko ezingapheliyo zomqolo. Kukho iintlobo ngeentlobo zeebhloko zemithambo-luvo ezilawulwa kwisibhedlele, kwaye zixhomekeke kwindawo yomzimba ophathwayo. Ngokwesiqhelo, bajojowe kwingingqi yomqolo.
• Ibangela inaliti yenqaku: Olunye uhlobo lwenkqubo yolawulo lwentlungu lubhekiswa kuyo njengenaliti yenaliti (TPI). Lo ngumjovo oqukethe i-corticosteroid kunye / okanye i-anesthetic, kwaye ijojowe ngqo kwindawo ebangela intlungu.
• Iipioids: Xa isetyenziswe ngokufanelekileyo, ukuba amayeza angenayo i-opioid ayisebenzi okanye ayinyamezelwa, ii-opioid zinokusebenza kakuhle ekulawuleni iintlobo ezithile zentlungu engapheliyo. Zivame ukungasebenzi kakuhle okanye zifuna iidosi eziphezulu kuhlobo lwentliziyo yeentlungu. Ngentlungu ekhoyo imini nobusuku, i-opioid esebenza ixesha elide ihlala icetyiswa, kwaye inokuncediswa nge-opioid emfutshane esebenza ngokuqaqamba kwentlungu. Ingcali yolawulo lweentlungu inokuvavanya isidingo se-opioids.

Ezinxulumene: Yeyiphi eyona nto ilungileyo yokuphucula iintlungu?

Xa iintlungu zinzima, abaguli banokukhetha ukuguqukela kwiiopioids ukuze bafumane isiqabu. Nangona kunjalo, oogqirha kuye kwafuneka babambelele kwimigangatho emitsha emiselweyo emiselwe yi-U.S. Isixa sokufa okunxulumene ne-opioid siye sanda kakhulu kule minyaka imbalwa idlulileyo, eshiye oogqirha kunye nezigulana ezifumana iintlungu ezingapheliyo zifuna iindlela zokunyanga amanqanaba asezantsi ukuya kumodareyitha weentlungu ezingapheliyo.

Uncedo lwendalo olungapheliyo

Ukulawulwa kweentlungu ezingapheliyo, iindlela ezingezizo i-opioid zikhethwa, njenge:

• Olunye unyango: Kunconywe unyango olungelulo olonyango olunyango kubandakanya i-acupuncture, i-biofeedback, unyango lokuziphatha, ukuqonda, kunye nokusetyenziswa kweeyunithi ze-TENS zangaphandle. Iingxelo zibonisa ukuba ezi ndlela zolawulo lweentlungu zidityaniswe nonyango lwengqondo zisebenza kakhulu.
• Umthambo: Ukuzivocavoca ukukhanya, njenge yoga, kunokunceda kwiintlobo ezithile zentlungu engapheliyo ngokuphucula ukujikeleza kunye nokunciphisa uxinzelelo. Kusebenza ngokukodwa kwi-arthritis kunye nentlungu yangemva.
• Ubushushu nokubanda : Ukufudumeza ipads kunye nomkhenkce kunokusetyenziswa rhoqo ngeziphumo ebezingalindelekanga ezincinci ukukunceda ukulawula iintlobo ezininzi zeentlungu ezingapheliyo.
• Ukuvuselelwa kwentambo yomqolo: I-SCS lunyango olugquma imiqondiso yeentlungu ngaphambi kokuba zifike ebuchotsheni — isixhobo esincinci sifakwa emzimbeni ukuze sihambise imiqondiso kumqolo womqolo. Inokuba yinto onokukhetha kuyo ongapheliyo umva, umlenze, okanye iintlungu zengalo.

Ezinxulumene: Unyango lwe-Arthritis kunye namayeza

Iinketho zonyango lweentlungu ezingapheliyo ezivelayo

Ngenxa yokubanakho ukuba likhoboka le-opioid, abaphandi baqhubeka bekhangela ezinye iindlela ezinokuphelisa iintlungu kunokuba bazifihle.

Ukuqhubela phambili ngokuthe ngqo okwangoku, okanye Ii-TDCS , Ufumene i-traction njengendlela enokuthi isebenze engeyiyo ye-pharmacological kunyango lwentlungu engapheliyo. Uvavanyo lweklinikhi lubonakalise ukuphucuka okubalulekileyo kwintlungu ehambelana ne-osteoarthritis yamadolo.

Uphando luye lwagxininisa kwizizathu ezizimeleyo zentlungu engapheliyo. Usulelo okanye ukonzakala kunokubangela impendulo yokuzimela oko kuhlala kungabonakali, kwaye kunokubangela iintlungu ezigqithisileyo. Iipaneli ze-Antibody zinokuba lunyango olutsha lweentlungu ezingapheliyo kunye uphando kufuneka ivule iindlela ezintsha ezinomdla.

Unyango lwe-SPR wanikwa ikhontrakthi ye- $ 6 yezigidi evela kwiSebe lezoKhuseleko lase-US kuphando lwezonyango ezingezizo i-opioid. Iya kunceda ukuqhubela phambili iNkqubo ye-SPRINT yePeripheral Nerve Stimulation System kunye nokunceda ukuqhuba izilingo zeklinikhi eziphambili kwabo baphila intlungu ye-neuropathic . Yenzelwe ukuba isebenze kwimisonto yeethambo ekujolise kuyo kwaye ihlangule ukukhululeka kwentlungu ngaphandle kweeopioid.

Izixhobo zokulawulwa kwentlungu engapheliyo

Umbutho waseMelika ongapheliyo inikezela ngobutyebi bolwazi oluxabisekileyo kwabo baneentlungu ezingapheliyo. Abo ngoku bayanyangwa banokuphonononga ezinye iindlela kunye namayeza, kodwa kuhlala kulunge ukubonana nodokotela wakho kunye nosokhemesti kuqala.

Kwabo bafumene iintlungu zithathe uxinzelelo lwempilo kwimpilo yabo, t Isiseko se-US Pain inikeza uluhlu lwamaphulo okwazisa kunye namaqela enkxaso kwi-intanethi.