ICD 10. Rheumatoid Arthritis: Calaamadaha iyo Daaweynta

ICD 10 rheumatoid arthritis loola jeedaa fasal ee M: polyarthropathies bararka. Intaa waxaa dheer in ay, halkan waa JRA (Juvenile ama dhallinta rheumatoid arthritis), turqo iyo kale. Sababaha cudurkan waxaa weli aan si buuxda u fahamsan yahay. Waxaa jira aragtiyo dhowr ah oo ku saabsan dhinaca horumarinta, laakiin loo dhanyahay ayaa weli ma soo baxay. Waxaa la rumeysan yahay in cudurka sababa rabshooyin in xeerka nidaamka difaaca jirka ee dadka hiddaha, waxa uu. Sidaas darteed of formation of taagoo in baabbi'in unugyada wadajir ah. Against aragtida this soo jeedisay in (ICD code - 10 M05) rheumatoid arthritis, si xun loola dhaqmo dawooyinka bakteeriyada.

Taariikhda cudurka

Rheumatoid arthritis - Cudurka qadiimiga ah. The xaaladaha ugu horeysay waxaa ka mid ah ayaa laga helay waxbarasho oo ka mid ah Qalfoofkii ee Hindida, kuwaas oo da 'ahaa in ku dhow afar iyo badh kun oo sano. In suugaanta, sharaxaad ku saabsan Armenia buuxiya 123 sano our Zaman. Dadka qaba calaamadaha caadiga ah ee cudurka ayaa lagu sawiray ee farshaxanka ee Rubens.

Sida unugyada nosologic rheumatoid arthritis horeysay tilmaamay dhakhtar Landrum-Beauvais horrantii qarnigii sagaal iyo tobnaad iyo waxa la odhan jiray "turqo asthenic." Its magaca joogo cudurka uu leeyahay qarnigii badh ka dib, ee 1859, inta lagu guda jiro Xusuuso ah oo khuseeya a on dabeecadda iyo daaweynta turqo rheumatic. aqoonsado iyo konton kiisaska, inta badan oo ka mid ah haweenka halkii boqol oo kun oo qof. By 2010, lagu dilay in ka badan sagaal iyo afartan kun oo qof oo ka Republic of Armenia ee dunida.

Etiology iyo pathogenesis

RA - cudur si caadi ah in ay ka qayb qaatay cutub ee arthritis ICD 10. Lafa, iyo sidoo kale cudurada kale ee laabatooyinka, sababa arrimaha soo socda:

1. Hidduhu:

- janjeera in ay shalalka in qoyska;

- joogitaanka of class gaar ah antibodies histocompatibility.

2. Cudurka:

- jadeecada, qaamo-qashiir (mumps), cudurka syncytial neefsashada;

- hepatitis B;

- qoyska reer fayrusyada herpes oo dhan, CMV (cytomegalovirus), virus Epstein-Barr;

- retroviruses.

3. arrimo ay kiciyaan:

- hypothermia,

- sarkhaan,

- stress, daawo, khalkhal hormoon.

pathogenesis cudurka waa in an habka difaaca jawaab aan caadi ahayn in joogitaanka cudur cell. Limfosaytis soo saaro immunoglobulins ka dhanka ah unugyada jirka, halkii ay wax ku baabbi'iyo bakteeriya ama fayras.

rugta caafimaadka

Sida laga soo xigtay ICD-10, rheumatoid arthritis yeesho in saddex marxaladood. In marxaladda ugu horeysa ee bararka arkay kaabsoosha wadajir ah, kaas oo keena xanuun, qandho iyo badala qaabka laabatooyinka. In talaabada labaad unugyada nudaha, kaas oo daboolaya gudaha wadajir ah u bilaabaan inay si degdeg ah ugu qaybinaya. Sidaa darteed, synovium uu noqdo mid qaro weyn oo adag. In talaabada saddexaad unugyada bararka sii daayo falgalka baabbi'in unugyada wadajir ah. Taasina waxay keentaa dhibaato dhaq iskaa wax u qabso iyo keenaysaa in cilladaha jidheed.

Rheumatoid arthritis (ICD10 - M05) ayaa bilawga tartiib ah. Astaamaha si tartiib tartiib ah u muuqan, waxay qaadan kartaa bilo. Marar aad u yar, habka bilaabi kartaa ba'an ama subacute. Xaqiiqada ah in articular syndrome (xanuunka, defiguratsiya iyo sara kaco heerkulka hoose) ma aha calaamad pathognomonic waa weyn u adag tahay in la ogaado cudurka. Sida caadiga ah, qallafsanaan subaxdii (awood in ay soo saaraan mooshin ku jira laabatooyinka ee) qiyaastii saacad, oo waxaa la maqalka markii uu isku dayay dhaqdhaqaaq firfircoon. harbinger A cudurka waa xanuun si wadajir ah inta lagu guda jiro isbeddel cimilada iyo meteosensitivity guud.

Embodiments Dabcan clinical

Dhowr kala duwanaansho kala duwan ee cudurka, in cabbiri dhakhtarka rugta.

1. Classic markii dhaawac wadajir ah waa symmetrical, cudurka tartiib ah oo jira oo dhan ee barametereka ay.

2. Oligoarthritis in laga adkaado goysyada aad u weyn, sida caadiga ah jilibka. Waxaa si xun loo bilaabo, iyo dhammaan daliilka karo lix todobaad gudahood laga bilaabo Bilowgii hore ee cudurka. Xaaladdan oo kale, xanuunka ku jira laabatooyinka ee waa kacsan ee dabiiciga ah, on radiograph mar isbedel bahal ah iyo daaweynta NSAIDs (daawooyinka aan steroid ahayn ee bararka ka hortaga) waxay leeyihiin saamayn togan.

3. Felty syndrome waxaa lagu gartaa marka uu cudurka kalagoysyada la wayneeyo ka caan ku ah beeryarada sawirka dhiiga isbedel ku biiray.

4. arthritis Caruurta rheumatoid (ICD code 10 - M08). Muuqaalka caan ku yahay in ay saamayn ku carruurta jirta ilaa 16 sano. Kala laba nooc ee cudurka:

- la allergosepticheskim syndrome,

- wadajirka ah iyo foomka visceral oo ay ku jiraan vaskulitis (caabuq laabatooyinka), cudurka wadnaha valvular, kelyaha iyo mareenka dheefshiidka, iyo dhibaatooyin habdhiska.

kala soocidda

Sida ay dhacdo of hay'adaha kale ee cudurka, sida ka muuqata ICD 10, rheumatoid arthritis ayaa dhowr kala saaro.

1. daliilka Clinical:

- aad u hore marka calaamadaha kor socon ilaa lix bilood,

- hore, haddii cudurku ku socdaa ilaa hal sano,

- faahfaahsan - ilaa 24 bilood,

- dabayaaqadii - iyadoo muddo xanuun ka badan laba sano.

2. stage Radiographic:

- First. Waxaa adag iyo compaction of unug jilicsan oo ka mid ah si wadajir ah, meelo kala googo'an oo ka mid ah osteoporosis.

- Labaad. habka osteoporosis qabsatay oo dhan lafta epiphysis ah, cidhiidhi meel wadajir ah, u muuqdaan on nabaad carjawda;

- Saddexaad. Lahayo ku epiphysis lafaha, kala-baxa arimahan iyo subluxations;

- afaraad. Ankylosis (maqnaanshaha dhamaystiran oo meel bannaan oo si wadajir ah).

3. soocista difaaca:

Waayo, factor rheumatoid:

- arthritis seropositief rheumatoid (ICD10 - M05.0). Taas macnaheedu waa in bukaan-socodka la ogaado in dhiigga factor rheumatoid.

- rheumatoid arthritis seronegative.

Waayo, unugyada peptide tsitrullinovomu xilliile ah (anti-CCP):

- rheumatoid arthritis seropositief;

- arthritis seronegative rheumatoid (ICD10 - M06).

4. fasalka Functional:

• Midkii kowaad wuxuu u - si loo badbaadiyo dhammaan noocyada kala duwan ee hawlaha.
• Second - xadgudbay hawl xirfadeed.
• Saddexaad - ceshan awood u leh inay is-adeegga.
• Tan afraad - xadgudbay dhammaan noocyada kala duwan ee hawlaha.

Rheumatoid arthritis carruurta

Caruurta arthritis ICD rheumatoid 10 sida category gaar ah - sida cudur, shalalka carruurta yaryar. Inta badan, caruurta ku dhici xanuunsan cudurka culus, tallaalka ama dhaawacyada ah kala-goysyada ka dib. synovium horumarinta caabuq aseptic The taas oo horseedaysa in ay raasamaal xad-dhaafka ah ee dareeraha ah ee si wadajir ah saabka, xanuun, iyo ugu danbeyn - gidaarka adag ee kaabsal wadajirka ah iyo waxa dusin in carjawda. Muddo ka dib, carjawda waa la wada baabbi'iyey, oo ilmuhu naafo noqdo.

Rugta kala saaro Mono -, oligo - iyo polyarthritis. Marka ku dhuftay mid ka mid wadajir ah oo kaliya, waxaa la, siday u kala horreeyaan, monoarthritis. Haddii isbedel bahal ku xiran yihiin ilaa afar goysyada, waxaa oligoarthritis. Polyarthritis helay guuldaradii ee ku dhow oo dhan kala goysyada ah. Go'doonsan sida rheumatoid arthritis systemic, iyo marka saamaysaa xubnaha kale lafaha mooyee.

Baadhista xanuunada

Si loo ogaado a, waxaad u baahan tahay in si sax ah iyo si buuxda u ururiyaan anamnesis, sameeyo baaritaan dhiig lagmamaarmaanna, raajada x in ay sameeyaan kala-goysyada iyo serodiagnosis.

baaritaan dhiig ayaa dhakhtarkaaga u bixisaa in heerka erythrocyte Kimikada, factor rheumatoid, tirada unugyada dhiigga dareenka. The ugu horumarsan la joogo waa ogaanshaha ee anti-CCP, kaas oo go'doonsan ee 2005. Waa tilmaame sare oo gaar ah, taas oo had iyo jeer la joogo dhiigga dadka bukaanka ah, in la barbardhigo factor ee rheumatoid.

daaweynta

Haddii bukaanka soo gaaray cudurka ama iyadu waa in kasii darto, wuxuu muujinaysaa a therapy antibiotic gaar ah. Marka xulashada si darnaanta syndrome articular ka daawo dareenka pay a. Sida caadiga ah, bilaabmaa daawooyinka ka hortaga bararka magnyl iyo waqti isku mid ah corticosteroids intra-articular waxaa maamula. Intaa waxaa dheer, sida RA ah - cudur, shalalka, bukaanka u baahan yahay in la baabi'iyo plasmapheresis oo dhan kaxeynayo difaaca jidhka ka.

Daaweynta waa caadi ahaan muddo dheer iyo in dib loo dhigo waxaa laga yaabaa in muddo sanado ah. Tan waxa u sabab xaqiiqada ah in daroogada ayaa u ururay in unugyo ka. Mid ka mid ah daqiiqado ugu muhiimsan ee therapy waa daaweynta osteoporosis. Si arrintan loo sameeyo, bukaanka ayaa laga codsaday in ay ixtiraamaan cunto gaar ah oo la content sare oo kaalshiyam ah (waxyaabaha caanaha laga sameeyo, oo yicib ubaxeed, iniinta, qeedhin), iyo in la qaato calcium iyo vitamin D.