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腰椎侧弯的测量方法

Posted by hanbal @ 2008-03-12, 22:52

a. 初始姿势:光脚直立;背靠墙;膝伸直;肩胛骨、臀部和脚后跟紧靠墙;肩部保持水平;双脚平行且外边缘相距30cm。

b. 方法:在任何动作之前,使双臂、腕、手指伸直,测量中指尖至地板的距离。患者手掌沿着大腿外侧方侧屈伸向地板,重测中指尖至地板的距离。两次测量的差值即为侧弯的数值。重复另一侧。

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这是“强直性脊柱炎测量指数(BASMI, Bath AS Metrology Index)”的其中一项。还有一些项目以后有时间再说。

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Bath Ankylosing Spondylitis Disease Activity Index

Posted by hanbal @ 2008-03-10, 0:19

The gold standard for measuring and evaluating disease activity in Ankylosing Spondylitis is the BASDAI, or the Bath Ankylosing Spondylitis Disease Activity Index. The BASDAI is the result of the work of a research team consisting of rheumatologists, physiotherapists, and research associates with a special interest in AS who developed the index in Bath, England. The BASDAI consists of a one through 10 scale (one being no problem and 10 being the worst problem) which is used to answer 6 questions pertaining to the 5 major symptoms of AS:

  • Fatigue
  • Spinal pain
  • Joint pain / swelling
  • Areas of localized tenderness (also called enthesitis, or inflammation of tendons and ligaments)
  • Morning stiffness duration
  • Morning stiffness severity

To give each symptom equal weighting, the mean (average) of the two scores relating to morning stiffness is taken. The resulting 0 to 50 score is divided by 5 to give a final 0 – 10 BASDAI score. Scores of 4 or greater suggest suboptimal control of disease, and patients with scores of 4 or greater are usually good candidates for either a change in their medical therapy or for enrollment in clinical trials evaluating new drug therapies directed at Ankylosing Spondylitis.

from:http://www.basdai.com/

上面是“bath强直性脊柱炎活动性指数标准”。强直性脊柱炎患者可以到这里评定疾病的活动性。其中Medication项中的后三项是必须填写的,但对评定的结果并没有影响。Pain on a ten point scale (1 is none and 10 is the worst)中的前五项,按照1-10(1为没有任何问题,10为问题很严重)来评定,第六项是晨僵的时间。填写完毕后,点击Calculate Your Result,即可得出结果。小于4为绿色字体标识,为不活动;大于等于4为活动。

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强直性脊柱炎的治疗

Posted by hanbal @ 2007-12-17, 16:37

强制性脊柱炎是临床常见的疾病,很多临床医生对于该病的治疗并不规范,患者一来就上糖皮质激素,就是柳氮磺胺吡啶,特别地尤其是一些江湖游医,常常在所谓的秘方中添加了大量的糖皮质激素,这对患者的危害非常大,大大超出了疾病本身。

强制性脊柱炎的治疗当以非药物疗法为主,中华风湿病学杂志明确指出:

AS尚无根治方法。但是患者如能及时诊断及合理治疗,可以达到控制症状并改善预后。应通过非药物、药物和手术等综合治疗,缓解疼痛和发僵,控制或减轻炎症,保持良好的姿势,防止脊柱或关节变形,以及必要时矫正畸形关节,以达到改善和提高患者生活质量目的。
     1. 非药物治疗
     (1)对患者及其家属进行疾病知识的教育是整个治疗计划中不可缺少的一部分,有助于患者主动参与治疗并与医师的合作。  长期计划还应包括患者的社会心理和康复的需要。
     (2)劝导患者要谨慎而不间断地进行体育锻炼,以取得和维持脊柱关节的最好位置,增强椎旁肌肉和增加肺活量,其重要性不亚于药物治疗。
     (3)站立时应尽量保持挺胸、收腹和双眼平视前方的姿势。坐位也应保持胸部直立。应睡硬板床,多取仰卧位,避免促进屈曲畸形的体位。枕头要矮,一旦出现上胸或颈椎受累应停用枕头。
     (4)减少或避免引起持续性疼痛的体力活动。定期测量身高。保持身高记录是防止不易发现的早期脊柱弯曲的一个好措施。
     (5)对疼痛或炎性关节或其他软组织选择必要的物理治疗。

非药物治疗固然重要,但并不意味着可以完全脱离药物治疗,这两者按三七开,非药物治疗占7成。对于药物治疗,应注意以下几个方面:

(more…)

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