[手术治疗类风湿性关节炎:过去20年当前的概念和变化]
Jakob C Schindele1, Stephan F Schindele2
1Abteilung für Handchirurgie, Schulthess Klinik, Lengghalde 2, 8008, Zürich, Schweiz.
Operative Orthopadie und Traumatologie
|September 15, 2025
概括
类风湿性关节炎 (RA) 管理已经发展成为减少关节损伤的生物药物. 专注于关节保护的手术对RA患者来说仍然至关重要,适应外科手术期间的生物管理以预防感染.
科学领域:
- 类风湿病学 类风湿病学
- 整形外科手术 整形外科手术
- 免疫学 免疫学 免疫学
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性,免疫媒介的肌肉骨疾病,影响手和脚.
- 在过去的20年里,生物疾病修饰药物 (bDMARDs) 减少了严重关节破坏和RA的手术需求.
- 手术是RA跨学科护理的组成部分,尽管药理疗法的进步.
研究的目的:
- 讨论影响手和手腕的类风湿性关节炎的当前治疗建议.
- 为了突出手手术在RA治疗中的不断变化的作用.
- 对接受手术的RA患者使用生物药物的术后管理策略进行审查.
主要方法:
- 审查当前的文献和治疗指南的风湿性关节炎手和手腕管理.
- 分析手术干预的趋势,包括关节保护手术.
- 基于30多年治疗类风湿性疾病的临床经验的讨论.
主要成果:
- 生物疗法显著改变了RA治疗的格局,减少了严重关节破坏的发生率.
- 有一个转向关节保护的手术技术,如选择性关节塑造和部分关节切除,而不是传统的关节切除.
- 对bDMARDs的个性化术后管理对于最大限度地降低RA患者感染风险至关重要.
结论:
- 手术仍然是综合性RA护理的重要组成部分,适应新的治疗选择.
- 关节保护性手术对于RA患者来说越来越受欢迎,因为它提供了更好的功能结果.
- 针对生物药物的优化外科期间策略对于RA的安全手术管理至关重要.
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