The common symptoms of
rheumatoid arthritis include joint pain, swelling and stiffness, especially the stiffness after getting up in the morning or after a long period of rest, which often lasts for more than one hour, and often involves the proximal interphalangeal joints, metacarpophalangeal joints, wrist joints, knee joints, ankle joints and other symmetrical joints of both hands. If these symptoms occur, they should go to the Department of Rheumatology and Immunology in time. In addition, if joint symptoms persist or aggravate, such as pain affecting normal activities, joint deformity, or accompanied by fever, fatigue, weight loss and other systemic symptoms, it is more necessary to seek medical treatment as soon as possible. After the diagnostic test items are treated, the doctor usually orders a series of tests. In terms of blood tests, rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (anti-CCP antibody) are of great significance for diagnosis. They are often positive in patients with rheumatoid arthritis, but some patients may have negative results, which need comprehensive judgment. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) can reflect the degree of inflammatory activity. In addition, blood routine, liver and kidney function may also be checked to assess the overall physical condition of patients. In imaging examination, joint X-ray can show joint space narrowing, bone destruction and other lesions, and there may be no obvious abnormalities in the early stage; ultrasound can find joint synovial thickening, increased blood flow signals and other conditions; magnetic resonance imaging (MRI) is more sensitive to early diagnosis, and can clearly show the lesions of synovial membrane, cartilage and other structures. The goals of rheumatoid arthritis treatment are to relieve pain, reduce inflammation, control disease progression, protect joint function, and improve quality of life. Treatment options include the following. Drug therapy is the basis. Non-steroidal anti-inflammatory drugs (NSAIDs) can quickly relieve pain and inflammation, but can not control the development of the disease, such as ibuprofen, diclofenac sodium, etc. Anti-rheumatic drugs (DMARDs) are the key to control the disease, including methotrexate, leflunomide and other traditional synthetic DMARDs, which need to be used regularly for a long time; Biological agents are new therapeutic drugs in recent years, which have strong targeting and good effect on patients with severe illness or poor efficacy of traditional drugs, but the price is relatively high, so attention should be paid to possible adverse reactions when using them.
For patients with severe joint deformity affecting function in the late stage, surgical treatment, such as joint replacement, can be considered. Nursing guidelines Daily nursing 1. Rest and activity balance: In the acute attack period, patients need adequate rest, reduce joint activity, and use assistive devices (such as wheelchairs, crutches, etc.) To reduce joint burden. However, in the remission period, functional exercises should be carried out properly, such as clenching fists, extending fingers, flexing and extending wrist joints, knee joints and other simple movements, 10-15 minutes each time, 2-3 times a day, in order to maintain joint flexibility and muscle strength. 2. Joint protection: Avoid keeping the same posture for a long time, such as standing or sitting for a long time, and change posture regularly. In daily life, pay attention to the correctness of the action, such as when you get up from the chair, you should first move your feet to the edge of the chair, use the strength of your arms to support your body and relieve the pressure on your joints. When lifting heavy objects, try to use both hands, avoid one-handed force, and use tools such as carts when the objects are too heavy. 3. Adjust the living environment: keep the living environment dry and warm, avoid damp and cold, because cold and damp may aggravate joint pain. Humidifier can be used to adjust indoor humidity, pay attention to joint warmth in cold season, wear knee pads, wrist pads and so on. Dietary care for patients with rheumatoid arthritis 1. Balanced diet: ensure adequate intake of protein, carbohydrates, fats, vitamins and minerals. Increase foods rich in high-quality protein, such as lean meat, fish, beans, eggs and dairy products, to help maintain muscle strength and repair damaged tissues. Eat more fresh vegetables and fruits to provide rich vitamins and minerals and enhance the body’s immunity. 2. Special dietary considerations: Some studies suggest that certain foods may have an effect on rheumatoid arthritis. For example, reducing the intake of vegetable oils rich in omega-6 fatty acids (such as corn oil, sunflower oil, etc.) And increasing the intake of foods rich in omega-3 fatty acids (such as deep-sea fish, flaxseed, etc.) May help reduce inflammation. At the same time, high-sugar, high-salt and high-fat foods should be avoided, which may increase the risk of obesity, which is a greater burden on joints. It is hoped that patients themselves can also better treat diseases by participating in patient exchange activities.
