僵直性脊椎炎之防治

Prevention and Treatment of Ankylosing Spondylitis

彭靜尼(Ching-Ni Peng) ； 林詩淳(Shih-Chun Lin) ； 童建學(Chien-Hsueh Tung)

《醫學與健康期刊》 4卷1期 (2015/03) Pp. 99-104

摘要

僵直性脊椎炎常會被誤認為和一般運動傷害是相同的，往往患者因認知不夠延遲就醫，導致肢體活動度受限、駝背或肢體殘障而影響呼吸機能。在相關的國內外醫學及護理研究文獻中指出，藉由早期診斷、早期治療、早期使用生物製劑、復健治療及適當時機予以外科手術治療，可降低疾病活動度、減緩關節沾黏變形及殘障。另外，在使用生物製劑前須評估肺部及肝炎的病毒活動性，適時給予預防性投藥。目前護理人員對於僵直性脊椎炎認知有限，故本文提供僵直性脊椎炎相關診斷、症狀、治療及護理。冀望能提升臨床護理人員對於此疾病照護知識及能力。

關鍵字

值性脊椎炎 ； 生物製劑 ； 臨床症狀

並列摘要

Ankylosing spondylitis is often mistaken for a typical sports injury. A lack of awareness of the disease frequently leads to a delay in seeking medical attention and resulting in disability, kyphosis, deformity, and reduced respiratory functions. Findings from medical and nursing research indicate that the severity of the disease, formation of joint adhesion, levels of disability can be reduced through early diagnosis, early treatment, early use of biological agents, rehabilitation, and surgical intervention at appropriate time. Before the use of biological agents in patients with ankylosing spondylitis, the viral activities of tuberculosis and hepatitis must be evaluated and prophylactic medications should be given if indicated. The present review describes the diagnosis, symptoms, treatment, and nursing strategies for ankylosing spondylitis and adds to our knowledge base regarding this disease and promote nursing skills in the care of patients with this disease.

並列關鍵字

Ankylosing spondylitis ； Biological agents ； Clinical symptom

參考文獻

王政為、楊榮森:僵直性背脊炎之診斷、治療與併發症。台灣醫學 2013 ； 17 : 687-94

Rudwaleit M, Metter A, Listing J, et al: Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum 2006;54:569-78

Braun J, van den Berg R, Baraliakos X, et al: 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 2011;70: 896-904

van der Linden SM, Valkenburg HA, Cats A: Evaluation of diagnostic criteria for ankylosing spondylitis: a proposal for modification of the New York criteria. Arthritis Rheum 1984;27:361-8

Mau W, Zeidler H, Mau R, et al: clinical features and prognosis of patients with possible ankylosing spondylitis, Results of a 10 year follow up. J Rheumatol 1988;15: 1109-14