類風濕性關節炎是一種慢性反覆發作的全身性疾病,以關節炎症為主要徵象。
初期時,關節會疼痛、腫脹、活動功能障礙;晚期關節會僵硬和畸形,嚴重影響日常生活,下列事項將有助您控制病情:
1.每日適當的休息
1.1.在日常活動或工作當中,每小時至少應休息十分鐘;每日睡眠至少八小時,最好有午休。活動與工作要有計劃逐漸增加,避免過度疲勞。
1.2.您所須休息的量,視病情來決定,可請教醫生給予指導。
2.維持適當的姿勢,預防畸型發生
2.1.臥床休息時大多數時間應仰臥、平躺,保持侵犯關節伸展的姿勢。
2.2.應經常更換姿勢,每天至少有二至三次俯臥,每次十五至三十分鐘,以防髖關節攣縮。
2.3.避免突然移動或負重。坐或站立時,維持直挺姿勢,必要時使用固定架。
2.4.採坐姿時,座椅應選擇椅面可支持到大腿,高度到雙膝。
2.5.使用支架和輔助器材如特製拐、助行器及輪椅等,以減輕關節負擔,穩定關節並增進功能。
3.活動與運動方面
3.1.類風濕性關節炎病人常在清晨起床時,感到病變的關節或附近肌肉會僵硬,使得翻身、握拳或走路均感到困難。嚴重時,全身會有僵硬感,病人得要等到起床後活動筋骨或溫暖後才會減輕。故應每天以全關節運動方式進行和緩的關節運動,如使用固定架,仍應每日取下做關節運動,以免關節僵硬或肌肉因不用而萎縮。
3.2.急性期過後,即可開始逐漸增加活動量,可選擇游泳,或在溫水池中進行和緩的活動,避免過多的跑、跳或負重的活動,以免加速關節破壞。適當之活動量為:活動後,關節無疼痛情形或休息一下,疼痛情形即恢復之量。如經一段時間(約一小時)休息,疼痛現象未減輕反而加劇,則表示活動過量,應重新調整活動量。
3.3.關節活動時多少會有疼痛不適或僵硬難以移動,應儘量克服,以免關節不動過久產生畸型。
4.急性期用冰敷減少發炎反應,減輕疼痛,方法是:將冰塊放入塑膠袋,袋外用毛巾包覆,放在發炎的關節部位,每次約十五分鐘,一天可以施行數次。
5.急性期過後可熱敷關節以減輕關節腫脹疼痛、僵硬,並使肌肉放鬆,使關節活動更容易,熱敷時間一次不要超過三十分鐘,每天可使用二到三次,但應注意溫度,避免皮膚燙傷。
6.風濕性關節炎藥物的目的為減輕疼痛,請與醫生討論後依指示服用。
7.日常生活方面
7.1.攝取均衡營養及足夠蛋白質,進食時要有充分時間用膳。注意控制體重,肥胖者應適度減肥,避免增加關節負擔
7.2.人體足部的關節骨骼,是所有關節中承受重量最重的部位,只要關節有病變,足部就很容易出現變形而導致行動不便。因此選擇合宜舒適的鞋子及衣服,不可過大或過緊,避免壓迫關節,造成疼痛。必要時使用支持的鞋子。
7.3.睡硬板床、床舖應固定,避免覆蓋過多床單及拉動關節。
7.4.避免地板打蠟,可使用小型地毯及鬆軟地毯。
7.5.利用各種不同自我照顧的器具,以維持最大限度的獨立性。
7.6.在合理的體能範圍從事輕柔工作,選擇適合的職業,必要時求助伊甸殘障基金會等,學習謀生技能。
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