Haas J-P, Arbogast M
Deutsches Zentrum für Kinder- und Jugendrheumatologie, Kinderklinik Garmisch-Partenkirchen gGmbH, Gehfeldstr. 24, 82467, Garmisch-Partenkirchen, Deutschland.
Abteilung für Rheumaorthopädie und Handchirurgie, Zentrum für Rheumatologie, Orthopädie und Schmerztherapie, Klinik Oberammergau, Oberammergau, Deutschland.
Orthopade. 2018 Nov;47(11):912-918. doi: 10.1007/s00132-018-3645-1.
The treatment of children and adolescents with juvenile idiopathic arthritis (JIA) has progressed substantially during recent years. Multiple different factors have played a role in this advancement: improved medical treatment due to the introduction of new drugs, structural improvements with provision of units specializing in childhood rheumatology, multidisciplinary treatment concepts, structured educational programs for patients and parents, improved functional treatment including sports therapy, and selective surgical and orthopedic interventions improving functional capacities. Current treatment strategies in JIA are aimed at achieving disease remission, i.e., control of disease activity and re-establishment of age-appropriate functional capacities. This review summarizes important developments in the conservative treatment of JIA. Part 2 deals with orthopedic and surgical treatment strategies.
近年来,儿童和青少年幼年特发性关节炎(JIA)的治疗取得了显著进展。多种不同因素促成了这一进步:新药的引入改善了药物治疗;设立了儿童风湿病专科单位,在结构上有所改进;采用了多学科治疗理念;为患者及其家长制定了结构化教育计划;包括运动疗法在内的功能性治疗得到改善;以及通过选择性手术和矫形干预提高了功能能力。目前JIA的治疗策略旨在实现疾病缓解,即控制疾病活动并恢复适合年龄的功能能力。本综述总结了JIA保守治疗的重要进展。第二部分讨论矫形和手术治疗策略。