7 Treatment Options yeDupuytren's Contracture

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Kucherechedza

Dupuytren's contracture ndiyo kuvhara kweminwe iyo inowanikwa sechikonzero chechirwere cheDupuytren, dambudziko rekusagadzikana kwegogenjini maitiro muchanza chechipiri neminwe. Iyo yakawanda yakawanda inokonzera maitiro inokonzera zvikwata zvakasimba, zvinonzi mazuru, uye maketani-akafanana, anonzi matambo. Ndiyo tambo idzi dzinodhonza minwe kusvika padende uye dzinodzivirira kukwana kwakakwana kweminwe.

Mhando "yehutano" kukurudzirwa kune vanhu vane chirwere ichi kwaiva kumirira Databaytren's contract chero kwenguva yakareruka uye chete ipapo inobatwa kurapwa. Izvi ndizvo zvinonzi vanachiremba "kurinda kumirira." Chikonzero chekumirira pakushandiswa kurapwa ndechokuti Dupuytren haana kuzomboreswa uye kudzokorora kurapwa kwaigona kunge kwakakosha pane imwe nguva gare gare. Uye, nekumirira kubata chirwere chacho, nhamba yemishonga inoda nguva yose yehupenyu hwevarwere yakachengetwa kusvika padiki.

Sezvo dzimwe mishonga mitsva dzakapa nzira shoma-inotyisa yekugadzirisa chibvumirano cheDupuytren, kune vamwe vanachiremba avo zvino vanokurudzira kurapwa kwokutanga. Ne collagenase injection uye sindano aponeurotomy, kudzokorora kurapwa hakusi kukanganisa kwakanyanya. Nokudaro, kurapwa kwekutanga kana chirwere chisina kunyanya kuve chichizivikanwa. Uye, nekusaita kumirira, mukana wekugadzirisa zvibvumirano zvakakwana zviri nani izvo, zvakare, zvinomirira kurapa zvishoma kudarika.

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Kutarisa & Injections

Ikoko kwaisimbova nguva apo vanachiremba vakakurudzira kutambanudza, kupenya, uye kujova cortisone muDupuytren's tissue. Kazhinji, kurapwa uku, kwakanakisisa, kwekanguva kunobatsira uye, pakuipisisa, vanogona kuita kuti mamiriro acho afambe mberi nokukurumidza.

Zvirwere zveCortisone zvinowanzoshandiswa kuvhara chironga chinonzi nodular chaDupuytren (kwete micheka) uye chinogona kubatsira kuderedza marukisi. Icho chinokanganisa ndechokuti izvi zvinogunun'una zvinowanzodzoka kwenguva yakareba kusvika pakukura kwemajoka, saka kurapa uku hakuwanzoitiki. Mukuwedzera, pane zvinogona kuitika pamigumisiro ye cortisone shots iyo inogona kukonzera matambudziko kune vamwe vanhu.

Kutsika uye kupenya kwakashandiswa kakawanda munguva yakapfuura. Dambudziko nderokuti kurapwa uku kunoratidzika kunge kunowedzera kukanganisa chimiro pane kuibatsira. Vanhu vazhinji vanozoedza kutambanudza minwe yakagadziriswa, asi kazhinji tsika iyi inofanira kuora mwoyo.

Kutarisa uye kupenya dzimwe nguva kunoshandiswa mushure mokurapa kuwedzerwa kubatana pamwe chete nekudzivirira kudzokorora kwechibvumirano. Asi, izvi chaizvoizvo zvinobudirira sehutachire hunotevera kana huripo. Panguva iyoyo, kutarisa uye kupenya kunowanzokurudzirwa. Kutarisa semushonga unoshandiswa uri woga haubatsiri.

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Collagenase Injections

Collagenase is an enzyme inobviswa kubva kubhakitiriya. Iyi enzyme inorohwa zvakananga mumudonzvo wezvinyama zveDupuytren ndokubva yabvumira kuputsa pasi zvakasimba, zvibvumirano zvakasungwa. Vanhu vanogamuchira majekiseni aya kazhinji vanodzokera kuhofisi yechiremba zuva rakatevera, mushure mokunge enzyme yave nemukana wekuputsa zvimedu zvakaoma. Panguva iyoyo, chiremba wako achabata munwe nesimba zvakakwana kuti aputse zvachose zvigunwe zvakagadziriswa.

Collagenase injections, inotengeswa pasi pezita rekutengeserana raXiaflex, rave rakakurumbira sezvo iri nyore kuita uye saka marudzi mazhinji echiremba anozvipa. Iyo nzira inogona kuitwa zvachose mukati mehofisi yechiremba, kunyange zvazvo inoda kuti munhu ari kujowa kuti adzokere mazuva anotevera.

Izvo zvakaderera ndezvokuti collagenase ine zviratidzo zvakananga, zvinoreva kuti haisi mushonga unobatsira kune wese ane Dupuytren's. Vamwe vanachiremba vanonzwa kuti vanogona kubatsira varwere vakawanda neine sindano aponeurotomy kana kuti chirwere, izvo zvinowanzoshandiswa zvakasiyana-siyana. Mukuwedzera, kune mari yakakura ye collagenase uye zvirongwa zvizhinji zvehushuwarisi hazvizofukidzira mishonga.

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Needle Aponeurotomy

Bhuku reAlexle aponeurotomy ndiyo nzira inopedzisira isingaiti kuti panzvimbo yekubvisa chibvumirano cheDupuytren chibvumirano, inoshandisa nheyo yenzono kubvisa tambo uye kubvisa zvibvumirano. Chiremba wako anogadzira zviduku zvishoma paganda, kwete zvakakonzerwa, uye nekushandisa zvigunwe zvetsono, kudonha kuburikidza nemashizha akabatanidzwa mune dzimwe nzvimbo.

Vatsigiri veiyi nzira yose zvakasiyana-siyana zvinobatsira:

• Zvakachengeteka. Zvinetso zvinogona kuitika, asi zvinetso zvakakomba hazvishamisi.
• Iko haina mari. Kuenzaniswa nedzimwe mishonga, sindano aponeurotomy inowanzopa mari shoma kudarika collagenase kana kuvhiyiwa.
• Zviri nyore. Izvi zvinofananidzwa, zvichireva kuti zvingasava nyore kumunhu wese, asi zvinogona kuitika mumusingapfu kweawa uye kutevera hakuwanzodikanwi.

Ikoko kune zvingaita zvakaderera kusvika kune inonzi aponeurotomy. Haasi munhu wose ane chirwere cheDupuytren chaicho chichabudirira zvakarapwa nekugadziriswa kwetsano. Uyezve, kudzokorora kwemamiriro ezvinhu kunogona kuve kwakajairika. Uye apo kudzokorora nzira yacho kazhinji hakusi dambudziko, kudzokorora kunowanzoitika nokukurumidza nokukurumidza mushure mekutsvaga nenyuchi kuenzaniswa nekurapwa kunobata.

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Surgery

Kuvhiya kwave kwenguva refu ndiyo nzira yakajairika yehutano yeChipupu cheDupuytren. Kune zvakawanda zvakasiyana-siyana pakuvhiya kunogona kuitwa uye kuti yakazara sei. Apo kuvhiyiwa kunoitwa, kusanganisa kunowanzoitwa zvakananga pamusoro peharaunda reDupuytren's, zvipembenene zvisingawanzobviswa zvinobviswa, uye izvo zvinofungidzirwa zvinoputirwa zvakavharwa.

Kubudirira kwekurapwa kwakakonzerwa ndechokuti, kunyange mumatanho epamusoro eDupuytren, kazhinji pane chimwe chinhu chinogona kuitwa kubva pakufungidzira. Zvimwe zvakawanda zveDupuytren zvinogona kubvunzwa zvakanyanya, asi inenge nguva dzose inogona kugadziriswa kuburikidza nekukanganiswa.

Mukuwedzera, apo izvo zvose izvi zvinotarisana nehutachiona hweDupuytren's, hapana mumwe wavo anoporesa chirwere chinonzi Dupuyren's disease. Nokudaro, kudzokorora kwebvumirano nguva dzose kunogona, zvisinei kuti mishonga inoitwa sei. Ivhareji yenguva nguva pakati pemishonga nekudzoka ndiyo yakareba kwazvo (zvinoreva kuti vanhu havadi kudzokorora kurapwa kwenguva yakawanda) nekuvhiyiwa zvichienzaniswa nemajekiseni kana chirongwa chetsano.

Icho chikonzero chikuru chekuvhiya ndechekuti kupora kubva pamitemo kunogona kusanganisira kusagadzikana uye kunogona kuwedzerwa. Vanhu vangave vane mabhanji kwemavhiki uye mabheji kwemwedzi. Pane kazhinji kurapa kwepanyama kunobatanidzwa mukurapa. Kuenzaniswa ne collagenase kana nheyo nzira, kupora kubva pakuvhiya kunowanzobatanidzwa. Izvo zvinoshandiswa ndezvekuti chiremba wako anogona kukwanisa kugadzirisa zvakanyanya kupfurikidza kupfuura kuburikidza nekusarudzwa kwemashoma kudarika.

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Kuongorora Kuvhiya

Sezvambotaurwa kare, chimwe chezvinetso zvakakosha pakurapa kweDupuytren chibvumirano ndechokuti chinetso chikuru chinoshanduka. Chirwere cheDupuytren ndiyo mamiriro ezvinhu anoita kuti collagen mumuviri wako isarongedzwe zvakanaka. Vanhu vane chirwere ichi vanoita kuti collagen yakawanda uye havazoputsire collagen yakare zvakanaka. Mishonga inorondedzerwa pano yose inoporesa zviratidzo zvechinetso ichi-haisi kugadzirisa mamiriro ezvinhu akaoma.

Rimwe zuva, isu tinotarisira kuti tichakwanisa kupa mishonga kune vanhu vane Dupuytren yekudzivirira kufambira mberi kana kudzoka kwezvibvumirano. Zvisinei, kusvikira panguva iyo, isu takabatwa nemishonga yezviratidzo zvechirwere cheDupuytren chete. Nokuda kwechikonzero ichocho, Dupuytren anogona, uye nguva dzose nguva dzose, pakupedzisira achadzoka. Mune zviitiko izvi, kuwedzerwa kurapwa kunogona kufungwa.

Dzokorora kuvhiyirwa kunogona kunge yakanyengedza uye zvechokwadi kwete seiri mberi mberi sekuvhiya kwokutanga kweDupuytren's. Nemhaka yehutachi hwemavara akaumbwa , maitiro anowanzo maatomy nemaviri mukati meruoko anenge akanganisa, achiita zvekudzokorora (kudzokorora) kuvhiyiwa kunowanzoita nyore. Ichokwadi, zvimwe zvidzidzo zvakaratidza chidimbu chinokonzera zvinokwana kusvika 10 zvakapfuura pakuvandudzwa kwemamiriro ezvinhu.

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Salvage Treatments

Pane dzimwe nguva apo kurapwa hakubatsiri uye kwakatarisira kana kuti kufambira mberi kwaDupuytren pasinei nekurapwa. Mune vamwe vanhu, chibvumirano cheminwe chakafambira mberi kusvika kune imwe yero isingagoni kugadziriswa, kunyange nemishonga ine utsinye. Mune mamiriro ezvinhu aya, chirongwa che salvage chinogona kudiwa.

Nzira yekurapa ndiyo mushonga usingashandisi kugadzirisa dambudziko, asi pane kuita kuti mamiriro ezvinhu ave anonzwisisika sezvinobvira. Mimwe yemitambo ye salvage inowanzoitwa mukurapwa kweDupuytren's contract inosanganisira:

• Joint fusion : Kubatanidzwa kwekubatanidzwa ndiko kuvhiyiwa kunogadzirisa zvachose chibatanidzi mune imwe nzvimbo uye pfupa rinokura pamusoro paro kuitira kuti rirege kumbokotamazve. Kana chibatanidzwa ichikanganiswa, hachizogoni kubvumirana, kunyange kana Dupuytren iri kufambira mberi.
• Kugadziriswa kwekunze : Chigadziri chekunze chigadziriswe pfupa chinogona kutambanudza tete-tishu kumativi akabatanidzwa kwenguva refu. Muvanhu vane zvipembenene zvakawanda, kutora kwemavhiki kana mwedzi kunogona kubatsira.
• Kutemwa : Kutorwa kwomunwe kunowanzoitwa muDupuytren, asi kunogona kubatsira mumamiriro ezvinhu akaoma zvikuru. Kunyanya muminwe duku-uye kune vanhu vane zvikanganiso zvakakura mumabasa ekubvisa ruoko-kubvisa chidimbu kunogona kubatsira kune dzimwe nguva dzisina kuitika.

Zvakare, kurapa kwekuchengetedza kunochengeterwa mamiriro ezvinhu akaoma zvikuru akawanzokundikana mamwe mararamiro emagariro. Zvisinei, kune matanho anokwanisa kutora mumamiriro ezvinhu akaoma.

> Sources:

> Becker GW, Davis TR: Chigumisiro chekurapwa kwechirwere chekutanga cheDupuytren's: Kuongorora kwakarongeka. J Hand Surgery Eur Vol 2010; 35 (8): 623-626.

> Black EM, Blazar PE. "Dupuytren chirwere: kuchinzwisisa kuchinja kwechirwere chekare" J Am Acad Orthop Surg. 2011 Dec; 19 (12): 746-57.

> Denkler K: Surgical complications inosangana ne fasciectomy yeDupuytren's disease: Kuongorora kwemakore makumi maviri emabhuku echiChirungu. Eplasty 2010; 10: e15.

> Hindocha S, Stanley JK, Watson S, Bayat A: Dupuytren's diathesis yakadzokororwa: Kuongorora zviratidzo zvekufananidzira kwehuwandu hwekudzoka kwezvirwere. J Hand Surg Am 2006; 31 (10): 1626-1634.

> Hurst LC, Badalamente MA, Hentz VR, et al: CORD I Yokudzidza Bhuku: Injectable collagenase Clostridium histolyticum yeDupuytren's contracture. N Engl J Med 2009; 361 (10): 968-979.

> Van Rijssen AL, Gerbrandy FS, Ter Linden H, Klip H, Werker PM: Kufananidza kwemigumisiro yakananga yemashandisirwo emashandisirwo anonzi fasciotomy uye zvishoma nezvishoma fecectomy yechirwere cheDupuytren: Kuongorora kwemavhiki matanhatu. J Hand Surg Am 2006; 31 (5): 717-725.