A As-Surgical Option Chokuita neBent Doing
Dupuytren's contract isimboti inokonzera minwe kuti ibudiswe munzvimbo yakanamatira. Dupuytren's contract inowanika mumazana ezviuru zveAmerica nemamiriyoni evanhu munyika yose. Mamiriro aya anodzivirira avo vanobatwa kubva pakukwanisa kunyatsoruramisa minwe yavo, uye kusuruvara kunogona kubva kubva kune unyoro kwazvo uye kazhinji kazhinji kwemuviri kumhanya kumatambudziko akakura apo minwe inonamatira muchanza cheruoko.
Dupuytren's contract is a manifestation of Dupuytren's disease, a syndrome that can also cause contractures of the soft-tissue in the foot (Lederhose disease) kana kuti, muvarume, muchirwere ( Peyronie's disease ). Hapana chirwere chakazivikanwa chechirwere cheDupuytren, uye zvishoma zvinonzwisiswa pamusoro pechikonzero chechiitiko ichi. Kusvikira munguva pfupi ichangopfuura, kwaive kunewo mashoma masarudzo ekurapa kune varwere vanotambura nemamiriro aya.
Collagenase Injections
Collagenase yakabuda semushonga unobatsira kune vamwe varwere vane Dupuytren's contract. Mhando yezvibvumirano zvinopindira muchindwe neminwe zvinoitwa ne collagen. Chibvumirano chinoumba mafungiro nemaketani anokonzera minwe iri kune muchindwe. Collagenase iine enzyme inobudiswa nebhakitiriya inonzi Clostridium histolyticum, uye enzyme iyi inodya kudya kuC collagen, ichiita kuti chimiro chive chichikundikana. Collagenase inobviswa kubva kubhakitiriya, uye injowa mumaketani eDupuytren nechiremba wako.
Rimwe zuva mushure mokujaira, mushure mekunyora kwevhenekisi, iwe unodzokera kuna chiremba kuti iwe unobatwa nemunwe kuti uputse mishonga yakasimbiswa, uye udzorere unhu hunoita.
Iyo injenji ya collagenase inotengeswa pasi pezita rekutengesa Xiaflex. Iyo inouya yakagadzirirwa muuropi iyo inopihwa zvakananga kune chiremba wako kurapa.
Chiremba chero upi zvake anogona kuva chiziviso chekutarisira Xiaflex injection, asi izvi zvinowanzoitwa nevarapi vezvechiremba, vanovhiya maoko, uye rheumatologists.
Mishonga yeChipracture yaDupuytren
Kusvikira munguva pfupi yapfuura, zvingasarudzwa chete zvekurapwa kwechibvumirano cheDupuytren chaive chekucherechedza kana kuvhiyiwa. Nokuti chirwere ichi chinoparadza zvikuru, uye chinogona kusanganisira kupora kwenguva refu, vanachiremba vazhinji vakakurudzira kumirira kwenguva yakareba sezvinobvira, uye pakuvhiyiwa pazvinenge zvakakodzera. Zvinhu zvakashanduka, uye sekurapa kwakanyanya-kusingaoneki kwakave kuripo, vanachiremba vakawanda vari kuedza kubata chirwere cheDupuytren mumatanho ekutanga, kudzivirira kufambira mberi kune kuora kwakanyanya kwakanyanya kuoma kururamisa.
Muzhinji, pane maitiro mana ekurapa kweDupuytren's contracture:
- Kucherechedza: Kucherechedza ndiyo inotangira kurapa kweDupuytren's. Vanhu vazhinji vane zvibvumirano zvishoma havakanganiswi nemamiriro ezvinhu, uye kana pane kuwedzera kunonoka, chirwere chingasazodiwa. Ava varwere vangave vane mamiriro avo ega nguva dzose anoongororwa kuti aongorore kufambira mberi.
- Bhuku reAlexle Aponeurotomy : Needle aponeurotomy yakaitwa muEurope kwemazana emakumi emakore, uye yakave yakakurumbira muUnited States kwemakore gumi apfuura. Mune nzira iyi, chiremba wako anoshandisa chidimbu chetsono kuti aputse zvakananga matambo ezvigunwe kuti abvumira kuti munwe uone. Kukurukurwa kukuru hakudiwi. Vamwe vanachiremba nevarwere vanosarudza nzira iyi nokuti ndiyo inonyanya kudhura yemishonga (kunze kwekucherechedza), uye inowanzoitwa mukushanyira kumwe chete, uye kuderera kunonoka.
- Collagenase: Collagenase majoko ave akazivikanwa zvikuru kubva muna 2010 apo FDA yakagamuchira mushonga wekutanga wekushandiswa uku muUnited States. Collagenase inotengeswa pasi pezita rekutengeserana Xiaflex, uye inofanira kunge yakakonzerwa nechiremba anozivikanwa uyo akadzidziswa mukushandiswa kwemishonga. Collagenase injections inodhura (inodarika $ 3000 per vial), uye inogona kudarika zvinopfuura rimwechete yemishonga mune zvimwe zvibvumirano zvakawanda. Izvozvo zvakati, kurapwa uku kwagara kuchidhura kudarika kuva nekuvhiyiwa.
- Kuvhiya: Sezvakataurwa, kusvikira munguva pfupi yapfuura, kuvhiyiwa kwaive ndiko chete kurapwa kwakagadzirirwa Dupuytren's contract. Kunyange zvazvo kuvhiyiwa kazhinji ndiko kwakanakisisa kurapwa kwezvibvumirano zvakanyanya, pane zvimwe zvishoma. Kuvhiya kunowedzera kuipa, kunorwadza, uye kunowanzobatanidza kugadzirisa kwenguva yakareba kudarika zvishoma zvisingasviki. Izvozvo zvakati, zvisarudzo zvishoma-zvisingabatsiri zvinowanzoita zvakanakisisa kuvarwere vane mikana yakanyanyisa kusvika pakuenzanisa asi mitsva mushure mekukuvara kwakanyanya kunowanzobatwa zvakanaka nekuvhiyiwa. Mukuwedzera, kuvhiyiwa kwakaratidzwa kupa hupfumi hunogara kwenguva refu, kwenguva yakareba kusvikira kudzokorora kwekuora.
Ndeipi Yakanakisisa?
Icho hachisiko 'kurapa kwakanakisisa,' sezvo zvose izvi zvingasarudzwa uye zvinowedzera. Zvechokwadi, kana sarudzo shoma-yakashata yakakodzera, saka varwere vazhinji vanozosarudza dzakadaro. Zvinosuruvarisa, vamwe varwere vanoda kurapwa kwakanyanya, uye mumatambudziko iwayo, kuvhiyiwa kunogona kuva sarudzo yakanakisisa. Chero chipi zvacho chaunosarudza, zvakakosha kuziva chiremba anoshandisa kurapa nguva dzose, uye ane ruzivo rwese nguva nenguva nenzira yakasarudzwa. Vamwe vanachiremba vane unyanzvi mune dzimwe nzira imwe chete, asi kazhinji kana uchida kuenzanidza zvingasarudzwa, uchafanira kuona kupfuura dhigirii umwe.
Ndinogara ndichitaura nevarwere vangu, kuti pasinei nemishonga ipi inosarudzwa, varwere vanoda kunzwisisa kuti pane iye zvino hapana mushonga wechirwere cheDupuytren, chete marapirwo ekuratidzwa kwechiitiko (contract). Saka, zvisinei kuti mishonga inoitwa sei, kudzokorora kwechibvumirano ichida. Kudzokorora mushure mejinga aponeurotomy inopera makore matatu, mushure mekuvhiyiwa muvhareji makore mashanu. Izvo hazvina kukwana denguva panguva ino kuziva kuti zvakanaka collagenase injection treatments ichaita sei maererano nekudzoka kwehuwandu.
Sources:
Black EM uye Blazar PE. "Dupuytren Disease: Kuvandudza Kunzwisisa kwechirwere chekare" J Am Acad Orthop Surg December 2011; 19: 746-757.
Murphy K, "Kururamisa Kwemitsetse Yakaitwa, Hapana Kuvhiya Kunodiwa" The New York Times July 24, 2007.