Njira Yopanda Opaleshoni kwa Zing'ono Zomangira
Dupuytren ndi mgwirizano umene umapangitsa kuti zala zilowe mu malo osweka. Kulumikizana kwa Dupuytren kumachitika m'ma mazana ambiri a ku America ndi mamiliyoni ambiri padziko lapansi. Matendawa amalepheretsa anthu omwe ali ndi vutoli kuti athe kuwongola zala zawo, ndipo kufooka kungakhale kosavuta kwambiri komanso kumakhala kosavuta kuchimwa kwazimene zimakhala zovuta kwambiri ngati zala zikugwiritsidwa chanza.
Chigwirizano cha Dupuytren ndi chiwonetsero cha matenda a Dupuytren, matenda omwe angayambitsenso mgwirizano wa mankhwalawa (Lederhose matenda) kapena, mwa amuna, mu matenda a Peyronie . Palibe mankhwala omwe amadziwika pa matenda a Dupuytren, ndipo pang'ono amamvetsetsa chifukwa cha vutoli. Mpaka posachedwa, palinso njira zochepa zothandizira odwala omwe akudwala.
Collagenase Injections
Collagenase yakhala yothandiza kwa odwala omwe ali ndi mgwirizano wa Dupuytren. Mitundu ya minofu yomwe imagwira m'manja ndi zala ndi yopangidwa ndi collagen. Mitundu yamagetsi imayendetsa mitsempha ndi zingwe zomwe zimakoka zala kumtengo. Collagenase ndi puloteni yomwe imapangidwa ndi mabakiteriya otchedwa Clostridium histolyticum, ndipo enzyme iyi imadyera ku collagen, zomwe zimapangitsa kuti zifooke. Collagenase imachotsedwa ku mabakiteriya, ndipo imayikidwa mu zingwe za Dupuytren ndi dokotala.
Tsiku lina jekeseni atatha kugwira ntchito, mumabwereranso kwa dokotala kuti mutenge chidutswa chazitsulo, ndikubwezeretsanso mankhwala.
Kujambulidwa kwa collagenase kugulitsidwa pansi pa dzina la malonda Xiaflex. Amabwera kutsogolo mu sirinji yomwe imaperekedwa mwachindunji kwa dokotala wanu.
Dokotala aliyense angakhale wotsimikizirika kuti apereke zilonda za Xiaflex, koma izi zimachitidwa ndi opaleshoni zamatenda, opaleshoni opaleshoni, ndi a rheumatologists.
Kuchiza kwa Dupuytren's Contracture
Mpaka posachedwapa, njira zokhazo zothandizira mgwirizano wa Dupuytren zinali zochitika kapena opaleshoni. Chifukwa opaleshoniyo imakhala yovuta kwambiri, ndipo imatha kukhalapo nthawi yaitali, madokotala ambiri amalimbikitsa kuyembekezera kuyembekezera nthawi yaitali, ndikuchitidwa opaleshoni nthawi zonse. Zinthu zasintha, ndipo mankhwala ochepetsetsa atha kukhalapo, madokotala ambiri akuyesa kulandira mgwirizano wa Dupuytren m'mayesero oyambirira, kuteteza kupita patsogolo ku kuwonongeka kwakukulu komwe kuli kovuta kwambiri kukonza.
Kawirikawiri, pali njira zinayi zothandizira mankhwala a Dupuytren:
- Kuwunika: Kuwonetsetsa ndi njira yoyamba yothandizira Dupuytren's. Anthu ambiri omwe ali ndi mgwirizano wochepa savutika ndi vutoli, ndipo ngati pang'onopang'ono pang'onopang'ono, mankhwala sangafunike. Odwalawa akhoza kukhala ndi chikhalidwe chawo nthawi zonse kuyang'aniridwa kuti apite patsogolo.
- Needle Aponeurotomy : Chida cha apulourotomy chakhala chikuchitidwa ku Ulaya kwazaka makumi angapo, ndipo chatchuka kwambiri ku US zaka khumi zapitazo. Mwa njirayi, dokotala wanu amagwiritsa ntchito nsonga ya singano kuti aswetse zingwe za minofu kuti alole kuti awonongeke. Kusintha kwakukulu sikofunikira. Madokotala ena ndi odwala amasankha njirayi chifukwa ndizovuta kwambiri pazochiza (kupatulapo kuona), ndipo nthawi zambiri zimachitika paulendo umodzi wokha, popanda kuchepa pang'ono.
- Collagenase: Collagenase jekeseni yadziwika kwambiri kuyambira 2010 pamene FDA inavomereza mankhwala oyamba kuti agwiritsidwe ntchito ku United States. Collagenase ikugulitsidwa pansi pa dzina la malonda Xiaflex, ndipo iyenera kuyiritsidwa ndi dokotala wodziwika amene waphunzitsidwa kugwiritsa ntchito mankhwala. Majekeseni a Collagenase ndi okwera mtengo (oposa $ 3000 pa vial), ndipo angafunike mankhwala ochulukirapo oposa amodzi. Izi zinati, mankhwalawa nthawi zambiri amakhala otsika mtengo kusiyana ndi opaleshoni.
- Opaleshoni: Monga tafotokozera, mpaka posachedwa, opaleshoni ndiyo yokhayo yothandizira Dupuytren. Ngakhale kuti opaleshoni nthawi zambiri ndi mankhwala abwino kwambiri pamagulu akuluakulu, pali zochepa. Opaleshoni ndi yovuta kwambiri, yowopsya, ndipo kawirikawiri imakhala yokonzanso nthawi yayitali kusiyana ndi zosankha zochepa. Izi zati, zosankha zochepa zochepa zimakhala zabwino kwambiri kwa odwala omwe ali ndi mgwirizano wochepa koma zotsatira zake zowonongeka kwambiri nthawi zambiri zimachiritsidwa ndi opaleshoni. Kuonjezera apo, opaleshoni yawonetsedwa kuti imapereka chithandizo chokhalitsa, ndi nthawi yayitali mpaka kuwonongeka kwa kuwonongeka.
Ndi Yabwino Kwambiri?
Palibe kwenikweni 'chithandizo chabwino,' chifukwa zonsezi ndizopindulitsa ndi zosokoneza. Ndithudi, ngati njira yosadziwika yosafunika, ndiye kuti odwala ambiri angasankhe zosankhazo. Mwatsoka, odwala ena amafunikira chithandizo chokwanira, ndipo pazochitikazo, opaleshoni ikhoza kukhala yabwino kwambiri. Kaya mungasankhe kuchita chiyani, ndikofunika kudziwa dokotala yemwe amagwiritsa ntchito chithandizo nthawi zonse, ndipo amakhala ndi chizoloŵezi chokhazikika ndi njira yosankhidwa. Madokotala ena ali ndi luso mu njira zingapo, koma nthawi zambiri ngati mukufuna kulinganitsa zosankha, muyenera kuwona oposa dokotala mmodzi.
Nthawi zonse ndimawauza odwala anga kuti, ngakhale atasankhidwa chithandizo chotani, odwala ayenera kumvetsetsa kuti pakalipano palibe chithandizo cha matenda a Dupuytren, mankhwala okhawo omwe amawonekera. Choncho, ziribe kanthu mankhwala omwe akuchitidwa, kubwereza mgwirizano ndizovuta. Kuchulukanso pambuyo pa apulourotomy ya singano ndi pafupifupi zaka zitatu, pambuyo pochita opaleshoni pafupifupi zaka zisanu. Palibe deta yokwanira pa nthawi ino kuti mudziwe momwe mankhwala ogwiritsira ntchito jekeseni amathandizira pafupipafupi.
Zotsatira:
Black EM ndi Blazar PE. "Matenda a Dupuytren: Kusintha Kumvetsetsa kwa Matenda a Ukalamba" J Am Acad Orthop Surg December 2011; 19: 746-757.
Murphy K, "Zolemba Zowongoka Zowonongeka, Palibe Opaleshoni Yofunikidwa" The New York Times July 24, 2007.