Zifukwa ndi Chithandizo
Kulumikizana kwa Dupuytren ndi chikhalidwe chomwe chimayambitsa mgwirizano, kapena kuti mgwirizano, wa fascia wamtengo wapatali, zomwe zimagwira pansi pa khungu m'dzanja lako. Chifukwa cha mgwirizano, zala zimatha kugwa pansi, ndipo ntchito ya dzanja lanu ilibe vuto.
Fascia ya palmu ndi minofu yambiri yomwe ili pamwamba pa tchutchu ndi pansi pa khungu la dzanja.
Mtunduwu umagwirizanitsidwa ponse pakhungu pamwamba ndi kumtundu wapansi. Fascia ya palmu imathandiza kumapangitsa kuti dzanja ndi zala zikhale zolimba.
Zimayambitsa
Palibe amene akudziwa chomwe chimayambitsa mgwirizano wa Dupuytren, koma zimadziwika bwino kuti zimakhala m'mabanja-60 peresenti mpaka 70 peresenti ya anthu ali ndi mbiri ya banja. Zina mwazinthu zikuganiziridwa kuti zimayambitsa mgwirizano wa Dupuytren, monga matenda, shuga , uchidakwa, matenda a khunyu, ndi matenda a chiwindi, koma palibe mgwirizano woonekera.
Matendawa amapezeka kwambiri akale (kawirikawiri pambuyo pa zaka 40), amuna (ofala kwambiri kuposa akazi), ndi makolo a ku North Europe. Gulu limodzi lomwe limatchulidwa ndi omwe ali ndi makolo a Viking, ndipo akhoza kutchedwa matenda a Viking.
Pali umboni wakuti kusokonezeka kungathandize kuti Dupuytren agwirizane. Afufuzidwa ngati zochitika zowopsya kapena mbiri ya ntchito yowonjezera ikhoza kuthetsa vutoli.
Pang'ono ndi pang'ono, pali umboni wotsanzika m'magazi okhudzidwawo, umboni wakuti kusokonezeka kungapangitse vutoli. Izi zimati, Dupuytren amawonekera m'manja onse awiri, ndipo amapeza nthawi zambiri zogwira mtima komanso zopanda umboni kuti vutoli sili chifukwa cha kupwetekedwa mtima.
Zimene muyenera kuyembekezera
Chizindikiro choyamba cha mankhwala a Dupuytren ndizochepa, zopanda ululu m'mimba. Mitsemphayi imayamba kuyamba kugunda, ndipo khungu limayamba kuphulika. Potsirizira pake, m'kupita kwa nthawi kwa matendawa, khungu ndi zokhazokha zimagwira ntchito, zomwe zimapangitsa kuti munthu azilephera kugwira ntchito ndi manja. Anthu omwe ali ndi mgwirizano wa Dupuytren ali ndi zala zomwe zimagwera kumanja.
Ngakhale kuti zala zonse zingagwirizane, mgwirizano wa Dupuytren umakhudza kwambiri mphete ndi zala zazing'ono. Kukula kwa Dupuytren kumawoneka mofulumira, potsatira nthawi yochepa. Kulumikizana kwa Dupuytren sikumakhala kowawa kawirikawiri, koma kungakhale kovuta kwambiri. Kawirikawiri Dupuytren amangofuna kugwira dzanja koma amatha kuphatikizapo mbali zina za thupi, makamaka pamapazi. Pafupifupi asanu pa anthu 100 alionse omwe ali ndi Dupuytren amagwirizananso ndi matenda a Lederhose.
Dupuytren's Contracture vs. Mliri
Anthu ambiri, madokotala akuphatikizapo, gwiritsani ntchito mawu awa mosiyana. Malingaliro apadera, matenda a Dupuytren amatanthauza kuwonjezeka kwa maselo omwe amachititsa kupanga mapulaneti ndi mavenda.
Kugwirizana kwa Dupuytren ndi chifukwa cha kuchuluka kwa maselowa ndi kusonyeza kufanana kwa matenda a Dupuytren. Kuchiza kwa mgwirizano wa Dupuytren kungaganizidwe ngati chikhalidwe chimayambitsa zovuta kugwira ntchito za tsiku ndi tsiku.
Zinthu Zotsatsa
| Ukhondo | Mbiri ya chikhalidwe ichi mkati mwa banja lanu ndi chisonyezo chakuti izo zidzakhala zowawa kwambiri. |
| Kugonana | Nthawi zambiri Dupuytren amayamba pang'onopang'ono ndipo amapita patsogolo pang'onopang'ono kwa amayi. |
| Kuledzeretsa kapena Khunyu | Zinthu zimenezi zimagwirizana ndi Dupuytren zomwe zimakhala zowawa kwambiri, ndipo zimatha kubwereranso. |
| Malo a Matenda | Pamene manja awiri onsewa, kapena pamene pali mbali yothandizira mapazi, zotsatirazi zimakhala mofulumira kwambiri. |
| Chikhalidwe cha Matenda | Dupuytren wowonjezereka kwambiri amatha kubwereranso pambuyo pochita opaleshoni ndikupitiriza kukhala wachiwawa. |
Kwa zaka zambiri, kuchipatala kumayambiriro kwa mgwirizano wa Dupuytren kunali mlonda ndikudikirira. Chifukwa mankhwala opaleshoni ndi ovuta ndipo angafunike kupeza nthawi yowonongeka ndi kukonzanso, nthawi zambiri amawasungira ngati njira yomaliza yosankha ngati zizindikiro zayamba kusokoneza kwambiri ndi ntchito za tsiku ndi tsiku.
Posachedwapa, njira zochepetsera zochepa zowonjezereka za mankhwala zimapereka chiyembekezo chakuti Dupuytren angagwirizane bwino, makamaka ngati atachiritsidwa kale.
Tikudziwa kuti pangowonjezereka mgwirizano, zimakhala zovuta kuti mukhale ndi ntchito yatsopano. Chifukwa chake, anthu ambiri akuyang'ana njira zochepetsera zosavuta, makamaka poyambitsa mgwirizano wa Dupuytren.
Chithandizo
Pali njira zinayi zofunika zomwe mungapeze mankhwala omwe alipo pakuthandizidwa ndi Dupuytren:
- Kuwonetsetsa: Kawirikawiri kuwonetseredwa kumaganiziridwa kumayambiriro kwa mgwirizano wa Dupuytren. Izi ndizo zabwino kwambiri kwa anthu omwe sali olumala ndi manja awo. Izi zikhoza kuphatikizapo anthu omwe sagwirizana kwenikweni, kapena anthu omwe sagwiritsa ntchito manja awo, ndipo akhoza kuchita ntchito zawo zonse.
- Needle Aponeurotomy : Ndalama ya aponeurotomy ndi njira yomwe inakhazikitsidwa ku France, yomwe yangotchuka kwambiri ku United States. Popanda kugwiritsa ntchito, singano imagwiritsidwa ntchito polekanitsa zingwe za Dupuytren, ndi kubwezeretsa zina kapena zozizwitsa zonse. Pulogalamu ya aponeurotomy imapindula kwambiri pamayambiriro a mgwirizano wa Dupuytren.
- Majekeseni a Collagenase : Collagenase ndi mankhwala omwe amapangidwa ndi bakiteriya omwe amalowetsedwa mu chingwe cha Dupuytren. Enzyme imayesetsa kuthetsa minofu yolimba ya Dupuytren. Tsiku lina jekeseni atatha kugwira ntchito, mumabwereranso kwa dokotala kuti mutenge chidutswa chazitsulo, ndikubwezeretsanso mankhwala.
- Opaleshoni: Opaleshoni imachitidwa pofuna kuchotsa fascia ya kanjedza kuchokera pachikhatho cha dzanja. Kuchita opaleshoni kungakhale kothandiza pakubwezeretsa ntchito, ndipo kungakhale kofunikira pazigawo zina za mgwirizano wa Dupuytren. Kuchita opaleshoni kawirikawiri kumakhala kukonzanso kwa nthawi yaitali.
Opaleshoni
Kwa odwala ena, mankhwala ochepetsetsa angakhale osayenera. Komanso, si madokotala onse omwe akudziwa kuti chithandizo cha singano ndi chithandizo cha mankhwala a Dupuytren. Pali kutsutsana pankhani yogwiritsiridwa ntchito kwa mankhwalawa, choncho palibe madokotala onse omwe amalimbikitsa apulourotomy. Ngati mukufuna kukambirana za singano aponeurotomy ndi physicin, mukhoza kupeza mndandanda wa madokotala akuchita izi pa webusaiti ya Dupuytren's-Online.
Kuchita opaleshoni kwa mgwirizano wa Dupuytren kumatchedwa fasciectomy, kumene mbali zina za palcia zimachotsedwa. Cholakwika cha opaleshoni ndi chakuti pali ngozi zazikulu zogwirizana ndi ndondomekoyi. Chofala kwambiri ndi chakuti minofu yowopsya ingapangidwe pambuyo pa opaleshoni, zomwe zimayambitsa vuto lofanana ndi la Dupuytren, koma ndi minofu yofiira. Komanso, a Dupuytren akhoza kubwerera, ndipo opaleshoni yachiwiri imadzaza ndi mavuto. Mavuto ena ndi opaleshoni amatenga mitsempha ya mitsempha, matenda, ndi machiritso a nthawi yaitali.
Kukonzekera
Kukonzekera pambuyo pothandizira aponeurotomy ndizodziwikiratu. Kawirikawiri, odwala angayambirenso ntchito zachizolowezi nthawi yomweyo, ndipo amauzidwa kuti asamachite masewera ndi ntchito yolemetsa kwa pafupifupi sabata imodzi. Malinga ndi mtundu wa mgwirizano, chotsitsa chochotserapo chingaperekedwe kuti chikhale chovala maola angapo tsiku lililonse.
Kukhazikitsidwa pambuyo pa opaleshoni kumasiyanasiyana kwambiri. Odwala omwe ali ndi mgwirizano wochepa angayambirenso ntchito zabwino zomwe amachiritsidwa, mkati mwa masabata angapo. Ma mgwirizano ovuta kwambiri angafunike miyezi yambiri yokonzedwa ndi kukonzanso ndi wothandizira manja kuti asamapangidwe minofu.
Zotsatira:
Benson LS, et al. "Chigwirizano cha Dupuytren" J. Am. Acad. Ortho. Kupita .; 6: 24 - 35.
Eaton C, The Hand Center © 2007.
Murphy K, "Zolemba Zowongoka Zowonongeka, Palibe Opaleshoni Yofunikidwa" The New York Times July 24, 2007.