Dupuytren ndi mgwirizano wa dzanja lomwe limakhudza pafupifupi atatu peresenti ya anthu. M'mbuyomu, njira zokhazo zothandizira chithandizo sizinali kanthu, kapena njira yaikulu yopaleshoni. Kwa zaka 10 zapitazo, njira zina zochepetsetsa zinawoneka ngati mankhwala otheka. Imodzi mwa njira zamakono zamakono ndi njira yowonongeka yomwe imatchedwa singano aponeurotomy.
Dupuytren ali ndi vuto lomwe limakhudza dzanja; Amapezeka mwa anthu omwe ali ndi matenda a Dupuytren. Zimayambitsa minofu pansi pa khungu pambali ya dzanja kuti ikhale yowonjezereka ndi yogwidwa. Mtunduwu, fascia wa kanjedza, nthawi zambiri amapereka mphamvu ndi kuthandizira khungu. Komabe, ku Dupuytren, mgwirizano wa kanjedza ukhoza kufupikitsa kwambiri, zomwe zimawathandiza kuti asayambe kuwongolera zala. Matendawa amapezeka kwambiri mwa amuna a ku Northern Europe omwe ali ndi zaka zoposa 50.
Chithandizo ndi chigwirizano cha Dupuytren chimadalira kukula kwa zizindikiro. Odwala ambiri omwe ali ndi vutoli amakhala ndi mitsempha yolimba kwambiri yomwe imapanga mipira yowopsya mu kanjedza, kapena zingwe zomwe zimapanga magulu amphamvu omwe amayenda pambali ya chala. Mankhwala a Dupuytren akhoza kuchiritsidwa ndi jekeseni ya cortisone kapena angathe kuyang'anitsitsa popanda chithandizo china.
Chingwe cha Dupuytren chingakhale chovuta kwambiri pamene izi zingayambe kukokera zala kumka ku dzanja la dzanja.
Pakapita nthawi, ngati mgwirizano ukupita, odwala sangathe kuwongola zala. Izi zikhoza kupanga zinthu zosavuta monga kutsuka nkhope yanu, kugwirana chanza, kapena kuvala magolovesi, zosatheka.
Chithandizo
Chithandizo choyenera cha Dupuytren ndi njira yopaleshoni yotchedwa partial palmar fasciectomy.
Chimanja ndi chala chokhudzidwacho chimatsegulidwa opyola muzithunzi zazikulu. Kenako amawononga mtambo wodabwitsa wa kanjedza. Chifukwa cha kupaleshoni kwakukulu, zida zofiira zidzakhala m'manja ndi zala. Kuchita opaleshoni kungafunike kukonzanso kwa nthawi yaitali. Odwala ena angafunike kutenga miyezi iwiri kapena miyezi kuchokera kuntchito, malingana ndi ntchito zawo.
Ndalama ya aponeurotomy (NA) ndi njira yowonongeka yomwe imagwiritsidwa ntchito popanga mgwirizano wa Dupuytren. Ku NA, dokotalayu amagwiritsa ntchito nsonga ya singano kuti agawanire chipatso cha palmark chophatikizidwa. Izi zimachitidwa mwa mabala aakulu oponyedwa. Mosiyana ndi opaleshoni yotseguka, dzanja silikutsegulidwa kwambiri, ndipo pali minofu yochepa yopangidwira. Ndondomekoyi imachitidwa ku ofesi ya dokotala pansi pa anesthesia. NA anayamba kukambidwa ku France m'ma 1970 ndipo anabweretsedwa ku United States ndi Dr. Charles Eaton wa Jupiter, Florida.
Needle Aponeurotomy
Mukachita ndi dokotala wochita opaleshoni kwa odwala woyenera, NA ndi yotetezeka kwambiri. Mlingo wa mavuto, monga tetoni kapena kuvulala kwa mitsempha, sizomwe ndi opaleshoni yachibadwa. Kuvuta kumakhala kochepa kwambiri pakhungu, komwe kumachiritsa ndi ma bandage osavuta.
Mlingo wa Dupuytren wobwereza pambuyo pa NA ndi wapamwamba poyerekeza ndi opaleshoni yotseguka. Pambuyo pa opaleshoni yotseguka, odwala 50 peresenti adzabwerenso patatha zaka zisanu. Izi zikuyerekeza ndi 50 peresenti kubwereza pambuyo pa zaka zitatu ndi NA. Matenda a Dupuytren angabwererenso ndi mankhwala, posakhalitsa kanthawi kochepa.
Kawirikawiri, mankhwala opangidwa ndi manja sali oyenera pambuyo pa NA. Odwala akufunsidwa kuti apitirize kugwira ntchito yawo mofulumira kwa masiku awiri mutatha njirayi. Odwala amatha kubwerera kuntchito zovuta nthawi yomweyo. Ntchito yovuta, maseŵera, kapena zosangalatsa siziloledwa kwa sabata imodzi.
Nthaŵi zina, kupatulidwa kumapangidwira kuvala usiku pambuyo pa NA.
Zotsatira:
Eaton C, The Hand Center © 2007.
Mahoney JD, Kulankhulana Kwaumwini, Midwest Orthopedic Center, Anakambirana 11/2007.
Murphy K, "Zolemba Zowongoka Zowonongeka, Palibe Opaleshoni Yofunikidwa" The New York Times July 24, 2007.