Option Not-Surgical Optional for Bent Fingers
Isivumelwano sikaDupuytren ngumqathango obangela ukuba iminwe ifakwe kwisithuba esixhaswe. Isivumelwano sikaDupuytren senziwa ngamakhulu amawaka aseMelika kunye nezigidi zabantu emhlabeni wonke. Iimeko ziyabavimbela abo bachaphazelekayo ukuba banakho ukulungisa ngokupheleleyo iminwe yabo, kwaye ubunzima bunokuqala ukusuka kumnene kakhulu kunye nokuqheleka komnwe ukuhamba kwiimeko ezinzima apho iminwe ifakwe kwisandla sandla.
Isivumelwano sikaDupuytren sibonakaliso sesifo sikaDupuytren, isifo esinokubangela ukuba izivumelwano zithenda ezithambileyo zisezinyaweni (iLederhose isifo) okanye, kubantu, kwi-penis ( isifo sikaPeyronie ). Akukho nonyango eyaziwayo yesifo sikaDupuytren, kwaye encinci iyaqondwa ngesizathu salo mqathango. Kuze kube kutshanje, kwakukho neendlela ezimbalwa zokonyango kwizigulane ezixhomekeke kule miqathango.
I-Collagenase Injections
I-Collagenase iye yavela njengonyango oluluncedo kwizigulane ezithile ezinezivumelwano zikaDupuytren. Uhlobo lweethambo ezinesivumelwano esentendeni neminwe yenziwe ngu-collagen. Isivumelwano sifakela iigununu kunye neentambo ezidonsa iminwe entendeni. I-Collagenase yi-enzyme eyenziwa yi-bhakteriya ebizwa ngoClostridium histolyticum, kwaye le nzyme idla i-collagen, eyenza ukuba isakhiwo sibe buthathaka. I-Collagenase isuswa kwiibhaktheriya, kwaye ijojowe kwiinkambo zikaDupuytren ngugqirha wakho.
Ngelinye ilanga emva kwentsholongwane, emva kokuba i-enzyme yenze umsebenzi, ubuyela kugqirha ukuze ube nomunwe owenziwe ukuze uqhekeza izicubu eziqinisiweyo, kwaye ubuyisele ukuhamba komzimba.
Ijokeji ye-collagenase ithengiswa phantsi kwegama lezorhwebo Xiaflex. Iza kuza kuqala kwisirinji esithunyelwa ngqo kumgqirha wakho wokunyanga.
Naliphina ugqirha angaqinisekiswa ukulawula iijoyi ze-Xiaflex, kodwa oku kufuthi kwenziwa ngabagqirha bamazinyo, oogqirha bezandla, kunye ne-rheumatologists.
Unyango lwe-Dupuytren's Contracture
Kuze kube kutshanje, okukhethwa kwindlela yokwenza unyango lwesivumelwano sikaDupuytren kwakubonwayo okanye ukuhlinzwa. Ngenxa yokuba utyando luyingozi kakhulu, kwaye lunokubandakanya ukulungiswa okusisigxina, oogqirha abaninzi bancoma ukuba balinde ixesha elide kunokwenzeka, ngoko utyando xa kuyimfuneko. Izinto ziye zatshintshile, kwaye njengonyango oluncinci oluye lwaba luncedo, oogqirha abaninzi bazama ukunyanga isivumelwano sikaDupuytren kumanyathelo okuqala, ukukhusela ukuqhubela phambili kwimeko yokukhubazeka okunzima kakhulu ukulungisa.
Ngokubanzi, kukho iindlela ezine zokonyango kwi-Dupuytren:
- Ukuqwalaselwa: Ukuqwalaselwa yinkqubo yokuqala yokwelashwa kweDupuytren. Uninzi lwabantu abaneemvumelwano ezincinci aluxhatshazwa yimeko, kwaye ukuba kukho ukunyuka okuthe ngcipheko, kungenjalo kufuneka unyango lube lufuneka. Ezi zi gulane zinokuthi imeko yazo ihlolwe rhoqo ukuba ihlole ukuqhubela phambili.
- I-Needle Aponeurotomy : I- needle aponeurotomy yenziwe eYurophu iminyaka emininzi, ibe sele idume kakhulu kwi-US kwiminyaka elishumi edluleyo. Kule nkqubo, ugqirha wakho usebenzisa isaliti yenaliti ukuze aphule ngokucophelela intambo yeethambo ukuze avumele ukuba umlenze uqonde. Ukubandakanywa okukhulu akudingeki. Abanye oogqirha kunye nezigulane zikhetha le nkqubo kuba ixabiso elincinci lezonyango (ngaphandle kokubonwa), kwaye lingahlala lwenziwa kwindwendwe elilodwa kuphela, ngokuphindaphindiweyo.
- I-Collagenase: Iilenjini ze-Collagenase zithandwa kakhulu ukususela ngo-2010 xa i-FDA ivunyiwe imithi yokuqala yokusetyenziswa kule Merika. I-Collagenase ithengiswa phantsi kwegama lezorhwebo Xiaflex, kwaye kufuneka ijojowe ngugqirha oqinisekisiweyo oqeqeshiwe ekusebenziseni amayeza. Iilenjini ze-Collagenase zibiza (ngaphezulu kwe-$ 3000 nge-vial), kwaye zingadinga ngaphezulu kweyodwa imithi yamachiza kwizivumelwano ezininzi. Oko kwathiwa, le nyango ihlala ibiza ngokuthe gqolo kunokuhlinzwa.
- Ugqirha: Njengoko kuchaziwe, kude kube kutshanje, utyando lwaluyodwa yonyango efumanekayo kwisivumelwano sikaDupuytren. Ngoxa utyando luhlala lusetyenziso olungcono kwiinkontrakthi ezinzima, kukho ezinye iindawo eziphantsi. Uphando luyingozi kakhulu, luba buhlungu, kwaye luhlala lubandakanya ukulungiswa okude kunokuba kungenakuncipha. Oko kwathiwa, ukhetho olungaphantsi kwexesha lusetshenziselwa ukwenza okusemandleni kwizigulane ezineemvumelwano ezincinci ukuya kwi-moderation kanti iziphumo emva kokukhubazeka ngakumbi zihlala zibhetele kangcono ngokuhlinzwa. Ukongezelela, utyando luye lwaboniswa ukubonelela ngoncedo olungapheliyo, ixesha elide kude kube yinto ephindayo.
Yiyiphi Impumelelo?
Kukho ngokwenene 'akukho unyango olungcono,' njengoko zonke ezi zikhetho ziye zenzelela kwaye zixhamle. Ngokuqinisekileyo, ukuba ukhetho oluncinci luyafaneleka, ngoko ke izigulane ezininzi ziya kukhetha ezi zikhetho. Ngelishwa, ezinye izigulana zifuna unyango oluninzi, kwaye kwiimeko, utyando lungaba lukhetho oluhle. Naluphi na ukhetho olukhethileyo, kubalulekile ukuchonga ugqirha osebenzisa unyango rhoqo, kwaye unamava aqhelekileyo kwinkqubo ekhethiweyo. Abanye oogqirha banamakhono kwiinkqubo ezingaphezu kweyodwa, kodwa ngokuqhelekileyo ukuba ufuna ukuthelekisa okukhethwa kukho, uya kufuneka ufumane ngaphezu kogqirha omnye.
Ndihlala ndixelela izigulane zam, ukuba kungakhathaliseki ukuba unyulwa unyango, izigulane zifuna ukuqonda ukuba akukho mphulo yesifo sikaDupuytren okwangoku, unyango kuphela lwemiboniso yeso simo (isivumelwano). Ngoko ke, kungakhathaliseki ukuba yintoni unyango olwenziwa, ukuphindaphinda kwesivumelwano kuya kwenzeka. Ukuphindaphinda emva kokuba i-alex aponeurotomy ingumyinge we-3 iminyaka, emva kokutyunjwa umyinge iminyaka emi-5. Akukho datha okwaneleyo ngeli xesha ukukwazi ukuba kakuhle unyango lwe-collagenase lungayenza njani ngokwemilinganiselo yokuphindaphinda.
Imithombo:
Omnyama EM kunye noBlazar PE. "I-Dupuytren Disease: Ukuguqulwa kokuqonda kweSifo esikudala" J Am Acad Orthop Surg ngoDisemba 2011; 19: 746-757.
UMurphy K, "Ukulungiswa kweeNgqumbo eziBanjisiweyo, Akukho buChengechunge obufunekayo" I-New York Times ngoJulayi 24, 2007.