Izizathu kunye neNyango
Isivumelwano sikaDupuytren ngumqathango obangela ukuqinisa, okanye ukudibanisa, i-fascia yesundu, isisombululo esilapha phantsi kwesikhumba esesandleni sakho. Ngenxa yesivumelwano, iminwe ingakwazi ukuguquka ngokusisigxina, kunye nomsebenzi wesandla sakho.
I-fascia yesundu i-tissue ekhuni ephezulu ngaphezu kwetoni kunye nangaphantsi kwesikhumba sesandla.
I-fascia iqhotyoshelweyo kunye nesikhumba esingentla kunye nezakhiwo ezingezantsi. I-fascia yesundu ikunceda ukubonelela ngokukhawuleza, ukukhupha isandla kunye neminwe.
Izizathu
Akukho mntu uyazi ukuba yintoni eyenza isivumelwano sikaDupuytren, kodwa saziwa kakuhle ukuba ihamba kwiintsapho-iipesenti ezingama-60 ukuya kuma-70 ekhulwini abantu banembali yentsapho kwimeko. Ezinye izinto zikhankanywe ukuba zenze isivumelwano sikaDupuytren, njengesifo sikashukela , isifo sikashukela , ukutywala utywala, ukuhluthwa, kunye nesifo sesibindi, kodwa akukho buhlobo obucacileyo.
Le meko ixhaphakile kumdala (ngokuqhelekileyo emva kweminyaka engama-40), amadoda (aqhelekileyo kunabesifazana), kunye neNtshonalanga Yurophu. Elinye iqela eliqhelekileyo likhankanywe ngabo bazalwa ngeViking, kwaye kungabizwa ngokuthi isifo sikaViking.
Kukho ubungqina bokuthi ingcinezelo inganceda ekuphuculeni isivumelwano sikaDupuytren. Kuphandwe ukuba iziganeko ezichaphazelekayo okanye imbali yabasebenzi besikhokelo zingabangela ingxaki kule ngxaki.
I-Microscopically, kukho ubungqina bokuphuma kwiimfucu ezichaphazelekayo, ubungqina bokuthi ingcinezelo inokubangela ukuba le nkalo ibambelele. Oko kwathiwa, i-Dupuytren idlalwa kwizandla zombini, kwaye ifunyenwe ngokuphindaphindiweyo kwimandla engabonakaliyo kwaye ingabonakaliyo-ubungqina bokuba le ngxaki ayikho imbangela yokuphinda ixinzeleleke.
Yintoni ongayilindela
Iimpawu zokuqala zekliniki zesivumelwano sikaDupuytren zivame ukuba zincinci, zintlungu ezingenasifo entendeni. Iinqununu zingase ziqale ukudibanisa, kwaye ulusu luba lukhuni. Ekugqibeleni, kwizigaba ezilandelayo zesifo, isikhumba kunye neenkontileka ze-fascia eziphantsi, kubangela ukukhubazeka kwesandla somnwe kunye nomnwe. Abantu abanesivumelwano sikaDupuytren baneminwe eguqulwe entendeni yesandla.
Nangona yonke iminwe ingabandakanyeka, isivumelwano sikaDupuytren sithintela kakhulu intsimbi kunye neminwe encinane. Ukuqhubela phambili kweDupuytren kuhlalutya ngokukhawuleza, kulandelwa ngamaxesha atshintsha utshintsho. Isivumelwano sikaDupuytren asisoloko sibuhlungu, kodwa sinokukhathazeka kakhulu. I-Dupuytren idla ngokukhawuleza ukubandakanyeka kwesandla kodwa ingabandakanya ezinye iindawo zomzimba, ngokuqhelekileyo iziqatha zeenyawo. Phantse iipesenti ezintlanu zezigulane ezinesivumelwano sikaDupuytren nazo zinomxholo ofanayo weenyawo ezibizwa ngokuba yiLederhose's disease.
I-Dupuytren's Contracture kunye neSifo
Uninzi lwabantu, oogqirha abandakanyekileyo, sebenzisa le migaqo ngokungafaniyo. Ukuthetha ngokwezakhono, isifo sikaDupuytren sibhekisela ekugqibeleni kweeseli ezibangela ukubunjwa kweengqungquthela kunye nezivumelwano.
Isivumelwano sikaDupuytren sisiphumo solu hlobo lwentlupheko kunye nesibonakaliso esifanayo sesifo sikaDupuytren. Ukunyangwa kwesivumelwano sikaDupuytren sinokuqwalaselwa xa imeko ibangela nzima ukwenza imisebenzi yemihla ngemihla.
Izinto zokuxela
| Heredity | Imbali yale meko ngaphakathi kwentsapho yakho ibonisa ukuba iya kuba nobudlova. |
| Ngesondo | I-Dupuytren ihlala iqalisa kamva kwaye iqhubela phambili kancinci kwabasetyhini. |
| Utywala okanye utywala | Le miqathango inxulumene neDupuytren eyona enobudlova, kwaye kungenzeka ukuba iphinde ibuye. |
| Indawo yeSifo | Xa ezandleni zombini, okanye xa kunokubandakanyeka kweenyawo ezihambelanayo, ukuqhubela phambili kuhamba ngokukhawuleza. |
| Ukuziphatha kwezifo | I-Dupuytren yenyameko iyakwazi ukubuyela emva kokuhlinzwa kwaye uqhubeke uhlasele. |
Kwiminyaka emininzi, unyango kwiinqanaba zokuqala zesivumelwano sikaDupuytren wawulindi kwaye ulinde imeko. Kungenxa yokuba unyango olusakhulayo luyingozi kwaye ludinga ukufumana ixesha elide lokubuyiselwa kunye nokuvuselelwa, kwakudla ngokugcinwa njengento yokugqibela yokukhetha ukuba iimpawu zaqala ukuphazamisa kakhulu imisebenzi yemihla ngemihla.
Kungekudala, ukhetho oluncinci lwezokwelapha luye lunika ithemba lokuba isivumelwano sikaDupuytren sinokulawulwa kakuhle, ngakumbi xa siphathwa kwiimvavanyo zangaphambili zengxaki.
Siyazi ukuba ukugqithisa kwesivumelwano, kunzima ukuba kubekho umsebenzi wesandla oqhelekileyo kwakhona. Ngenxa yoko, abantu abaninzi bafuna iindlela zokunyanga ezingaphantsi, ngokukodwa kwintsebenzo yokuqala yeDupuytren.
Unyango
Kukho iindlela ezine eziphambili zonyango olukhoyo okwangoku unyango lwesivumelwano sikaDupuytren:
- Ukuqwalasela: Ukuqwalaselwa kwisoloko kuthethwa kwinqanaba lokuqala likaDupuytren. Oku kudla ngokuba yinto enhle kakhulu kubantu abangenakukhubazeka ngumsebenzi wabo wesandla. Oku kungabandakanya abantu abanesivumelwano esincinci, okanye abantu abangazisebenzisi ngezandla zabo, kwaye banokwenza yonke imisebenzi yabo eqhelekileyo.
- I-Needle Aponeurotomy : I- needle aponeurotomy yinkqubo ephuhliswe eFransi, esanda kudlalwa kakhulu e-United States. Ukusebenzisa izinto ezingabonakaliyo, inaliti isetyenziselwa ukwahlula iintambo zeDupuytren, nokubuyisela ezinye okanye ukunyakaza kwamanwe. I-needle aponeurotomy iphumelele kakhulu kwiimpawu zokuqala zikaDupuytren.
- I-Collagenase Injections : I- Collagenase yi-enzyme eyenziwa yi-bhakteriya ejoyiweyo kwintambo ye-Dupuytren. I-enzyme isebenza ukutshabalalisa izicubu ezinzima zikaDupuytren. Ngelinye ilanga emva kwentsholongwane, emva kokuba i-enzyme yenze umsebenzi wayo, ubuyela kugqirha ukuze ube nomunwe owenziwe ukuze udibanise izicubu eziqinisiweyo, kwaye ubuyisele ukuhamba komunwe.
- Ugqirha: Uphando lwenziwe ukususa i-fascia yesundu entendeni yesandla. Ugqirha lunokusebenza ngokubuyisela umsebenzi, kwaye unokuba luyimfuneko kwizigaba ezilandelayo zesivumelwano sikaDupuytren. Utyando luvame ukuhlaziywa ixesha elide.
Ukuhlinzwa
Kwezinye izigulane, unyango oluncinci olungapheliyo lungafanelekanga. Kwakhona, akubona bonke oogqirha bayazi ukuba i-needle aponeurotomy yinkqubo yokonyango kwintengiso kaDupuytren. Kukho imbambano malunga nokusetyenziswa kolu unyango, ngoko ke akubona bonke oogqirha batusa i-needle aponeurotomy. Ukuba ufuna ukuxoxa nge-alexone aponeurotomy kunye ne-physicain, unokufumana uluhlu lwamagqirha enza le nkqubo kwiwebhusayithi yeDupuytren's-Online.
Inkqubo yokuhlinzwa yesikontraka seDupuytren yaziwa ngokuba yi-fasciectomy, apho iinqununu ze-fascia yesundu zisuswa. Ingcipheko yokuhlinzwa kukuba kukho iingozi ezibalulekileyo ezihambelana nenkqubo. Into eqhelekileyo kukuba iishubhu ezibomvu zingenza emva kokuhlinzwa, ezikhokelela kwingxaki efana nesivumelwano sikaDupuytren, kodwa sinokubunjwa kwamathambo. Kwakhona, i-Dupuytren iya kubuya, kwaye ukuhlinzwa okwesibini kubangele iingxaki. Ezinye iingxaki zokuhlinzwa zibandakanya ukulimala kwentsholongwane, ukusuleleka kunye nokuphilisa ixesha elide.
Ku hlaziywa
Ukubuyiselwa emva kwe-needle aponeurotomy ngokukhawuleza. Ngokuqhelekileyo, izigulane ziyakwazi ukuqhuba izinto eziqhelekileyo ngokukhawuleza, kwaye ziyalelwe ukuba zibalekele ezemidlalo kunye nokusebenza nzima ngenxa yeveki. Ngokuxhomekeke kwintlobo yesivumelwano, unqabileyo olukhutshwayo lunokunikwa ukuba lunxibe iiyure ezimbalwa ngosuku.
Ukubuyiselwa emva kokuhlinzwa kuhluka kakhulu. Izigulane ezineemvumelwano ezincinci zinokukwazi ukuphinda zenze imisebenzi eqhelekileyo enye yokunyanga okukuphilisa, kwiiveki ezimbalwa. Izivumelwano ezinzima kakhulu zingadinga iinyanga zokudibanisa kunye nokuvuselela ngesandla somthintelo ukukhusela ukubunjwa kweethambo.
Imithombo:
Benson LS, et al. "Isivumelwano sikaDupuytren" J. Am. Acad. IOrn. Surgery; 6: 24 - 35.
I-Eaton C, Isixhobo soPhatha © 2007.
UMurphy K, "Ukulungiswa kweeNgqumbo eziBanjisiweyo, Akukho buChengechunge obufunekayo" I-New York Times ngoJulayi 24, 2007.