Chirwere cheDupuytren chirwere chinoramba chichienderera mberi chinokonzera kushanduka uye kusingagadziriswi kwechigunwe chimwe kana kupfuura cheruoko. Chibvumirano ichi chisingaperi chinokanganisa munwe wechina nechishanu. Kurwiswa uku kuri kuremadza muchimiro chayo chakakomba (apo chigunwe chakanyatsopetwa muchanza), asi kazhinji chisingarwadze. Kwakabva chirwere ichi, chakatumidzwa zita raBaron Guillaume de Dupuytren uyo akaritsanangura muna 1831, haazivikanwi kusvikira nhasi. Kuvhiya kungave kuri madikanwa kudzorera chigunwe chakakanganisika pakukwanisa kwayo kufamba, asi kudzokorora kwakajairika.

Chirwere cheDupuytren chinoratidzwa nekukora kwenyama pakati peganda uye tendon pachanza cheruoko pamwero weminwe (palmar fascia). Sezvo inoshanduka (kazhinji isingaiti asi isingadzivisiki), "inoputira" chigunwe kana zvigunwe kune muchanza uye inodzivirira kuwedzera kwavo, asi kwete kutenderera kwavo. Iko kufambira mberi kwekugadzirisa kwezvinyama kunoonekwa kune ziso nekuumbwa kwe "tambo".

Zvinowanzoitika pazera remakore makumi mashanu kuti zviratidzo zvekutanga zvechirwere cheDupuytren zvinoonekwa. Zvinofanira kuonekwa kuti vakadzi vanowanzoita chirwere gare gare kupfuura varume. Iva sezvazvingaite, kukurumidza kurwisa, ndiko kunonyanya kukosha.

Zvose zvigunwe zvemaoko zvinogona kuchinjwa, asi mu75% yezviitiko kubatanidzwa kunotanga nechigunwe chechina nechishanu. (1) Izvo zvakanyanya zvishoma, asi chirwere cheDupuytren chinogona kukanganisa kumashure kweminwe, pasi petsoka (chirwere cheLedderhose) uye murume wepabonde (Peyronie's disease).

Kwakabva chirwere cheDupuytren hachisati chazivikanwa nanhasi. Chingave chikamu (kana chisiri zvachose) chekwakabva, nhengo dzakawanda dzemhuri dzinowanzobatwa.

Kunwa doro uye fodya kunozivikanwa sechinhu chinokonzera njodzi, sezvinoonekwa kuti zvirwere zvakawanda dzimwe nguva zvinosanganiswa nechirwere cheDupuytren, zvakadai sepfari uye chirwere cheshuga. Kukakavadzana kunomutsa nyika yezvehutano pamusoro pekuratidzwa kwebasa rebiomechanical sechinhu chinokonzera chirwere cheDupuytren. Chokwadi, zvidzidzo zvesainzi zvakaitwa pakati pevashandi vemaoko zvinoratidza kushamwaridzana pakati pekusangana nekudengenyeka uye chirwere cheDupuytren, asi mabasa emawoko haazivikanwe - kusvika nhasi - sechikonzero kana njodzi. (2) (3)

Zvikonzero zvechirwere hazvizivikanwe, hapana kurapwa kuripo kusvika nhasi, kunze kwekuvhiyiwa. Chokwadi, kana kudzokororwa kuchidzivirira kuwedzera kwechigunwe chimwe chete kana kupfuura, kuvhiyiwa kunozotariswa. Inoitirwa kudzoreredza huwandu hwekufamba kumunwe wakabatwa uye kudzikisira njodzi yekupararira kune zvimwe zvigunwe. Muedzo wakapfava ndewekukwanisa kuisa ruoko rwako rwakati sandarara panzvimbo yakati sandara. Rudzi rwekupindira kunoenderana nedanho rechirwere.

• Chikamu chematomu (aponeurotomy): izvi zvinoitwa pasi peanesthesia yemunharaunda, asi inopa njodzi yekukuvara kumidziyo, tsinga uye tendon.
• Kubviswa kwematomu (aponevrectomy): kuvhiyiwa kunotora pakati pemaminitsi makumi matatu nemaawa maviri. Mune maitiro akaoma, kubvisa kunoperekedzwa nekugadzirisa ganda. Iyi "inorema" yekuvhiya ine mukana wekudzikamisa njodzi yekudzokazve, asi iyo yakashata yekusiya yakakosha aesthetic sequelae.

Sezvo chirwere ichi chiri kufambira mberi uye kuvhiyiwa kusingagadziri zvikonzero zvayo, njodzi yekudzoka zvakare yakakwirira, kunyanya munyaya yeaponeurotomy. The recidivism rate inosiyana pakati pe41% ne66% zvichienderana nekwakabva. (1) Asi zvinokwanisika kudzokorora kupindira kwakawanda panguva yechirwere.

Mushure mekuvhiyiwa, murwere anofanira kupfeka orthosis kwemavhiki akati wandei, mudziyo unochengeta munwe wakavhiyiwa uchiwedzera. Inogadzirwa neoccupational therapist. Kugadziriswa kweminwe kunozonyorwa kuitira kuti udzorere huwandu hwayo hwekufamba kumunwe. Kuvhiya kunoratidza njodzi, mu3% yezviitiko, yekuburitsa trophic kusagadzikana (yakashata vascularization) kana algodystrophy. (IFCM)