A Yankin Ƙananan Tsakanin Don Kwancen Yatse
Kamfanin Dupuytren yana da yanayin da zai sa yatsunsu su shiga cikin matsayi. Kamfanin Dupuytren na faruwa ne, a dubban dubban jama'ar {asar Amirka da miliyoyin mutane, a dukan fa] in duniya. Halin yana hana wadanda ke fama da damar yada yatsunsu yatsunsu, kuma mummunan zai iya tsaura daga matsananciyar sauƙi tare da yawancin motsi na yatsa na al'ada zuwa lokuta mai tsanani idan yatsunsu suka zama a cikin hannun hannun.
Druytren kwangila shine bayyanar cutar ta Dupuytren, ciwon da zai iya haifar da kwangila na laushi a kan ƙafafun (Lederhose) ko, a cikin maza, a cikin azzakari ( cutar Peyronie ). Babu magani da aka sani don cututtukan Dupuytren, kuma kadan ya fahimci dalilin wannan yanayin. Har zuwa kwanan nan, akwai magungunan marasa lafiya da yawa waɗanda ke shan wahala daga waɗannan yanayi.
Collagenase Injections
Collagenase ya samo asali ga wasu marasa lafiya da kwangilar Dupuytren. Irin nau'in nama da ke aiki a cikin dabino da yatsunsu ya kasance daga collagen. Kasuwancin yana samar da nodules da igiyoyi waɗanda ke jan yatsunsu a cikin dabino. Collagenase wani enzyme ne wanda kwayar halitta mai suna Clostridium histolyticum ta samo, kuma wannan enzyme yana cinyewa a collagen, yana haifar da tsarin da ya raunana. Ana fitar da collagenase daga kwayoyin, kuma an sanya shi a cikin igiyoyin Dupuytren ta likitan ku.
Wata rana bayan allurar, bayan da enzyme ya yi aiki, sai ku koma likitan don yatsan yatsan don karya abin da ya fi ƙarfafa, kuma ku sake motsa motsi.
An sayar da allurar collagenase karkashin sunan Xiaflex kasuwanci. Ya zo shirya a cikin wani sirinji wanda aka kai tsaye zuwa ga likitanka.
Duk wani likita zai iya zama kwarai don gudanar da inganci na Xiaflex, amma wannan magungunan likitoci ne, likitocin hannu, da masu ilimin rheumatologists.
Jiyya ga kwangilar Dupuytren
Har zuwa kwanan nan, kawai zaɓuɓɓuka don kula da kwangilar Dupuytren an lura ko tiyata. Domin tiyata yana da mummunan haɗari, kuma yana iya haɗawa da gyaran gyare-gyare, mafi yawan likitocin sunyi shawarar jira har tsawon lokacin da zai yiwu, to, yana da tiyata lokacin da ake bukata. Abubuwa sun canza, kuma kamar yadda cututtuka marasa galihu sun samo asali, da dama likitoci suna ƙoƙari su bi da kwangilar Dupuytren a farkon matakai, don hana ci gaba zuwa nakasar da ya fi tsanani wanda ya fi sauƙi a gyara.
Gaba ɗaya, akwai nau'ukan maganin hudu don yarjejeniyar Dupuytren:
- Abinda ke lura: Abinda ke kallo shi ne daidaitaccen maganin farko na Dupuytren. Yawancin mutane da ƙananan kwangila ba su damu da yanayin, kuma idan akwai ci gaba kadan, to, ba za a buƙaci magani ba. Wadannan marasa lafiya suna iya kula da yanayin su akai-akai don bincika cigaba.
- Abun bugun fata : An yi amfani da ƙwayoyin bugun zuciya a Turai har tsawon shekarun da suka gabata, kuma ya zama mafi shahara a Amurka a cikin shekaru goma da suka gabata. A cikin wannan hanya, likitanka yana amfani da tipar allura don kwance ƙirar nama don warwareccen yatsa don daidaitawa. Ba a buƙatar haɗari mai yawa. Wasu likitoci da marasa lafiya sun fi son wannan hanya saboda yawancin maganin (wanda ba a lura da shi) ba ne, kuma ana iya yin sau ɗaya kawai a ziyarar guda ɗaya, tare da karamin ƙima.
- Collagenase: Harkokin Collagenase sun zama shahararrun tun daga shekara ta 2010 lokacin da FDA ta yarda da maganin farko don amfani a Amurka. Ana sayar da collagenase karkashin sunan kasuwanci Xiaflex, kuma dole ne a likita ta likita wanda aka horar da amfani da magani. Gudun maganin collagenase yana da tsada (fiye da $ 3000), kuma yana iya buƙatar fiye da ɗaya nau'i na magani a cikin kwangila da yawa. Wannan ya ce, wannan magani yana kusan ko da yaushe tsada fiye da ciwon tiyata.
- Tiyata: Kamar yadda aka fada, har kwanan nan, tiyata ne kawai magani don kwangilar Dupuytren. Duk da yake aikin tiyata ne sau da yawa mafi kyawun maganin kula da kwangila mafi tsanani, akwai wasu ƙananan. Jirgin ya fi muni, ya fi zafi, kuma sau da yawa ya ƙunshi gyara fiye da yadda ba za a iya ba. Wannan ya ce, zaɓuɓɓuka marasa rinjaye sun fi dacewa su yi mafi kyau a marasa lafiya tare da kwangila masu sauƙi da matsakaici yayin da sakamakon bayan da aka fi dacewa da maganin deformities tare da tiyata. Bugu da ƙari, an nuna tiyata don bayar da agaji na tsawon lokaci, tare da tsawon lokaci har sai sake dawo da nakasar.
Wanne Ne Mafi Girma?
Babu ainihin 'mafi kyau maganin,' kamar yadda duk waɗannan zaɓuɓɓuka suna da ribobi da kuma fursunoni. Tabbas, idan wani zaɓi mai raguwa ya dace, to, mafi yawan marasa lafiya zasu fi son irin wadannan zaɓuɓɓuka. Abin takaici, wasu marasa lafiya suna buƙatar karin magani, kuma a waɗannan lokuta, tiyata yana iya zama mafi kyau. Duk wani zaɓi da ka zaɓi, yana da muhimmanci a gano likita wanda ke yin amfani da magani a kai a kai, kuma yana da kwarewa ta yau da kullum tare da zaɓaɓɓun hanya. Wasu likitoci sun gwada da fasaha fiye da ɗaya, amma sau da yawa idan kana so ka kwatanta zaɓuɓɓuka, dole ne ka ga likita fiye da ɗaya.
A koyaushe ina fada wa marasa lafiya, ko da wane irin magani ne aka zaba, marasa lafiya suna bukatar fahimtar cewa akwai maganin cutar Dupuytren a halin yanzu, kawai jiyya don bayyanar yanayin (kwangila). Sabili da haka, ko da wane irin maganin da ake yi, sake komawa kwangilar wataƙila. Komawa bayan bugun kwayar cutar tazarar shekaru 3 yana da shekaru 3, bayan aikin tiyata yawancin shekaru biyar ne. Babu cikakkun bayanai a wannan lokaci don sanin yadda yaduwar cututtuka na collagenase zai yi dangane da ƙimar komawa.
Sources:
Black EM da Blazar PE. "Cututtuka na Dupuytren: Ƙwarewar Juyewar Halitta na Tsofaffi" J Am Acad Orthop Surg Disamba 2011; 19: 746-757.
Murphy K, "Dattijon Tsarkakewa, Babu Wajibi Da ake Bukata" The New York Times Juli 24, 2007.