Dupuytrens病——新发现:综述。

IF 0.6 Q4 SURGERY
Andrzej Żyluk
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引用次数: 0

摘要

Dupuytrens病是一种常见的掌腱膜纤维化疾病,其特征是结节和索的形成,以及手指进行性屈曲畸形的发展,导致功能障碍。手术切除受影响的腱膜仍然是最常见的治疗方法。关于该病的流行病学、发病机制,特别是治疗方面出现了不少新信息。本研究的目的是对这一主题的科学数据进行最新的回顾。流行病学研究结果表明,Dupuytrens病在亚洲和非洲人群中并不像以前认为的那样罕见。遗传因素在一部分患者的疾病发展中发挥了重要作用,然而,它既没有转化为治疗,也没有转化为预后。最大的变化涉及Dupuytrens病的管理。在早期阶段,向结节和索内注射类固醇对疾病的抑制有积极作用。在晚期,部分筋膜切除术的标准技术部分被微创方法取代,如针筋膜切开术和胶原酶注射。2020年,胶原酶意外退出市场,导致这种治疗的可获得性受到相当大的限制。似乎关于Dupuytrens病的最新知识可能对参与疾病管理的外科医生感兴趣和有用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dupuytrens disease - whats new: a review.

Dupuytrens disease is a common fibrotic disorder of the palmar aponeurosis characterized by the formation of nodules and cords, as well as development of progressive flexion deformities in the digits, leading to functional impairment. Surgical excision of the affected aponeurosis remains the most common treatment. Quite a few new information appeared about epidemiology, pathogenesis and particularly treatment of the disorder. The objective of this study is an updated review of scientific data in this topic. Results of epidemiologic studies showed that Dupuytrens disease is not so uncommon in Asian and African population as it was earlier believed. An important role of genetic factors on development of the disease in a proportion of patients was demonstrated, however, it did not translate neither to the treatment nor to the prognosis. The most changes concerned the management of Dupuytrens disease. A positive effect of steroids injections into the nodules and cords for inhibition of the disease in early stages was shown. In the advanced stages, a standard technique of partial fasciectomy was partly replaced by mini-invasive methods such as needle fasciotomy and collagenase Clostirdium hystolyticum injections. Unexpected withdrawal of collagenase from the market in 2020 resulted in considerable limitation of the availability of this treatment. It seems that updated knowledge on Dupuytrens disease may be interested and useful for surgeons involved in management of the disorder.

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CiteScore
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