国人掌腱膜挛缩症69例疗效分析

The treatment of Dupuytren's disease in 69 Chinese cases

目的 探讨国人掌腱膜挛缩症的发病特点与治疗效果。方法 收集本院近 2 0年的临床 6 9例资料 ,从发生率、家族史、相伴的慢性心肺疾病、吸烟饮酒生活习惯、病理组织检查和手术效果等进行回顾性分析。结果 国人的本症发生率近几年有上升趋势 ;有家族史的患者罕见 ;且常伴有影响氧交换的慢性呼吸循环系统疾患 ;有烟酒嗜好者占 39 1% ;活动期有肌成纤维细胞簇集成团及大量Ⅲ型胶原纤维的病理组织出现 ;掌腱膜全部切除与部分切除的治疗效果无差异性。结论 戒烟戒酒及治疗慢性心肺疾病对防治国人掌腱膜挛缩症有积极意义 ;挛缩的病理组织基础是肌成纤维细胞簇集成团及大量Ⅲ型胶原纤维形成 ;应用显微外科手术彻底切除手掌。

Objective To investigate the incidence of Dupuytrens contracture and its treatment result. Methods Clinical data in 69 Chinese cases were collected and systematic review from its incidence, patients family history,association with chronic pulmonary heart disease,the habit of smoking or drinking,examination of pathological tissue and operative results.Results In recent years,the incidence of Dupuytrens contracture tends to rise.There were a few patients with inherited history.The patients used to associate with chronic pulmonary heart disorder,which affected oxyenic exchange.39 1% patients were found of smoking and drinking.The myofibroblast connected cell to cell and the type Ⅲ collagen tibers appeared in the lesion tissues in the active stage of Dupuytrens contracture.There was no significant difference from treament result between plam total aponeurectomy and segmental aponeurectomy.Conclusion To stop smoking and drinking have great significance of preventing Dupuytrens contracture.The chronic pulmonary heart disease must be treated.The pathological base of Dupuytrens contracture are the connection of myofibroblast and the formation of type Ⅲ collagen.To dissect the lesion tissues of palm and fingers thorougthly with microsurgical technique can prevent recurrence of disease.