Sibutsetelo
Isimo sobuhlungu besifunda esiyinkimbinkimbi (i-CRPS) yisimo esibuhlungu esingapheli esicatshangelwa ukuthi siwumphumela wokungasebenzi emisebenzini yezinzwa noma eziyinkimbinkimbi. Amagama asebekhulile asetshenziselwa ukuchaza isifo esibucayi se-syndrome yesifunda kukhona:
- I- dlexstyphy syndrome ye-Reflex (RSDS)
- Causalgia
I-Causalgia yayiyisikhathi sokuqala esasetshenziswa ngesikhathi seMpi Yombango ukuchaza ubuhlungu obukhulu, obubuhlungu obuzwa abanye abadala ngemuva kokuba amanxeba abo aphulukiswe.
Izici ezijwayelekile zesifo esibucayi se-syndrome zesifunda zihlanganisa izinguquko ezinkulu embala kanye nokushisa kwesikhumba phezu kwesigungu esithintekayo noma ingxenye yomzimba, ephelezelwa:
- ubuhlungu obuvuthayo obukhulu
- ukuzwela kwesikhumba
- ukuthuthumela
- ukuvuvukala
I-CRPS Ivame ukubangelwa ukulimala kwezicubu; leli gama lichaza zonke iziguli ezinezimpawu ezingenhla kodwa ngaphandle kokulimala kwesibindi. Abantu abane-CRPS II bahlangabezana nezimpawu ezifanayo kodwa amacala abo ahlotshaniswa ngokucacile nokulimala komzimba. Isimo sezinhlungu zesifundazwe esiyinkimbinkimbi singashaya kunoma yikuphi ubudala futhi sithinta kokubili amadoda nabesifazane, nakuba ochwepheshe abaningi bevuma ukuthi kuvame kakhulu kwabesifazane abasha.
Izimpawu
Isibonakaliso esiyinhloko se-syndrome yesifo esiyinkimbinkimbi esiyinkimbinkimbi siqhubeka, ubuhlungu obuningi bukhulu ngokulingana nobukhulu bokulimala (uma kwenzeka ukulimala), okubi kakhulu kunokuba kungcono ngokuhamba kwesikhathi. Isimo sezinhlungu zesifundazwe esiyinkimbinkimbi ngokuvamile sithinta enye yezimiso ezifana nalezi:
- izingalo
- imilenze
- izandla
- izinyawo
Isimo sezinhlungu zesifundazwe esiyinkimbinkimbi sivame ukuhambisana nalokhu:
- "ukushisa" ubuhlungu
- ukwandisa ukuzwela kwesikhumba
- izinguquko ekushiseni kwesikhumba: efudumele noma epholile uma kuqhathaniswa nomkhawulo ohlukile
- Izinguquko embala wesikhumba: zivame ukuhlunga, zibomvu, ziphaphathekile noma zibomvu
- Izinguquko ekuthungweni kwesikhumba: zikhazimulayo futhi zizincane, futhi ngezinye izikhathi zithuthuka ngokweqile
- ushintsho emaphethini okukhula kwe-nail nezinwele
- ukuvuvukala nobunzima emajoyini abathintekayo
- ukukhubazeka kwezimoto, futhi kunciphise ikhono lokuhambisa umzimba okhuthele
Ngokuvamile ubuhlungu buyasakazeka ukufaka yonke ingalo noma umlenze, nakuba ukulimala okuqala kungenzeka kube ngomunwe noma ngomunwe. Ngezinye izikhathi ubuhlungu bungahamba ngisho nokuya emkhawulweni ohlukile. Kungase kukhuliswe ukucindezeleka ngokomzwelo.
Izimpawu zesifo esiyinkimbinkimbi yesifo esifundazweni ziyahlukahluka ngobude nobude. Abanye ochwepheshe bakholelwa ukuthi kunezigaba ezintathu ezihambisana nesifo esibucayi se-syndrome esifundazweni, esibhalwe izinguquko eziqhubekayo esikhumbeni, emisipha, emagxeni, emigqeni, nasemathanjeni endaweni ethintekile, nakuba lokhu kuqhubeka kungakaqinisekiswa ngezifundo zokwenza ucwaningo.
- Isiteleka esisodwa kucatshangwa ukuthi sihlala ezinyangeni ezi-1 kuya kwezingu-3 futhi sibonakala ngobuhlungu obunzima, obuvuthayo, kanye nobuhlungu besisu, ukuqina okuhlangene , ukukhula kwezinwele okusheshayo, nokuguqulwa emithanjeni yegazi okwenza isikhumba sishintshe umbala nokushisa.
- Isigaba sesibili sithatha izinyanga ezintathu kuya kweziyi-6 futhi sibonakala ngokuqinisa ubuhlungu, ukuvuvukala, ukunciphisa izinwele ezikhulayo, eziphukile, ezinamahloni, ezinamakhaza, noma ezinamabala, amathambo athambile, amalunga anamandla, kanye nezwi elibuthakathaka.
- Esigabeni sesithathu i -syndrome iqhubekela phambili ekugcineni lapho izinguquko esikhumbeni nasetheni zingasakwazi ukuguqulwa. Ubunzima buyabalaza futhi bungabandakanya wonke umlenze noma indawo ethintekile. Kungase kubekwe ukulahleka kwemisipha (i-atrophy), ukuhamba okulinganiselwe kakhulu, nokuphambana okungazibandakanyi kwemisipha namathenda aguqulela amalunga. Ama-limbs angase ahlelwe.
Izimbangela
Odokotela abaqiniseki ukuthi yini ebangelwa isifo esibucayi se-syndrome yesifunda. Kwesinye isikhathi isistimu yomzwelo enozwela idlala indima ebalulekile ekusimeni ubuhlungu. Izinganekwane zamuva zisho ukuthi izimpande zobuhlungu ezingxenyeni ezithintekayo zomzimba ziphendukela emndenini wezikhonzi zesistimu zesisindo ezibizwa ngokuthi ama-catecholamines.
Ucwaningo lwezilwane lubonisa ukuthi i-norepinephrine, i-catecholamine ekhishwe emisebeni yethando, ithola ikhono lokuvuselela izinhlungu ezibuhlungu ngemuva kokulimala noma ukulimala kwenzwa. Isimo sobuhlungu obuzwakalayo obunomusa esibucayi esifundeni se-syndrome esifundazweni asiyazi.
Abanye ochwepheshe bakholelwa ukuthi ukubaluleka kwesimiso sezinzwa ezizwelayo kuncike esigabeni sesifo.
Enye inkolelo yukuthi isifo esibucayi esifundazweni esibuhlungu ngemuva kokulimala (CRPS II) sibangelwa ukuvusa ukuphendula kwamagciwane, okuholela ekubonakalweni kwezimpawu zokuvuvukala, ukufudumala nokuvuvukala endaweni ethintekile. Ngakho-ke isifo sezinhlungu zesifundazwe singavumelana nokuphazamiseka kwenqubo yokuphulukisa. Kungenzeka ukuthi, i-syndrome yesifo esiyinkimbinkimbi yesifunda ayinaso isizathu esisodwa, kodwa kunalokho kungumphumela wezimbangela eziningi eziveza izimpawu ezifanayo.
Ukuxilongwa
I-syndrome yesifo esiyinkimbinkimbi yesifunda (i-CRPS) itholakala ngokuyinhloko ngokubheka izimpawu nezimpawu. Kodwa ngenxa yokuthi ezinye izimo eziningi zinempawu ezifanayo, kungaba nzima odokotela ukuxilongwa ngokuqinile kwesifo esibucayi esifundeni se-syndrome ekuqaleni kwenkinga lapho izimpawu zimbalwa noma zincane. Noma, isibonelo, i-nerve entrapment elula ingase ibangele ubuhlungu obukhulu ngokwanele ukuthi bufane nobuhlungu besifo sezwe esifundazweni. Ukuthola ukuxilonga kuyinkimbinkimbi nakakhulu yokuthi abanye abantu bayothuthuka kancane kancane ngokuhamba kwesikhathi ngaphandle kokwelapha.
Njengoba kungekho ukuhlolwa okuqondile kokuxilongwa kwe-syndrome yesifo esiyinkimbinkimbi yesifunda, indima ebaluleke kakhulu yokuhlola ukusiza ukulawula ezinye izimo. Abanye odokotela basebenzisa isisusa endaweni ukuze babone ukuthi kubangela ubuhlungu njengalawa:
- thinta
- pinpricks
- ukushisa
- kubanda
Odokotela bangase basebenzise ama-bone scans-phase scans ukuze babone izinguquko ezitheni nasegazini legazi.
Ukwelapha
Ngenxa yokuthi ayikho indlela yokwelashwa kwesifo esiyinkimbinkimbi yesifunda, ukwelashwa kuhloswe ekuqedeni izimpawu ezibuhlungu ukuze abantu bakwazi ukuqhubeka nokuphila kwabo okuvamile. Izindlela zokwelapha ezilandelayo zivame ukusetshenziswa:
- Ukwelapha ngokomzimba: Ukwelapha ngokomzimba okuqhubeka kancane noma ukuvivinya umzimba ukuze ugcine isilonda esibuhlungu noma isitho somzimba esihambayo kungasiza ukubuyisela ezinye izinyathelo zokuhamba nokusebenza.
- I-Psychotherapy: I- Complex syndrome yesifo esiyinkimbinkimbi ngokuvamile iba nemiphumela emibi yengqondo kubantu nasemindenini yabo. Labo abanesifo esibuhlungu besifunda esifundazweni bangase babe nezinkinga zokucindezeleka, ukukhathazeka, noma ukucindezeleka kokucindezeleka ngemva kokucindezeleka , konke okukhulisa umbono wezinhlungu nokuyenza imizamo yokuvuselela kunzima kakhulu.
- Isibungu sezinzwa ezizwelayo: Ezinye iziguli zizothola impumuzo enkulu ebuhlungu kusuka emabhuloki anomzwelo. Amabhuloki azwelayo angenziwa ngezindlela ezihlukahlukene. Inqubo eyodwa ihilela ukuphathwa kwe-phentolamine, okuyisithiyo esivimbela ama-receipt sympathetic. Enye inqubo ihilela ukufakwa kwe-anesthetic eduze komgogodla ukuvimbela ngqo izinzwa zomzwelo.
- Imithi: Amakilasi amaningi ahlukene wemithi asetshenziselwa ukwelapha isifo esibucayi se-regional syndrome, kuhlanganise:
Kodwa-ke, ayikho isidakamizwa esisodwa noma ukuhlanganiswa kwezidakamizwa kuye kwaveza ngcono okuqhubekayo okuqhubekayo ezimpawu.
- izidakamizwa ze-analgesic ezishintshayo ezisebenza endaweni yangakini ezinemizwa ebuhlungu , isikhumba, nemisipha
- izidakamizwa zokuhlukunyezwa
- ukucindezeleka
- i-corticosteroids
- ama-opioid
- I-sympathectomy yokuhlinza : Ukusetshenziswa kwe-sympathectomy yokuhlinzwa, inqubo ebulala izinzwa ezihilelekile ebuhlungu besifo sezwe esifundazweni, inengxabano. Abanye ochwepheshe bacabanga ukuthi akudingekile futhi kwenza ubuhlungu besifundazwe buhlungu kakhulu; abanye babika umphumela omuhle. I-sympathectomy kufanele isetshenziswe kuphela kwiziguli ezinobuhlungu obukhulu kakhulu (nakuba okwesikhashana) yizivimbela ezithandekayo.
- Ukuvuselela kwentambo yomgogodla : Ukufakwa kwamagesi okuvuselela eduze komgogodla kunikeza ukuzwa okujabulisayo endaweni ebuhlungu. Le nqubo ivela ukusiza iziguli eziningi ngobuhlungu bazo.
- Amapompo e-intrathecal izidakamizwa: Lawa madivaysi alawula izidakamizwa ngqo kumgogodla we-spinal, ukuze ama-opioid kanye nama-anesthetic zendawo angakhululwa ekuboniseni izinhlungu emgodini womgogodla emazingeni aphansi kakhulu kunezo ezidingekayo zokuphatha ngomlomo. Le nqubo yehlisa imiphumela emibi futhi yandisa ukusebenza kwezidakamizwa.
Isibikezelo
Isibikezelo se-syndrome yesifo esiyinkimbinkimbi esifundeni siyahlukahluka kusuka komuntu kuya komuntu. Ukuxoxwa okungajwayelekile kwamabonakaliso kubonakala kubantu abathile. Abanye bangaba nobuhlungu obungenakuqhathaniswa nokukhubazeka, izinguquko ezingaphenduki naphezu kokwelashwa. Abanye odokotela bakholelwa ukuthi ukwelashwa kwasekuqaleni kuyasiza ekunciphiseni ukukhubazeka, kodwa le nkolelo ayikakasekelwa ubufakazi obuvela kwizifundo zempilo. Ucwaningo olwengeziwe luyadingeka ukuze siqonde izimbangela zesifo esiyinkimbinkimbi yesifo esifundazweni, ukuthi siqhubeka kanjani, kanye nendima yokwelashwa kokuqala.
Umthombo: I-NIH Publication No. 04-4173 (ehleliwe)