I-Phenomenon kaRaynaud ichazwe
Isimo sikaRaynaud siyisifo esithinta imithwalo yegazi eminwe, izinzwane, izindlebe nekhala. Le disorder ibhekene nokuhlaselwa kwe-episodic, okubizwa ngokuthi ukuhlasela kwe-vasospastic, okubangela imithwalo yegazi emadijinini (iminwe kanye nezinzwane) ukuze iminyene (emincane). Isimo sikaRaynaud singase senzeke sodwa, noma singaba sesibili kwezinye izimo.
Nakuba izilinganiso zihluka, ukuhlolwa kwamuva kubonisa ukuthi isenzo sikaRaynaud singathinta amaphesenti angu-5 ukuya kwangu-10 ebantwini abaningi e-United States. Abesifazane banamathuba amaningi kunamadoda ukuthi abe nesifo. Isimo sikaRaynaud sibonakala sivame kakhulu kubantu abahlala ezindaweni ezibandayo. Kodwa-ke, abantu abane-disorder abahlala ezindaweni ezimbi kakhulu bangase babe nokuhlaselwa okuningi ngesikhathi sezulu sezulu.
Kwenzekani Ngesikhathi Sokuhlaselwa?
Kubantu abaningi, ukuhlaselwa kuvame ukubangelwa ukuvezwa kokucindezeleka okubandayo noma ngokomzwelo. Ngokuvamile, ukuhlaselwa kuthinta iminwe noma izinzwane kodwa kungathinta izindebe, izindebe, noma indlebe.
Ukwehliswa Kwegazi Ngehla Ezimweni Ezimbi
Uma umuntu evezwa amakhaza, impendulo evamile yomzimba ukuphuza ukulahlekelwa kokushisa nokulondoloza izinga lokushisa eliyisisekelo. Ukugcina le lokushisa, imithwalo yegazi elawula ukugeleza kwegazi kuze kube yilapho isikhumba sithinta igazi kusuka emithanjeni eduze kwendawo kuya emithanjeni ejulile emzimbeni.
Kubantu abanemiphumela kaRaynaud, lokhu kuphendulwa komzimba okujwayelekile kuqiniswa yiziphazamiso eziphuthumayo ze-spasmodic emithonjeni encane yegazi enika igazi eminwe nasezinzwaneni. Imisipha yeminwe nezinzwane nayo ingase iwa. Ngenxa yalokho, ukunikezwa kwegazi emaphethelweni kunciphisa kakhulu, okwenza ukusabela okubandakanya ukuguqulwa kwesikhumba nezinye izinguquko.
Izinguquko Embala Wesikhumba Nesizwe
Uma kuqala ukuhlaselwa, umuntu angase ahlangane nezinguquko ezintathu zombala wesikhumba (ezimhlophe, okwesibhakabhaka, nokubomvu) eminwe noma ezinzwaneni. Ukuhlelwa kwezinguquko zombala akufani nabo bonke abantu, futhi akuwona wonke umuntu onemibala emithathu.
- I-Pallor (ubumhlophe) ingase isenzeke ekuphenduleni i-spasm ye-arterioles kanye nokuwa kwe-arteries ye-digital.
- I-Cyanosis (blueness) ingase ibonakale ngoba iminwe noma izinzwane azitholi igazi elanele-oksijini.
Iminwe noma izinzwane nazo zingase zizwe zibandayo futhi zinzima. Okokugcina, njengoba i-arterioles igaxa futhi igazi libuyela kumadijithi, ubomvu bungenzeka. Njengoba ukuhlaselwa kuphelile, ukubhoboza nokuxubha kungenzeka eminwe nasezinzwaneni. Ukuhlaselwa kungadlula kusuka ngaphansi kweminithi kuya emahoreni amaningana.
I-Phenomenon kaRaynaud yahlukanisa kanjani?
Odokotela bahlukanisa indaba kaRaynaud njengendlela yokuqala noma eyesibili . Ezincwadini zokwelashwa, "isenzakalo esiyinhloko sikaRaynaud" singase sabizwe ngokuthi:
- Isifo sikaRaynaud
- Idiopathic Raynaud's phenomenon
- i-Raynaud's primary syndrome
Imigomo idiopathic futhi eyinhloko kokubili isho ukuthi imbangela ayifakazi.
Phenomenon eyinhloko kaRaynaud
Iningi labantu abanesimo sikaRaynaud sinombomu oyinhloko (inguqulo ekhudlwana).
Umuntu onomsebenzi oyinhloko kaRaynaud awunayo isifo esiyinhloko noma izinkinga zezokwelapha ezihambisanayo. Abesifazane abaningi kunabesilisa abathintekayo, futhi cishe amaphesenti angu-75 azo zonke izimo atholakala kubesifazane abaneminyaka engama-15 no-40 ubudala.
Ukucwaninga kubonisa ukuthi abantu abangaphansi kuka-10% abanokuhlasela kwe-vasospastic kuphela iminyaka eminingana, ngaphandle kokubandakanyeka kwamanye amasistimu noma izitho zomzimba, abavame ukuthuthukisa noma ukuthuthukisa isifo sesibili kamuva.
Phenomenon yesibili sikaRaynaud
Nakuba isimo sika-Raynaud sesibili singavamile kakhulu kunefomu eliyinhloko, ngokuvamile kuyisifo esiyinkimbinkimbi nakakhulu. Sekondari kusho ukuthi iziguli zinezifo eziphansi noma isimo esibangela isenzo sikaRaynaud.
Izifo ezixhumene nezicubu ziyimbangela evame kakhulu yento yesibili kaRaynaud. Ezinye zalezi zifo zinciphisa ukugeleza kwegazi kuya kumadijithali ngokubangela izindonga zamanzi ezakhiwe ngegazi futhi zenzeke kalula. Isimo sikaRaynaud sibonakala kuziguli ezine:
- i-scleroderma (cishe u-85%)
- izifo ezixutshwe nezicubu ezixubile (cishe u-85%)
- i-lupus (i-systemic lupus erythematosus) (cishe i-33%)
Isimo sikaRaynaud singase senzeke ezigulini ezinezinye izifo ezixhumene nezicubu , kuhlanganise:
- I-Sjögren's syndrome
- dermatomyositis
- i-polymyositis
Izimbangela ezenzekayo ezenzakalweni zikaRaynaud sesibili, ngaphandle kwezifo ezixhumene nezicubu, ziyizi:
- i-carpal tunnel syndrome
- isifo se-arterial obstructive
- ezinye izidakamizwa (ezifana ne-beta-blockers, amalungiselelo e-ergotamine, ama-chemotherapy athile)
- izidakamizwa ezibangelwa i-vasoconstriction (njengezinye izidakamizwa ezibandayo kanye nezidakamizwa)
- abantu emisebenzini ethile (njengezisebenzi ezitholakala ku-vinyl chloride noma abasebenzi abasebenzisa amathuluzi okududuza)
Abantu abanesimo sesibili sikaRaynaud bavame ukubhekana nezinkinga zezokwelapha ezihlobene. Izinkinga ezinkulu kakhulu izilonda zesikhumba noma izilonda eminwe noma iminwe. Izilonda ezibuhlungu ne-gangrene zivame kakhulu futhi kungaba nzima ukuphatha. Ukuntula amandla emisipha yesikhumba kungabangela ukuguquka kwenhliziyo noma ubunzima ekugwineni.
Uma udokotela ephikisa isenzo sikaRaynaud, uzocela isiguli ngomlando wezokwelapha okuningiliziwe. Udokotela uzobe esehlola isiguli ukulawula ezinye izinkinga zezokwelapha. Isiguli singase sibe nokuhlaselwa kwe-vasospastic ngesikhathi sokuvakasha kwehhovisi, okwenza kube lula kudokotela ukuba ahlolisise isenzo sikaRaynaud. Odokotela abaningi bakuthola kulula ukuthola into kaRaynaud kodwa kunzima ukubona ukuthi uhlobo luni lwesifo.
Imigomo Yokuqaphela I-Phenomenon kaRaynaud
Odokotela basebenzisa izindlela ezithile zokuxilonga ukuze bahlolwe isenzakalo sokuqala noma sesibili sikaRaynaud.
Imigomo: Phenomenon eyinhloko kaRaynaud
Izindlela zokuxilonga ezisetshenziselwa ukuxilonga iphutha eliyinhloko le-raynaud zihlanganisa:
- Ukuhlaselwa kwe-vasospastic ngezikhathi ezithile ze-pallor (ubumhlophe) noma i-cyanosis (blueness) (Qaphela: abanye odokotela bafaka umbandela owengeziwe wokuba khona kwalokhu kuhlaselwa okungenani iminyaka emibili)
- Iphethini ejwayelekile ye-nailfold capillary
- I-ANA ye-anti-nuclear anti-test
- Isilinganiso sedimentation e-erythrocyte evamile (ESR)
- Ukungabikho kwezibazi noma izilonda zesikhumba, noma ukufa kwesibindi (iminwe yokufa) eminwe noma iminwe
Imigomo: I-Phenomenon yesibili kaRaynaud
Izindlela zokuxilonga ezisetshenziselwa ukuxilonga iphutha le-raynaud yesibili zihlanganisa:
- Ukuhlaselwa kwe-vasospastic ngezikhathi ezithile ze-pallor (ubumhlophe) ne-cyanosis (blueness)
- Iphethini engavamile ye-nailfold capillary
- I-ANA ye-anti-nuclear anti-antibody
- Isilinganiso se-erythrocyte sedimentation engavamile (ESR)
- Ukutholakala kwezibazi noma izilonda zesikhumba, noma isilonda eminwe noma iminwe
Izivivinyo zokuxilonga zikaPhenomenon kaRaynaud
Izivivinyo eziningana zokuxilonga zingase zilayishwe udokotela wakho ukusiza ukuqinisekisa ukuhlolwa kukaRaynaud.
I-Capillaroscopy ye-Nailfold
I-capillaroscopy ye-Nailfold (ukutadisha ama-capillaries ngaphansi kwe-microscope) ingasiza udokotela ukuba ahlukanise phakathi kwesenzo sika-Raynaud esiyisisekelo nesesekondari.
Phakathi nalesi sivivinyo, udokotela ubeka uphonsa lwamafutha emaphoyiseni omuthi wesiguli, isikhumba esisebunzini somunwe. Udokotela bese ehlola izintambo ze-nail ngaphansi kwe-microscope ukuze abheke ukungavamile kwamanzi amancane wegazi okuthiwa i-capillaries. Uma ama-capillari ekhuliswa noma ekhubazekile, isiguli singase sibe nesifo sofuba.
Udokotela angase ahlele nokuhlolwa kwegazi ezimbili, i-antinuclear anti-test test (ANA) kanye ne-erythrocyte sedimentation rate (ESR).
I-Antinuclear Antibody Test (ANA)
Ukuhlolwa kwe- antinuclear anti-anti (ANA) kunquma ukuthi umzimba uveza amaprotheni akhethekile (ama-antibodies) avame ukutholakala kubantu abanesifo sofuba noma ezinye izifo ezizimele. Iziguli ezinalezi zifo ezixhumene nezifo noma ezinye izifo ezizimele, yenza ama-antibodies ku-nucleus, noma isikhungo somyalo, amangqamuzana omzimba. Lezi zinselo zamagciwane zibizwa ngokuthi i-antitinuclear antibodies futhi zivivinywa ngokubeka i-serum yegazi le-samu kwi-microscope slide equkethe amaseli nge-nuclei ebonakalayo. I-substance equkethe idayi ye-fluorescent yengezwe ehlangene nama-antibodies. Ngaphansi kwe-microscope ama-antibodies angavamile angabonakala ebopha kule nuclei.
Isilinganiso se-Erythrocyte Sedimentation (ESR)
Isilinganiso se-erythrocyte sedimentation (ESR) yisilingo sokuxilonga sokuvuvukala.
Ukuhlolwa kwesilinganiso se- erythrocyte sedimentation (ESR) kuyisilinganiso sokuvuvukala emzimbeni futhi kuhlola ukuthi amangqamuzana egazi abomvu ashesha kanjani ahlukaniswe ngaphandle kwegazi elingenalutho ngokulinganisa izinga lapho amangqamuzana egazi abomvu ewela khona phansi kwebhubhisi ngokuhamba kwesikhathi. Ukukhula kwesidumbu sokukhula kufana nokukhuphuka okungaqondile okuqondene nomzimba. Ngokuvame ukubizwa ngokuthi "sedrate" okwesikhashana.
Isivivinyo Sokukhuthazwa Kwamafutha
Isivivinyo sokushukumisa abandayo kungenye indlela u-dokotela wakho angayisebenzisa ukuze ahlolisise umphumela kaRaynaud. Ukuhlolwa okubanda ukushisa kubonisa izinga lokushisa komunwe ngamunye emva kokugezwa ngaphakathi kwamanzi okugeza amanzi.
Izinzwa zokushisa zihlanganiswe iminwe yakho futhi izinga lokushisa lirekhodwa kuze kube yilapho ukushisa kwakho komunwe kufana nokufana nokubekwa ngaphambi kokufakwa ebhodini lokugeza amanzi.
Yikuphi ukucwaningwa okwenziwe ukusiza abantu abanenhlanhla kaRaynaud?
Abacwaningi bafunda izindlela zokuthola kangcono indaba kaRaynaud futhi babikezele futhi baqaphe inkambo yabo kanye nokuhlangana nezinye izifo. Baphinde bahlole ukusetshenziswa kwezidakamizwa ezintsha ukuze kuthuthukiswe ukugeleza kwegazi esimweni sikaRaynaud. Abacwaningi e-scleroderma nezinye izifo ezixhumene nezicubu baphinde baphenye ngalesi simo sikaRaynaud ngokuphathelene nalezi zifo.
Izinhloso zokwelapha ukunciphisa inani nenkinga yokuhlaselwa nokuvimbela ukulimala kanye nokulahlekelwa kwezicubu eminwe nasezinzwaneni. Odokotela abaningi banokuzimela ekuphulukeleni iziguli ngesisulu samabanga aphansi nesisemkhatsini kaRaynaud; okungukuthi, batusa ukungelashwa kwezidakamizwa nezinyathelo zokuzisiza kuqala.
Odokotela bangase banikeze imithi yeziguli ezithile, ngokuvamile labo abanesimo sika-Raynaud sesibili.
Ngaphezu kwalokho, iziguli zelashwa nganoma yisiphi isifo esiwumgogodla noma isimo esibangela isenzo sesibili sikaRaynaud.
Izinsizakalo ezingekho izidakamizwa kanye nezinyathelo zokuzisiza
Ukunakekelwa kwezimboni eziningi kanye nezinyathelo zokuzisiza kunganciphisa ukuhlukumeza kukaRaynaud nokukhuthaza inhlalakahle yonke.
Thatha isinyathelo ngesikhathi sokuhlaselwa:
Ukuhlaselwa akufanele kunganakwa. Ubude nobukhulu bayo bunganciphisa izenzo ezimbalwa ezilula. Isenzo sokuqala nesibaluleke kakhulu ukufudumala izandla noma izinyawo. Emoyeni abandayo, abantu kufanele bangene endlini. Ukugijima kwamanzi afudumele phezu kweminwe noma izinzwane noma ukuwafaka esitsheni samanzi afudumele kuzowafudumala. Ukuthatha isikhathi sokuphumula kuzosiza ngokwengeziwe ukuqeda ukuhlaselwa. Uma isimo esicindezelayo sibangela ukuhlaselwa, umuntu angasiza ukuyeka ukuhlaselwa ngokuphuma esimweni esicindezelayo nokuphumula. Abantu abaqeqeshwe ku-biofeedback bangasebenzisa le nqubo kanye nokufudumala izandla noma izinyawo emanzini ukusiza ukunciphisa ukuhlaselwa.
Gcina ufudumele:
Kubalulekile hhayi kuphela ukugcina imikhawulo efudumele kodwa futhi nokugwema ukugoqa noma iyiphi ingxenye yomzimba. Emoyeni abandayo, abantu abanezimo zikaRaynaud kumele banakekele ngokugqoka.
- Kunconywa izambatho eziningana zokugqoka okuxekethile, amasokisi, izigqoko, namagilavu noma ama-mittens.
- Isikhumba sibalulekile ngoba ukushisa komzimba okuningi kulahlekile nge-scalp.
- Izinyawo kufanele zigcinwe zomile futhi zifudumele.
- Abanye abantu bakuthola kuwusizo ukugqoka amakhanda namasokisi okulala embusika.
- Izifudumala zamakhemikhali, njengezikhumba ezincane zokushisa ezingafakwa emaphaketheni, ama-mittens, amabhuthini noma izicathulo, zinganikeza ukuvikeleka okungeziwe phakathi nezinkathi ezide ngaphandle.
Abantu abanezimo zikaRaynaud kufanele baqaphele ukuthi isimo se-air conditioning singabangela ukuhlaselwa. Ukuvala isimo sezulu noma ukugqoka i-sweater kungasiza ukuvimbela ukuhlaselwa. Abanye abantu bakuthola kuwusizo ukusebenzisa izibuko zokuphuza ezingasetshenzisiwe nokugqoka amagilavu ngaphambi kokuphatha ukudla okubandayo noma okufriji.
Yeka ukubhema:
I-nicotine egwayi yenza ukuba izinga lokushisa kwesikhumba liwehlise, okungaholela ekuhlaselweni.
Ukucindezeleka Ukulawula:
Ukucindezeleka ukucindezeleka kubalulekile. Ukucindezeleka nokucindezeleka ngokomzwelo kungabangela ukuhlaselwa, ikakhulukazi kubantu abanezinto eziyinhloko zikaRaynaud, ukufunda ukuqonda nokugwema izimo ezicindezelayo kungasiza ukulawula inani lokuhlaselwa. Abantu abaningi bathole ukuthi ukuphumula noma ukuqeqeshwa kwe-biofeedback kungasiza ukunciphisa inani nenkinga yokuhlaselwa. Ukuqeqeshwa kwe-Biofeedback kufundisa abantu ukuletha ukushisa kweminwe yabo ngaphansi kokulawula ngokuzithandela.
Ukuzivocavoca:
Odokotela abaningi bakhuthaza iziguli ezinezinkinga zikaRaynaud, ikakhulukazi ifomu eliyinhloko, ukuzivocavoca njalo.
Iningi labantu lithola ukuthi ukuvivinya umzimba:
- ikhuthaza impilo yonke
- kwandisa izinga lamandla
- kusiza ukulawula isisindo
- ikhuthaza ukulala okuphumula
Kufanele ukhulume nodokotela wakho njalo ngaphambi kokuqala uhlelo lokuzivocavoca. Abantu abanesimangaliso sikaRaynaud kumele baxoxe nodokotela babo ngaphambi kokusebenzisa ngaphandle kwezulu ebanda.
- Ukudla / Ukuzivocavoca
Bheka Udokotela Wakho:
Abantu abanezinkinga zikaRaynaud kufanele babone odokotela babo uma bekhathazekile noma besaba ngokuhlaselwa noma uma benemibuzo mayelana nokuzinakekela. Kufanele bahlale bebona odokotela babo uma ukuhlaselwa kwenzeka kuphela eceleni komzimba (isandla esisodwa noma unyawo olulodwa) futhi noma nini ukuhlaselwa kubangela izilonda noma izilonda eminwe noma iminwe.
Ukwelashwa Nemithi
Abantu abanezimo ezivamile zakwaRaynaud baningi kakhulu kunabo abanesimo esiyinhloko sokuphathwa ngemithi.
Odokotela abaningi bakholelwa ukuthi izidakamizwa eziphumelela kakhulu futhi eziphephile kakhulu ziyi-block-calcium-blockers, ezitholela imisipha epholile futhi zinciphisa imithwalo encane yegazi. Lezi zidakamizwa zinciphisa ukuvama nokuqina kokuhlaselwa kweziguli ezingaba ngu-65% ezinezici eziyinhloko nezesibili zikaRaynaud. Lezi zidakamizwa nazo zingasiza ukuphulukisa izilonda zesikhumba eminwe noma iminwe.
Ezinye iziguli zithole ukukhulula ngezidakamizwa ezibizwa ngokuthi i-alpha blockers eziphikisana nezenzo ze-norepinephrine, i-hormone ebeka imithwalo yegazi. Abanye odokotela babela umuthi ohoxisa imithwalo yegazi, njenge-nitroglycerine paste, esetshenziswa eminwe, ukusiza ukuphulukisa izilonda zesikhumba. Ngokuvamile, iziguli ezinefomu lesibili ngeke ziphendule kanye nokwelapha njengalabo abanefomu oyinhloko yesifo.
Iziguli kufanele zikhumbule ukuthi ukwelashwa kwesenzo sikaRaynaud akuhlali ngaso sonke isikhathi siphumelele.
Umthombo:
I-NIH Publication No. 01-4911