Sibanzi
I-Complex ye-syndrome yesifo seengingqi (CRPS) yimeko enokuhlala ibuhlungu ekholelwa ukuba yiphumo lokungasebenzi kwiinkqubo zesiseko okanye ze-nervous system. Amagama asebekhulile asetyenziselwa ukuchaza isifo esiyinkimbinkimbi yesifo sengingqi yile:
- I-Reflex enobubele besifo se-dystrophy syndrome (RSDS)
- Causalgia
I-Causalgia yayiyithuba lokuqala elisetyenzisiweyo ngexesha leMfazwe yoLuntu ukuchaza intlungu, intlungu ebushushu evezwe ngabalindi bexesha elide emva kokuba amanxeba aphilise.
Iimpawu eziqhelekileyo zentlungu yesifo seengingqi zibandakanya utshintsho oluphawulekayo kumbala kunye nobushushu besikhumba phezu kwelungu elichaphazelekayo okanye inxalenye yomzimba, ehamba kunye:
- buhlungu obukhulu
- uvelwano lwesikhumba
- ukuthuka
- ukuvuvukala
I-CRPS Ndidla ngokubangela ukulimala kwamathambo; eli gama lichaza zonke izigulane zibonakaliswe ngasentla kodwa zingekho nzakalo zentlungu. Abantu abane-CRPS II bafumana iimpawu ezifanayo kodwa iimeko zabo zihambelana ngokucacileyo nenzakalo yesondlo. Inkqubo yesifo seentlungu zesifo seengingqi singabetha naluphi na ubudala kwaye ichaphazela amadoda namabhinqa, nangona ininzi iingcali zivuma ukuba ziqhelekileyo kubasetyhini abaselula.
Iimpawu
Iimpawu ezibalulekileyo zesifo esiyinkimbinkimbi yesifo seengingqi ziqhubekayo, intlungu eninzi ngenxa yexinzelelo yokulimala (ukuba kwenzeke ukulimala), okuya kuba kubi kunokuba kulunge ixesha. Iintlanzi zesifo seengxaki zesithili sezona zihlala zichaphazela esinye seziphelo ezinjenge:
- i ingalo
- imilenze
- izandla
- iinyawo
I-Complex ye-pain syndrome yesithili ihlala ihamba kunye nayo:
- "evuthayo" intlungu
- ukwanda kwesikhumba
- utshintsho lokushisa kwesikhumba: ukufudumala okanye ukupholisa ngokuthelekiswa nomda ochaseneyo
- utshintsho kumbala wesikhumba: ngokuphindaphindiweyo ukucima, obomvu, obalaphu, okanye obomvu
- utshintsho lwesikhumba: lukhanyayo kwaye lunqabile, kwaye ngamanye amaxesha ludla
- utshintsho kwimizekelo yokukhula kwesikhonkwane kunye neenwele
- ukuvuvukala nokuqina kumalungu achaphazelekayo
- ukukhubazeka kwemoto, kunye nokunciphisa amandla okuhambisa inxalenye yomzimba ochaphazelekayo
Ngokuqhelekileyo intlungu isasazeka ukubandakanya ingalo yonke okanye umlenze, nangona ukulimala kokuqala bekube ngumnwe okanye inzwane kuphela. Ubunzima ngamanye amaxesha uhamba ukuya kumgama ochaseneyo. Inokuphakanyiswa ukuxinezeleka kwengqondo.
Iimpawu zeengxaki zesifo seengingqi zomeleleka ziyahluka ngobunzima nobude. Ezinye iingcali zikholelwa ukuba kukho izigaba ezintathu ezinxulumene nesifo esiyinkimbinkimbi yesifo senzululwazi, esibonakaliswe ngenguqu eqhubekayo kwesikhumba, izihlunu, amajoni, iigaments, namathambo endle echaphazelekayo, nangona le nkqubela ingazange iqinisekiswe ngophando lweklinikhi.
- Isigaba esisodwa sicingelwa ukuba siphelele kwiinyanga ezi-1 ukuya kwezi-3 kwaye sibonakaliswe yintlungu enzima, kunye ne- spasm muscle , ukuqina okuhlangeneyo , ukukhula kweenwele ezikhawulezayo kunye nokuguqulwa kwimithambo yegazi okwenza ulusu luguqulwe umbala kunye nobushushu.
- Isigaba sesibini siphelela kwiinyanga ezi-3 ukuya kwezi-6 kwaye sibonakala ngokuqinisa intlungu, ukuvuvukala, ukuncipha kweenwele, ukuphuka, izikhonkwane eziqhekekileyo, izikhwebu, okanye izikhonkwane, amathambo athambileyo, amanxeba aqinile, kunye ne-tone muscle ebuthakathaka.
- Kwinqanaba lesithathu i-syndrome iqhubekela phambili kwindawo apho utshintsho kwesikhumba nasethambo alusayi kubuyiselwa. Ubunzima buba nzima kwaye bunokubandakanya inxalenye yonke okanye indawo echaphazelekayo. Ku no kubakho ukulahleka kwemisipha (i-atrophy), ukuhamba okukhawulezileyo, kunye nokungahambisani nokuzibandakanya kweemisipha kunye neentoni ezixhamla amajoyina. Iimpawu zingabhalwa.
Izizathu
Oogqirha abaqinisekanga ukuba yintoni ebangela i-syndrome yeentlungu zesimo seengingqi. Kwezinye iimeko inkqubo yokukhathazeka yentsholongwane idlala indima ebalulekileyo ekugcineni intlungu. Iingcamango zakutshanje zibonisa ukuba imiphunga yeentlungu ezichaphazelekayo kumzimba ziphendulela kwintsapho yabathunywa benkqubo yeentlanzi ezibizwa ngokuba yi-catecholamines.
Uphando lwezilwanyana lubonisa ukuba i-norepinephrine, i-catecholamine ekhutshwe kwiiswini zomzwelo, ifumana amandla okuvuselela intlungu emva kweethambo okanye ukulimala kwentsholongwane. Iziganeko zentlungu egcinwe ngovelwano kwintlungu yesifo seengingqi aziwaziwa.
Ezinye iingcali zikholelwa ukuba ukubaluleka kwenkqubo yokutya yeentlungu kuxhomekeke kwisigaba sesifo.
Enye ingcamango kukuba isifo esiyinkimbinkimbi esisemva kwengxaki yesifo seengingqi (CRPS II) kubangelwa kukubangela ukuphendula kwamagciwane, okukhokelela kwiimpawu ezivuthayo zokubomvu, ukufudumala nokuvuvukala kwindawo echaphazelekayo. I-Complex ye-syndrome yesifo seengingqi ingabonisa ukuphazamiseka kwenkqubo yokuphilisa. Kukho konke, inzima yesifo sesifo seengingqi ayinayo imbangela enye, kodwa kunokuba yimbangela yezizathu ezininzi ezivelisa iimpawu ezifanayo.
Ukuxilongwa
I-Complex ye-pain syndrome yesithili (CRPS) ifunyanwe ngokuyinhloko ngokuqwalasela impawu kunye neempawu. Kodwa ngenxa yokuba ezinye iimeko ezininzi zinempawu ezifanayo, kunokuba nzima ukuba oogqirha benze ukuxilongwa ngokuqinisekileyo kwintlungu yesifo seengingqi ekuqaleni kwexesha lokugula xa iimpawu zimbalwa okanye zincinci. Okomnye, umzekelo, isilonda esilula sinokubangela ukuba ubuhlungu bunzima bube bufana nobuhlungu besifo seengingqi. Ukuxilongwa kulukhuni ngakumbi kukuba abanye abantu baya kuphucula ngokuthe ngcembe kwexesha ngaphandle kwonyango.
Ekubeni akukho luvavanyo oluchanekileyo lokuxilonga kwi-syndrome yesifo seengingqi eziyinkimbinkimbi, inxaxheba ebaluleke kakhulu yokuvavanya kukunceda ezinye izimo. Abanye oogqirha basebenzise ukuvuselela kwindawo ukuba babone ukuba kubangela intlungu efana nale:
- ku thintela
- pinpricks
- bushushu
- kubanda
Oogqirha banokusebenzisa izicatshulwa zethambo zesithathu ukuze zichonge utshintsho kwithambo nasekujikelezeni kwegazi.
Unyango
Ngenxa yokuba ayinakho unyango lweengxaki zesifo seengingqi eziyinkimbinkimbi, unyango lujoliswe ekunciphiseni iimpawu ezibuhlungu ukuze abantu bakwazi ukuqhuba ubomi babo obuqhelekileyo. Ezi zihlandlo zilandelayo zisetyenziswa:
- Ukwelapha ngokwenyama: Ukunyanga okwenyuka komzimba okanye inkqubo yokuzilolonga ukugcina isigxina esibuhlungu okanye inxalenye yomzimba ishukumisa kunokunceda ukubuyisela ezinye iinkqubo zokuhamba kunye nokusebenza.
- I-Psychotherapy: I- Complex ye-pain syndrome yesithili isoloko inefuthe elikhulu kwengqondo kubantu nakwiintsapho zabo. Labo abanesifo esiyinkimbinkimbi yesifo seengingqi banokuba neengxaki zokuxinezeleka, ukuxhalabisa, okanye ukuphazamiseka kwengxaki yokudandatheka , konke okuphakamisa ukuqonda kwentlungu kunye nokwenza imizamo yokuvuselela nzima.
- Isibilini sentliziyo: Ezinye izigulane ziya kufumana intlungu ekhululekile kwiimpawu zentlungu. Iibhloko zentlungu zinokuthi zenziwe ngeendlela ezahlukeneyo. Enye inqubo iquka ukulawulwa kwe-phentolamine, ukusetyenziswa kwezilwanyana ezikhuselekileyo. Olunye uphuhliso lubandakanya ukufakwa kwe-anesthetic ecaleni komgudu ngokukhawuleza ukuvimbela izithintelo zenceba.
- Amachiza: Iindidi ezininzi ezahlukeneyo zonyango zisetyenziselwa ukuphatha i-syndrome yesifo esiyinkimbinkimbi, kuquka:
Nangona kunjalo, akukho nkunkuma enye okanye udibaniso lweziyobisi lenze ukuphucula okuqhubekayo kwimiqathango.
- iziyobisi ezisemgangathweni ezisebenza ngaphakathi kwimizi ebuhlungu , isikhumba kunye nezihlunu
- iziyobisi
- ezixinzelelekileyo
- corticosteroids
- opioids
- I-sympathectomy yokupanda: Ukusetyenziswa kwe-sympathectomy, inqubo ebhubhisa iimbilini ezithintekayo kwintlungu yesifo seengingqi, ixabana. Ezinye iingcali zicinga ukuba akunakulungele kwaye zenza ingxaki yesifo seengingqi ezibi kakhulu; abanye babika isiphumo esihle. I-sympathectomy ifanele isetyenziswe kuphela kwizigulane ezinobuhlungu obukhululekileyo (nangona kwithuba elithile) ngokuzikhethela okuthandayo.
- Ukuvuselela intambo yomgca : Ukufakwa kwee electrode ezikhuthazayo ecaleni lomgca womgogodla kunika ukuvakala komsindo kwiindawo ezibuhlungu. Le ndlela ibonakala ikunceda izigulane ezininzi ngeentlungu.
- Izipompo zamachiza e-intrathek: Ezi zixhobo zilawula izidakamizwa ngqo kwi-spinal fluid, ukwenzela ukuba i-opioids kunye ne-anesthetic agents zingeniswe kwiintlungu-zokubonisa iithagethi kumgca wesipelini kwimilinganiselo ephantsi kunezo ezifunekayo ekulawuleni komlomo. Le ndlela iyanciphisa imiphumo yecala kwaye iyakwandisa ukusebenza kweziyobisi.
Prognosis
Ukugxekwa kwintlungu yesifo seengingqi kunzima ukusuka kumntu ukuya kumntu. Ukuxolelwa ngokukhawuleza kwiimpawu kubakho kubantu abathile. Abanye banokuba nobuhlungu obukhulu kunye nokukhubazeka, utshintsho olungenakuguquka nangona unyango. Abanye oogqirha bakholelwa ukuba unyango lokuqala luncedo ekunciphiseni ingxaki, kodwa le nkolelo ayisayixhaswa bubungqina obuvela kwizifundo zeklinikhi. Uphando olungakumbi lufunekayo ukuqonda izizathu zesifo seengxaki zentlupheko yesithili, indlela eqhubeka ngayo kunye nenxaxheba yonyango lokuqala.
Umthombo: Upapasho lwe-NIH no-04-4173 (ehleliwe)