Isifo seentlungu zesithili

Isifo seentlungu zommandla (CRPS) sisifo sexesha elide (esingapheliyo) esinokuchaphazela nayiphi na indawo yomzimba, kodwa ihlala ichaphazela ingalo okanye umlenze.

Oogqirha abaqinisekanga ukuba yintoni ebangela i-CRPS. Ngamanye amaxesha, inkqubo yeemvakalelo enovelwano idlala indima ebalulekileyo kwintlungu. Enye inkolelo kukuba i-CRPS ibangelwa kukuxhokonxwa kwempendulo yomzimba, ekhokelela kwiimpawu zokudumba kobomvu, ukufudumala, kunye nokudumba kwindawo echaphazelekayo.

I-CRPS ineendlela ezimbini:

• I-CRPS 1 sisifo sexesha elide (esinganyangekiyo) esenzeka ngokufuthi ezingalweni okanye emilenzeni emva kokonzakala okuncinci.
• I-CRPS 2 ibangelwa kukwenzakala kwimbilini.

I-CRPS icingelwa ukuba ibangelwe ngumonakalo kwinkqubo yeemvakalelo. Oku kubandakanya imithambo-luvo elawula imithambo yegazi kunye namadlala okubila.

Iimbilini ezonakalisiweyo azisakwazi ukulawula ngokufanelekileyo ukuhamba kwegazi, ukuziva (ukuziva), kunye nobushushu kwindawo echaphazelekayo. Oku kukhokelela kwiingxaki kwi:

• Ivazi yegazi
• Amathambo
• Imisipha
• Imithambo-luvo
• Ulusu

Unobangela onokubakho weCRPS:

• Ukwenzakala ngqo kwimbilini
• Ukonzakala okanye usuleleko engalweni okanye emlenzeni

Kwiimeko ezinqabileyo, ukugula ngesiquphe njengokuhlaselwa sisifo sentliziyo okanye ukubetha kungabangela i-CRPS. Le meko ngamanye amaxesha inokuvela ngaphandle kokulimala ngokucacileyo kwilungu elichaphazelekayo.

Le meko ixhaphake kakhulu kubantu abaneminyaka engama-40 ukuya kuma-60, kodwa abantu abancinci banokuyiphuhlisa.

Uphawu oluphambili yintlungu:

• Inamandla kwaye iyatshisa kwaye yomelele ngakumbi kunokuba bekulindelekile kuhlobo lokwenzakala okwenzekileyo.
• Iya iba mbi, kunokuba ibe ngcono ngokuhamba kwexesha.
• Iqala kwinqanaba lokonzakala, kodwa inokwasazeka kulo lonke ilungu, okanye ingalo okanye umlenze kwelinye icala lomzimba.

Kwiimeko ezininzi, i-CRPS inezigaba ezithathu. Kodwa, i-CRPS ayisoloko ilandela le patheni. Abanye abantu bahlakulela iimpawu ezinzima ngokukhawuleza. Abanye bahlala kwinqanaba lokuqala.

Inqanaba 1 (iinyanga ezi-1 ukuya kwezi-3):

• Utshintsho kubushushu besikhumba, ukutshintshela phakathi kobushushu okanye ukubanda
• Ukukhula ngokukhawuleza kweenzipho neenwele
• Ukudumba kwemisipha kunye nentlungu edibeneyo
• Ukutsha kakhulu, iintlungu ezibuhlungu eziba mandundu nangomlingo omncinci okanye impepho
• Ulusu olucothayo lube mfiliba, mfusa, mfusa, okanye bomvu; ibhityile kwaye ikhazimla; ukudumba; ndibile ngakumbi

Inqanaba 2 (iinyanga ezi-3 ukuya kwezi-6):

• Utshintsho oluqhubekayo kulusu
• Izipikili eziqhekekileyo kwaye zaphuka ngokulula
• Intlungu eya isiba mandundu
• Ukukhula kancinci kweenwele
• Amalungu aqinileyo kunye nezihlunu ezibuthathaka

Inqanaba 3 (utshintsho olungenakulungiseka luyabonakala)

• Ukuhamba okulinganiselweyo kwilungu ngenxa yezihlunu eziqinisiweyo kunye neetoni (ikhontrakthi)
• Ukumosha izihlunu
• Intlungu kwilungu lonke

Ukuba iintlungu kunye nezinye iimpawu zinzima okanye zihlala ixesha elide, abantu abaninzi banokufumana uxinzelelo okanye uxinzelelo.

Ukuchonga i-CRPS kunokuba nzima, kodwa ukuxilongwa kwangoko kubaluleke kakhulu.

Umboneleli wezempilo uya kuthatha imbali yezonyango kwaye enze uvavanyo lomzimba. Olunye uvavanyo lunokubandakanya:

• Uvavanyo lokubonisa utshintsho lobushushu kunye nokungabikho kwegazi kwilungu elichaphazelekayo (thermography)
• Ukujonga amathambo
• Izifundo zokuqhutywa kwemithambo kunye ne-electromyography (ihlala yenziwe kunye)
• X-reyi
• Uvavanyo lwe-Autonomic luvo (amanyathelo okubila kunye noxinzelelo lwegazi)

Akukho lunyango lweCRPS, kodwa isifo sinokucothiswa. Eyona nto kugxilwe kuyo kukhulula iimpawu kunye nokunceda abantu abanale syndrome baphile ubomi obuqhelekileyo ngokusemandleni.

Unyango ngokwasemzimbeni kunye nasemsebenzini kufuneka luqale kwangoko kangangoko kunokwenzeka. Ukuqala inkqubo yokuzivocavoca kunye nokufunda ukugcina amalungu kunye nezihlunu zihamba kunokuthintela isifo ukuba siqhubeke. Inokukunceda ukuba wenze imisebenzi yemihla ngemihla.

Amayeza anokusetyenziswa, kubandakanya amayeza eentlungu, ii-corticosteroids, amayeza athile oxinzelelo lwegazi, amayeza okuphulukana namathambo kunye nezidambisi.

Olunye uhlobo lonyango lokuthetha, njengonyango lokuziphatha kwengqondo okanye unyango lwengqondo, lunokunceda ukufundisa izakhono ezifunekayo ukuze uphile neentlungu zexesha elide (ezingapheliyo).

Iindlela zokuhlinzwa okanye ezingenayo ezinokuzama:

• Iyeza elitofwayo elenza buthathaka imithambo-luvo echaphazelekayo okanye iintlungu zentlungu ejikeleze ikholam yomqolo (ibhloko yovalo)
• Impompo yeentlungu zangaphakathi ezihambisa ngokuthe ngqo amayeza kwintambo yomqolo (impompo yeziyobisi ye-intrathecal).
• Isikhuthazi sentambo yomqolo, ebandakanya ukubeka ii-electrode (izikhokelo zombane) ecaleni kwentambo yomqolo. Umbane okwinqanaba elisezantsi usetyenziselwa ukwenza ubumnandi okanye ukubetha kwindawo ebuhlungu yeyona ndlela yokunciphisa iintlungu kwabanye abantu.
• Ugqirha olusika imithambo-luvo ukutshabalalisa iintlungu (utyando lwesifo), nangona kungacaci ukuba kunceda abantu abanjani. Inokwenza ukuba iimpawu zibe mbi ngakumbi kwabanye abantu.

Umbono ungcono ngokufumanisa isifo kwangoko. Ukuba ugqirha ufumanisa imeko kwinqanaba lokuqala, ngamanye amaxesha iimpawu zesifo zinganyamalala (ukuxolelwa) kunye nokuhamba okuqhelekileyo kunokwenzeka.

Ukuba imeko ayifumaneki ngokukhawuleza, utshintsho kwithambo nakwisihlunu lunokuba mandundu kwaye alunakubuyiselwa.

Kwabanye abantu, iimpawu zihamba ngokwabo. Kwabanye abantu, nokuba unyango luyaqhubeka kwaye imeko ibangela ukukhubazeka, utshintsho olungenakulungiswa.

Iingxaki ezinokubangela zibandakanya:

• Iingxaki ngokucinga nangogwebo
• Uxinzelelo
• Ukuphulukana nobukhulu bemisipha okanye amandla kwilungu elichaphazelekayo
• Ukusasazeka kwesi sifo kwelinye ilungu lomzimba
• Ukunyuka kwelungu elichaphazelekayo

Iingxaki zinokuthi zenzeke kunye nolunye unyango kunye nonyango.

Nxibelelana nomboneleli wakho ukuba ukhula rhoqo, iintlungu ezivuthayo ngengalo, umlenze, isandla okanye unyawo.

Akukho sithintelo saziwayo ngeli xesha. Unyango lwakwangoko sisitshixo sokunciphisa ukuqhubela phambili kwesi sifo.

IINKCUKACHA; I-RSDS; Causalgia - RSD; Isifo segxalaba; Reflex uvelwano lweedystrophy syndrome; Sudeck yoma; Intlungu-CRPS

UAburahma AF. Isifo seentlungu zesithili. Ku: Sidawy AN, Perler BA, ii-eds. Rutherford Uqhaqho lweMithambo kunye noNyango lwe-Endovascular. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2019: isahluko 192.

I-Gorodkin R.I-syndrome yeentlungu zommandla (i-reflex novelwano lwe-dystrophy). Ku: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, ii-eds. Rheumatology. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2019: isahluko 90.

I-Stanos SP, iTyburski MD, iHarden RN. Intlungu engapheliyo. Ku: Cifu DX, ed. IBraddom's Physical Medicine kunye noQeqesho. Umhla we-5. IPhiladelphia, PA: Elsevier; 2016: isahluko 37.