Wake waba nesilonda esincane engalweni noma emlenzeni wakho, futhi ngisho nangemva kokuba sipholile, wawusazizwa ubuhlungu obungabekezeleleki kanye nomuzwa wokusha? Ngezinye izikhathi indawo yesilonda yayivuvukala, isikhumba sishintsha umbala, futhi ujuluka ngendlela exakile? Abantu abaningi bacabanga ukuthi lokhu kuyinto evamile uma bebhekana nalokhu. Kodwa-ke, lokhu kungaba uphawu lwesimo esingavamile kodwa esibuhlungu kakhulu esibizwa ngokuthi 'i-Complex Regional Pain Syndrome' noma i-CRPS . Ake sixoxe ngalokhu ngamazwi alula namuhla.
Iyini ngempela i-CRPS?
Kalula nje, i-CRPS yisimo esibangela ubuhlungu obukhulu, obuhlala isikhathi eside engxenyeni ethile yomzimba wakho, ikakhulukazi ingalo, umlenze, isandla, noma unyawo . Lobuhlungu bungahambisana nezinye izimpawu eziningi, njengokushintsha kombala wesikhumba nokuvuvukala.
Odokotela bakholelwa ukuthi imbangela eyinhloko yalokhu ushintsho ekusebenzeni kwesimiso sethu sezinzwa, okuwubuchopho, umgogodla, kanye nesimiso sezinzwa kuwo wonke umzimba (izinhlelo zezinzwa eziphakathi nezingaphandle). Cabanga ngesimiso sokwazisa ubuhlungu bomzimba wethu njenge-alamu ekhala lapho isigebengu singena endlini yethu. Uma sithola ukulimala okuncane, le alamu iyakhala, okusho ukuthi sizwa ubuhlungu. Kodwa ku-CRPS, le alamu iyaqhubeka nokukhala ngisho nangemva kokuba ukulimala sekupholile. Lokhu kusho ukuthi asisakwazi ukulawula izimpawu zobuhlungu.
Kunezinhlobo ezimbili eziyinhloko ze-CRPS:
| Uhlobo lwe-CRPS | Incazelo elula |
|---|---|
| Uhlobo I | Lokhu kwenzeka ngemva kokulimala noma ukugula okungalimazi ngqo inzwa. Isibonelo, lesi simo singavela ngemva kokuthile okufana nengalo noma umlenze ophukile. Ngaphambilini kwakubizwa ngokuthi 'i-reflex sympathetic dystrophy'. |
| Uhlobo II | Lokhu kwenzeka lapho inzwa yonakaliswe ngokusobala ukulimala. Lokhu kwakubizwa ngokuthi 'i-causalgia' ngaphambilini. |
Lesi simo sivame kakhulu kwabesifazane kunakwabesilisa. Nakuba singakhula kunoma yimuphi ubudala, sivame kakhulu ngemva kweminyaka engama-40.
Ziyini izimpawu ze-CRPS?
Izimpawu ze-CRPS zingahluka kumuntu nomuntu, futhi ubukhali bazo bungahluka. Izimpawu zivame ukuqala ukubonakala zingakapheli amasonto amane kuya kwayisithupha ngemuva kokulimala, ukuphuka, noma ukuhlinzwa.
Uphawu oluyinhloko nolunzima kakhulu ubuhlungu . Lobuhlungu abuyona nje ubuhlungu obuvamile.
- Ubuhlungu obuzwakala sengathi buhlala buvutha .
- Ubuhlungu obuzwakala sengathi inaliti iyahlaba noma idabuke .
- Ngokuvamile, ubuhlungu buzwakala sengathi buvela ekujuleni kwengalo noma umlenze obuhlungu.
Ngaphezu kwalolu buhlungu, kunezinye izimpawu eziningi ezingabonakala endaweni ethintekile. Ukuze kube lula, ake sibheke lezi etafuleni .
| Isigaba sezici | Incazelo |
|---|---|
| Izinguquko ekuzweleni | - Ukuzwa ubuhlungu obungabekezeleleki ngisho noma uthola iqhubu elincane noma ingubo emzimbeni wakho. - Ukuzwa ubuhlungu obukhulu ngenxa yento evame ukubangela ubuhlungu (isib. ukuncinza okuncane). - Ngezinye izikhathi uzizwa ungezwani. |
| Izinguquko zesikhumba | - Ukuvuvukala: Ukuvuvukala kungafika kudlule noma kuqhubeke njalo. - Izinga lokushisa: Ukuzizwa ushisa noma ubanda engalweni/emlenzeni owodwa kunomunye. - Umbala: Izinguquko kumbala wesikhumba. Kungaba namabala, kube mhlophe, kube nsomi, noma kube bomvu kwezinye izindawo. - Imvelo: Isikhumba singase sicwebezele futhi sibe sincane. Noma kungase kube nokujuluka ngokweqile. |
| Izinguquko ekusebenzeni | - Ukungakwazi ukuhambisa ingalo/umlenze obuhlungu kahle kanye nomuzwa wokuqina kwamalunga. - Ubunzima bokuthwala isisindo ngaleyo ngalo/umlenze. |
| Izinzipho nezinwele | Izinzipho noma izinwele kuleyo ndawo zingakhula ngokushesha kunokujwayelekile noma zingakhuli nhlobo. |
Into ebaluleke kakhulu ukubonana nodokotela ngokushesha okukhulu uma unalezi zimpawu, ngoba lesi simo kulula kakhulu ukuselapha uma sitholakala kusenesikhathi.
Kungani i-CRPS ikhula?
Abacwaningi abakakazi kahle ukuthi kungani umuntu oyedwa onokulimala okufanayo eba ne-CRPS kanti omunye engaba nayo, kodwa bakholelwa ukuthi kungenxa yokusabela okungavamile ohlelweni lwethu lokuzivikela komzimba kanye nolwezinzwa .
Iningi lamacala e-CRPS (angaphezu kuka-90%) abangelwa ukulimala kwemicu yezinzwa ethambile kakhulu engalweni noma emlenzeni ngenxa yokulimala.
Ezinye zezizathu ezivamile yilezi:
- Ukuphuka: Ukuphuka, ikakhulukazi esihlakaleni , kuyimbangela enkulu ye-CRPS. Ngezinye izikhathi, ngisho noma kufakwe i-cast, i-nerve ingacindezelwa.
- Ukuhlinzwa: Ngesikhathi sokuhlinzwa, imizwa ingalimala ngenxa yokusikwa nokuthungwa kwesikhumba.
- Ukusonteka: Uma ilunga lisonteka, imizwa elizungezile ingacindezelwa.
- Ukusha, ukuphuka, noma ukusikeka: Lezi zinhlobo zokulimala kwangaphandle zingalimaza nemizwa engaphansi kwesikhumba.
Ngezinye izikhathi i-CRPS ingenzeka ngaphandle kokulimala okusobala, futhi abanye abantu basengozini enkulu yokuthola lesi simo.
- Izinkinga zesimiso sezinzwa: Abantu abanezifo ezifana nesifo sikashukela banekhono eliphansi lokuphulukisa izinzwa zabo. Abantu ababhemayo nabo banenkinga enzima yokululama.
- Izinkinga zesimiso somzimba sokuzivikela: Abantu abanezimo ezifana ne-asthma banamazinga aphezulu amakhemikhali okuvuvukala (ama-cytokine) emizimbeni yabo, okwandisa ingozi ye-CRPS.
- Izimbangela zofuzo: Nakuba zingavamile kakhulu, kube nemibiko yamalungu omndeni amaningana athola i-CRPS.
Udokotela uyixilonga kanjani i-CRPS?
Akukho ukuhlolwa okuqondile kokuxilonga i-CRPS. Ngakho-ke, udokotela uzoxilonga lesi simo ngokusekelwe ezimpawu zakho, umlando wakho wezokwelapha (ukulimala kwamuva, ukuhlinzwa), kanye nokuhlolwa ngokomzimba.
Udokotela wakho uzogxila kakhulu kulezi zinto:
- Ingabe kukhona ubuhlungu obukhulu obungavamile obungaphezu kobukhulu besilonda?
- Ingabe kukhona ushintsho ekubukekeni, izinga lokushisa, kanye nokuthungwa kwesikhumba endaweni ethintekile?
- Zikhona yini ezinye izimo zezokwelapha ezingabangela lezi zimpawu?
Ngezinye izikhathi kwenziwa i-ultrasound scan noma i-MRI scan ukuze kubonakale ukuthi kukhona yini umonakalo wezinzwa ongaphansi.Kungenziwa okukodwa. Futhi, ukuhlolwa okufana ne -EMG (Electromyography) kungenziwa ukuze kukhishwe ezinye izifo zezinzwa ezibonisa izimpawu ezifanayo.
Yiziphi izindlela zokwelapha i-CRPS?
Imigomo eyinhloko yokwelashwa kwe-CRPS ukunciphisa ubuhlungu, ukubuyisela ukusebenza engalweni/emlenzeni othintekile, nokugcina ikhwalithi yempilo yakho. Uma ukwelashwa kuqala ngokushesha, umphumela uba ngcono. Uma kungelashwa, ubuhlungu bungaqhubeka buba bubi, ingalo/umlenze ungaqina, futhi ungase ungakwazi ukubushukumisa.
Inhlanganisela yezindlela eziningana zokwelapha iyindlela ephumelela kakhulu.
Ukwelashwa Komzimba Nomsebenzi
Lokhu kuyingxenye ebalulekile futhi ebalulekile yokwelashwa kwe-CRPS.
- Udokotela wezokwelapha uzokufundisa izivivinyo ezithile ezingakhulisa ukugeleza kwegazi endaweni yobuhlungu futhi zithuthukise ukuguquguquka namandla.
- Uchwepheshe wezokwelapha emsebenzini ufundisa izindlela ezintsha zokwenza imisebenzi yansuku zonke (isib. ukugqoka, ukudla) ngaphandle kobuhlungu obukhulu.
Ngaphezu kwalokho, kunezindlela ezikhethekile ezifana ne-'Mirror Therapy'. Kulokhu, uhlala phambi kwesibuko, ufihle ingalo/umlenze obuhlungu, bese ubeka ingalo/umlenze ophilile phambi kwakho. Ngemuva kwalokho, isibuko sibonisa ukuthi ingalo/umlenze obuhlungu uhamba ngendlela evamile. Lokhu kuye kwafakazelwa ukuthi 'kukhohlisa' ubuchopho bethu ukuze bunciphise ubuhlungu.
Izinguquko zendlela yokuphila
- Gwema ukubhema: Ukubhema kuyisithiyo esikhulu ekwelapheni izinzwa.
- Ukuphatha ezinye izifo: Kubalulekile ukuphatha izifo ezifana nesifo sikashukela kahle.
- Ukuphakamisa ingalo/umlenze: Ukuphakamisa ingalo/umlenze obuhlungu ngenkathi ulele noma uphumule, njengasesicamelweni, kuzonciphisa ukuvuvukala.
- Ukuzivocavoca: Ukuzivocavoca nsuku zonke kuhle kakhulu ekujikelezeni kwegazi.
- Amasokisi okucindezela: Udokotela wakho angase akuncome ukuthi uwagqoke ukuze ulawule ukuvuvukala.
Ukusekelwa kwempilo yengqondo
Kuvamile ukuzizwa ucindezelekile, uthukuthele, futhi ukhathazekile lapho uphila nobuhlungu obungapheli. Lezi zinto zingenza ubuhlungu bube bubi kakhulu. Ngakho-ke, ukufuna iseluleko sengqondo kungaba usizo olukhulu ekubhekaneni nobuhlungu ngokwengqondo nangokomzwelo.
Imithi (izidakamizwa)
Akukho muthi othize ovunyelwe i-CRPS. Kodwa-ke, udokotela angase anikeze imithi ehlukahlukene ukusiza ukulawula izimpawu.
- Ama-Painkiller ( ama-NSAID )
- Okhilimu bokuqeda ubuhlungu besikhumba
- Eminye imithi yokucindezeleka kanye nemithi yokulwa nokuquleka yobuhlungu bezinzwa
- Imijovo yeBotox
Ezinye izindlela zokwelapha ezithile zokulawula ubuhlungu
Uma ezinye izindlela zokwelapha kunzima ukulawula ubuhlungu, udokotela angase asebenzise izindlela zokwelapha eziyinkimbinkimbi njengalezi.
- Ama-sympathetic nerve blocks: Ukujova umuthi wokubulala izinzwa ukuze 'kulale' okwesikhashana imizwa ethwala izimpawu zobuhlungu ebuchosheni.
- Ukuvuselelwa kwentambo yomgogodla: I-electrode encane ifakwa ngokuhlinzwa eduze kwentambo yomgogodla futhi inikeze izimpawu zikagesi ezicashile ezivimba izimpawu zobuhlungu.
- Ukufakwa kwe-ketamine nge-IV: Umthamo ophansi we-ketamine yesidakamizwa unikezwa ngemithambo yegazi izinsuku eziningana.
Yini ongayilindela uma uhlala ne-CRPS?
Akuwona wonke umuntu onolwazi nge-CRPS olufanayo. Kwabaningi, ngokuhamba kwesikhathi nangokwelashwa okufanele, izimpawu zizoncipha futhi bazolulama cishe ngokuphelele.
Kodwa-ke, ezimweni ezingavamile, lesi simo singaba sibi kakhulu noma sisakazekele kwezinye izingxenye zomzimba. Ngakho-ke, kubalulekile ukulawula ubuhlungu nokugcina ukusebenza kwengalo/umlenze. Ngohlelo lokwelashwa olufanele, abantu abaningi bangaphila impilo esebenzayo nge-CRPS.
Ingabe i-CRPS isifo sengqondo?
Cha. I-CRPS akuyona isifo sengqondo. Yisimo sezinzwa. Kodwa-ke, ubuhlungu obukhulu kanye nomthelela empilweni okubangelwa yi-CRPS kungabangela noma kube kubi kakhulu izinkinga zempilo yengqondo njengokukhathazeka nokucindezeleka.
Umlayezo Wokuya Nawe Ekhaya
- I-CRPS akuyona into oyiqambela yona engqondweni yakho. Yisimo sangempela esibangela ubuhlungu obukhulu.
- Ngokuvamile, ngemva kokulimala okuncane, uma kukhona ukuvuvukala okukhulu, ubuhlungu, kanye nezinguquko embala wesikhumba kanye nokushisa okungafani nokulimala, khathazeka.
- Kubaluleke kakhulu ukuxilonga lesi sifo bese uqala ukwelashwa ngokushesha okukhulu. Lokhu kungavimbela izinkinga zesikhathi eside.
- Ukwelashwa akuyona into eyodwa. Kungumzamo weqembu ohlanganisa ukwelashwa ngokomzimba, imithi kanye nokusekelwa kwengqondo.
- Uma unezinsolo ezincane ngalezi zimpawu, sicela ukhulume nodokotela wakho ngakho.
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