Matenda ovuta akumadera

Matenda ovuta am'madera (CRPS) ndimavuto ataliatali (okhalitsa) omwe amatha kukhudza gawo lililonse la thupi, koma nthawi zambiri amakhudza mkono kapena mwendo.

Madokotala sakudziwa chomwe chimayambitsa CRPS. Nthawi zina, dongosolo lamanjenje lomvera limagwira gawo lofunikira pakupweteka. Lingaliro lina ndiloti CRPS imayambitsidwa chifukwa choyambitsa chitetezo cha mthupi, zomwe zimabweretsa zizindikiritso zotupa za kufiira, kutentha, ndi kutupa m'deralo.

CRPS ili ndi mitundu iwiri:

• CRPS 1 ndimatenda a nthawi yayitali (osatha) omwe amapezeka kwambiri m'manja kapena m'miyendo pambuyo povulala pang'ono.
• CRPS 2 imayambitsidwa ndi kuvulala kwa mitsempha.

CRPS imaganiziridwa kuti imadza chifukwa cha kuwonongeka kwa dongosolo lamanjenje. Izi zimaphatikizapo mitsempha yomwe imayendetsa mitsempha ya magazi ndi thukuta la thukuta.

Mitsempha yowonongeka singathenso kuyendetsa bwino magazi, kumva (kutengeka), ndi kutentha kumalo omwe akhudzidwa. Izi zimabweretsa mavuto mu:

• Mitsempha yamagazi
• Mafupa
• Minofu
• Mitsempha
• Khungu

Zomwe zingayambitse CRPS:

• Kuvulala molunjika ku mitsempha
• Kuvulala kapena matenda m'manja kapena mwendo

Nthawi zambiri, matenda mwadzidzidzi monga matenda a mtima kapena sitiroko amatha kuyambitsa CRPS. Vutoli nthawi zina limatha kuwonekera popanda kuvulaza mwendo.

Matendawa amapezeka kwambiri kwa anthu azaka zapakati pa 40 mpaka 60, koma achinyamata amatha kukhala nawo.

Chizindikiro chachikulu ndi ululu womwe:

• Ndi yamphamvu komanso yoyaka ndipo ndi yamphamvu kwambiri kuposa momwe timayembekezera chifukwa cha mtundu wovulala womwe udachitika.
• Zimakula kwambiri, m'malo mokhala bwino pakapita nthawi.
• Imayamba mpaka kuvulala, koma imafalikira ku chiwalo chonse, kapena kudzanja kapena mwendo mbali inayo ya thupi.

Nthawi zambiri, CRPS ili ndi magawo atatu. Koma, CRPS sikutsatira izi nthawi zonse. Anthu ena amakhala ndi matendawa nthawi yomweyo. Ena amakhala gawo loyamba.

Gawo 1 (limatha miyezi 1 mpaka 3):

• Kusintha kwa kutentha kwa khungu, kusintha pakati pa kutentha kapena kuzizira
• Kukula msanga kwa misomali ndi tsitsi
• Kupweteka kwa minofu ndi kupweteka kwa mafupa
• Kuwotcha kwakukulu, kupweteka komwe kumakulirakulira ndikungokhudza pang'ono kapena kamphepo kaye
• Khungu lomwe limatuluka pang'onopang'ono, lofiirira, lotuluka, kapena lofiira; woonda ndi wowala; kutupa; thukuta kwambiri

Gawo 2 (limatha miyezi 3 mpaka 6):

• Kupitiliza kusintha pakhungu
• Misomali yomwe yaphwanyika ndikuphwanya mosavuta
• Ululu womwe ukukula kwambiri
• Kukula pang'ono kwa tsitsi
• Malumikizidwe olimba ndi minofu yofooka

Gawo 3 (kusintha kosasinthika kukuwoneka)

• Kuyenda pang'ono pamiyendo chifukwa cha minofu yolimba ndi tendon (contracture)
• Minofu ikuwonongeka
• Kupweteka kwa chiwalo chonse

Ngati kupweteka ndi zizindikilo zina ndizovuta kapena zokhalitsa, anthu ambiri amatha kukhala ndi nkhawa kapena kuda nkhawa.

Kuzindikira CRPS kungakhale kovuta, koma kuzindikira koyambirira ndikofunikira.

Wothandizira zaumoyo atenga mbiri ya zamankhwala ndikuwunika. Mayesero ena atha kuphatikizira:

• Kuyesa kosonyeza kutentha ndi kusowa kwa magazi m'chiwalo chomwe chakhudzidwa (thermography)
• Kujambula mafupa
• Maphunziro owongolera amitsempha ndi ma electromyography (omwe amachitikira limodzi)
• X-ray
• Kuyesa kwamitsempha kwama Autonomic (kuyeza thukuta ndi kuthamanga kwa magazi)

CRPS ilibe mankhwala, koma matendawa amatha kuchepetsedwa. Cholinga chachikulu ndikuchepetsa zizindikilo ndikuthandizira anthu omwe ali ndi matendawa kukhala moyo wabwinobwino momwe angathere.

Thandizo lakuthupi ndi pantchito liyenera kuyambika mwachangu. Kuyambitsa pulogalamu yochita masewera olimbitsa thupi ndikuphunzira kusunga mafupa ndi minofu kusunthika kumatha kuteteza matendawa kuti asakule kwambiri. Ikhozanso kukuthandizani kuchita zinthu za tsiku ndi tsiku.

Mankhwala atha kugwiritsidwa ntchito, kuphatikiza mankhwala opweteka, corticosteroids, mankhwala ena othamanga magazi, mankhwala otaya mafupa komanso mankhwala opatsirana.

Mitundu ina yamankhwala oyankhulira, monga chidziwitso chazachipatala kapena psychotherapy, imatha kuthandiza kuphunzitsa maluso ofunikira kuti mukhale ndi ululu wanthawi yayitali.

Njira zopangira opaleshoni kapena zowononga zomwe zingayesedwe:

• Mankhwala ojambulidwa omwe amachititsa kuti mitsempha yokhudzidwa kapena ululu ulowe kuzungulira msana.
• Pampu yowawa yamkati yomwe imapereka mankhwala molunjika ku msana (pampu ya mankhwala osokoneza bongo).
• Spinal cord stimulator, yomwe imaphatikizapo kuyika ma elekitirodi (magetsi amagetsi) pafupi ndi msana. Mphamvu yamagetsi yotsika imagwiritsidwa ntchito kupangira chisangalalo chosangalatsa kapena cholira m'malo opweteka ndi njira yabwino yochepetsera kupweteka kwa anthu ena.
• Opaleshoni yomwe imadula mitsempha kuti iwononge ululu (opaleshoni ya sympathectomy), ngakhale sizikudziwika kuti ndi anthu angati omwe amathandizira. Zingapangitsenso kuti matendawa awonjezeke mwa anthu ena.

Maganizo ake ndi abwinoko ndikazindikira koyambirira. Ngati dokotala atazindikira kuti ali ndi vutoli mgawo loyamba, nthawi zina zizindikilo za matendawa zimatha kutha (chikhululukiro) ndipo kuyenda koyenera kumatheka.

Ngati vutoli silikupezeka msanga, kusintha kwa mafupa ndi minofu kumatha kukulira ndipo sikungasinthe.

Kwa anthu ena, zizindikiro zimatha mwa iwo okha. Kwa anthu ena, ngakhale atalandira chithandizo chowawa chimapitilira ndipo vutoli limapangitsa kusintha kwakulemala, kosasinthika.

Zovuta zomwe zingakhalepo ndi izi:

• Mavuto ndi kuganiza ndi kuweruza
• Matenda okhumudwa
• Kuchepetsa kukula kwa minofu kapena nyonga mu gawo lomwe lakhudzidwa
• Kufalitsa matendawa mbali ina ya thupi
• Kukula kwa gawo lomwe lakhudzidwa

Zovuta zimatha kuchitika ndi zina mwa mitsempha komanso chithandizo chamankhwala.

Lumikizanani ndi omwe amakupatsani ngati mukumva kupweteka kosalekeza, koyaka pamkono, mwendo, dzanja, kapena phazi.

Palibe choletsa kudziwika pakadali pano. Chithandizo choyambirira ndichofunika kuti muchepetse kukula kwa matendawa.

CRPS; Maofesi; Causalgia - RSD; Matenda am'manja; Reflex wachifundo matenda amtundu; Kudwala; Ululu - CRPS

Aburahma AF. Matenda ovuta akumadera. Mu: Sidawy AN, Perler BA, olemba. Rutherford Opaleshoni ya Mitsempha ndi Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019: mutu 192.

Gorodkin R. Matenda ovuta am'madera (Reflex sympathetic dystrophy). Mu: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, olemba. Zamatsenga. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2019: mutu 90.

Stanos SP, Tyburski MD, Wovuta RN. Kupweteka kosatha. Mu: Cifu DX, mkonzi. Mankhwala a Braddom Physical and Rehabilitation. 5th ed. Philadelphia, PA: Elsevier; 2016: chap 37.