Isifo esibuhlungu sesifunda

I-Complex Regional syndrome (CRPS) yisimo esibuhlungu sesikhathi eside (esingapheli) esingathinta noma iyiphi indawo yomzimba, kepha sithinte ingalo noma umlenze.

Odokotela abaqiniseki ukuthi yini ebangela i-CRPS. Kwezinye izimo, uhlelo lwezinzwa oluzwelayo lubamba iqhaza elibalulekile ebuhlungwini. Enye inkolelo ukuthi i-CRPS ibangelwa ukuqalwa kokuphendula komzimba, okuholela ezimpawu zokuvuvukala kokubomvu, ukufudumala nokuvuvukala endaweni ethintekile.

I-CRPS inezinhlobo ezimbili:

• I-CRPS 1 yisifo sezinzwa sesikhathi eside (esingapheli) esenzeka kaningi ezingalweni noma emilenzeni ngemuva kokulimala okuncane.
• I-CRPS 2 ibangelwa ukulimala kwenzwa.

I-CRPS icatshangwa ukuthi ibangelwe ukulimala kwesistimu yezinzwa. Lokhu kufaka phakathi izinzwa ezilawula imithambo yegazi nezindlala zomjuluko.

Izinzwa ezilimele azisakwazi ukulawula kahle ukugeleza kwegazi, ukuzwa (ukuzwa), nokushisa endaweni ethintekile. Lokhu kuholela ezinkingeni ku:

• Imithambo yegazi
• Amathambo
• Imisipha
• Imizwa
• Isikhumba

Izimbangela ezingaba khona ze-CRPS:

• Ukulimala ngqo kunzwa
• Ukulimala noma ukutheleleka engalweni noma emlenzeni

Ezimweni ezingavamile, ukugula okungazelelwe okufana nokuhlaselwa yinhliziyo noma isifo sohlangothi kungadala i-CRPS. Isimo kwesinye isikhathi singavela ngaphandle kokulimala okusobala kulowo mlenze othintekile.

Lesi simo sivame kakhulu kubantu abaneminyaka engama-40 kuya kwengama-60, kepha abantu abasha bangasithuthukisa futhi.

Uphawu oluyinhloko ubuhlungu obuthi:

• Inamandla futhi iyasha futhi inamandla kakhulu kunalokho obekulindelekile ngohlobo lokulimala okwenzekile.
• Kuba kubi kakhulu, kunokuba kube ngcono ngokuhamba kwesikhathi.
• Iqala lapho kulimala khona, kepha ingasakazeka kutho lonke lomzimba, noma engalweni noma emlenzeni ngakolunye uhlangothi lomzimba.

Ezimweni eziningi, i-CRPS inezigaba ezintathu. Kepha, i-CRPS ayilandeli njalo leli phethini. Abanye abantu baba nezimpawu ezinzima ngokushesha. Abanye bahlala esigabeni sokuqala.

Isigaba 1 (sithatha izinyanga ezi-1 kuye kwezi-3):

• Izinguquko ekushiseni kwesikhumba, zishintsha zifudumele noma zibande
• Ukukhula okusheshayo kwezipikili nezinwele
• Ukudumba kwemisipha nobuhlungu bamalunga
• Ukushisa okukhulu, ubuhlungu obuhlungu obukhula ngokuthinta okuncane noma umoya
• Isikhumba esiya ngokukhanyayo sifiphale, sibe nsomi, siphaphathekile noma sibe bomvu; mncane futhi uyacwebezela; ukuvuvukala; ajuluke kakhulu

Isigaba 2 (sithatha izinyanga ezi-3 kuye kwezi-6):

• Izinguquko eziqhubekayo esikhunjeni
• Izipikili eziqhephukile neziphuka kalula
• Ubuhlungu obuya ngokuya bubi
• Ukukhula kancane kwezinwele
• Amalunga aqinile nemisipha ebuthakathaka

Isigaba 3 (kungabonakala izinguquko ezingenakulungiswa)

• Ukuhamba okulinganiselwe emlenzeni ngenxa yemisipha eqinisiwe kanye nemisipha (isivumelwano)
• Ukuchitheka kwemisipha
• Ubuhlungu esithweni sonke

Uma ubuhlungu nezinye izimpawu zinzima noma zihlala isikhathi eside, abantu abaningi bangathola ukucindezeleka noma ukukhathazeka.

Ukuhlonza i-CRPS kungaba nzima, kepha ukuxilongwa kusenesikhathi kubaluleke kakhulu.

Umhlinzeki wezokunakekelwa kwempilo uzothatha umlando wezempilo futhi azihlole ngokomzimba. Ezinye izivivinyo zingafaka:

• Isivivinyo sokukhombisa ushintsho lwezinga lokushisa nokuntuleka kokutholakala kwegazi engalweni ethintekile (thermography)
• Amathambo ahlola
• Izifundo zokuqhuba imizwa kanye ne-electromyography (okuvame ukwenziwa ndawonye)
• Ama-X-ray
• Ukuhlolwa kwezinzwa ze-Autonomic (kukala ukujuluka nomfutho wegazi)

Alikho ikhambi le-CRPS, kepha isifo singancishiswa. Okugxilwe kakhulu ekunciphiseni izimpawu nokusiza abantu abanalesi sifo baphile impilo ejwayelekile ngangokunokwenzeka.

Ukwelashwa ngokomzimba nangokomsebenzi kufanele kuqalwe ngokushesha ngangokunokwenzeka. Ukuqala uhlelo lokuzivocavoca umzimba nokufunda ukugcina amalunga nezicubu zihamba kungavimbela lesi sifo ukuba sibi kakhulu. Kungakusiza futhi ukuthi wenze imisebenzi yansuku zonke.

Imithi ingasetshenziswa, kufaka phakathi imithi yezinhlungu, i-corticosteroids, imithi ethile yengcindezi yegazi, izidakamizwa zokulahleka kwamathambo kanye nezidambisi.

Olunye uhlobo lokwelashwa kokukhuluma, njengokwelashwa kokuziphatha kwengqondo noma ukwelashwa kwengqondo, kungasiza ukufundisa amakhono adingekayo ukuze uphile nobuhlungu besikhathi eside (obungapheli).

Izindlela zokuhlinza noma zokuhlasela ezingazama:

• Umuthi ojojowe ofaka izinzwa ezithintekile noma imicu yobuhlungu ezungeze ikholomu yomgogodla (i-nerve block).
• Iphampu yezinhlungu zangaphakathi eletha ngqo imithi entanjeni yomgogodla (ipompo yezidakamizwa ye-intrathecal).
• Isikhuthazi sentambo yomgogodla, okubandakanya ukubeka ama-electrode (imikhondo kagesi) eduze komgogodla. Amandla kagesi asezingeni eliphansi asetshenziselwa ukudala ukuzwa okujabulisayo noma okushoshozelayo endaweni ebuhlungu kuyindlela engcono yokunciphisa izinhlungu kwabanye abantu.
• Ukuhlinzwa okusika izinzwa ukuqeda izinhlungu (i-upasuaji sympathectomy), noma kungacaci ukuthi lokhu kusiza abantu abangaki. Kungenza izimpawu zibe zimbi kakhulu kwabanye abantu.

Umbono ungcono ngokuxilongwa kusenesikhathi. Uma udokotela ehlonza isimo esigabeni sokuqala, kwesinye isikhathi izimpawu zesifo zinganyamalala (ukuthethelelwa) nokunyakaza okujwayelekile kungenzeka.

Uma isimo singatholakali ngokushesha, izinguquko ethanjeni nasemisipheni zingase zibe zimbi kakhulu futhi zingaphinde ziguquke.

Kwabanye abantu, izimpawu zihamba zodwa. Kwabanye abantu, noma ngabe kwelashwa izinhlungu ziyaqhubeka kanti isimo sidala ukukhubazeka, nezinguquko ezingalungiseki.

Izinkinga ezingaba nomphumela zifaka:

• Izinkinga ngokucabanga nokwahlulela
• Ukucindezeleka
• Ukulahleka kobukhulu bemisipha noma amandla emlenzeni othintekile
• Ukusakazeka kwalesi sifo kwenye ingxenye yomzimba
• Ukuqina kwesitho esithintekile

Izinkinga zingenzeka nangezinye izindlela zokwelapha ezinzwa nezokuhlinzwa.

Xhumana nomhlinzeki wakho uma uhlakulela ubuhlungu obungapheli, obuvuthayo engalweni, emlenzeni, esandleni, noma enyaweni.

Akukho ukuvimbela okwaziwayo ngalesi sikhathi. Ukwelashwa kusenesikhathi kuyisihluthulelo sokunciphisa ukuqhubeka kwesifo.

CRPS; Ama-RSDS; I-Causalgia - i-RSD; I-shoulder-hand syndrome; I-Reflex sympathy systrophy syndrome; Isifo se-Sudeck; Ubuhlungu - i-CRPS

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I-Gorodkin R. I-Complex pain syndrome yesifunda (i-reflex sympathetic dystrophy). Ku: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, abahleli. I-Rheumatology. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2019: isahluko 90.

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