Syndromeungiyoyin ciwo na yanki mai rikitarwa

Syndromewararrun cututtukan yanki na yanki (CRPS) yanayin ciwo ne na dogon lokaci (na yau da kullun) wanda zai iya shafar kowane yanki na jiki, amma galibi yakan shafi hannu ko ƙafa.

Doctors ba su da tabbacin abin da ke haifar da CRPS. A wasu lokuta, tsarin juyayi mai juyayi yana taka muhimmiyar rawa a cikin ciwo. Wata ka'ida ita ce, CRPS ana haifar da shi ne ta hanyar haifar da martani na rigakafi, wanda ke haifar da alamun bayyanar cututtuka na ja, dumi, da kumburi a yankin da abin ya shafa.

CRPS yana da nau'i biyu:

• CRPS 1 cuta ce ta dogon lokaci (mai ɗorewa) da ke faruwa sau da yawa a cikin hannu ko ƙafa bayan ƙaramin rauni.
• CRPS 2 yana haifar da rauni ga jijiya.

Ana tunanin CRPS yana haifar da lalacewa ga tsarin mai juyayi. Wannan ya hada da jijiyoyin da ke kula da hanyoyin jini da gumi.

Jijiyoyin da suka lalace ba su da ikon sarrafa ƙwayar jini yadda ya kamata, ji (jin), da zafin jiki zuwa yankin da abin ya shafa. Wannan yana haifar da matsaloli a cikin:

• Maganin jini
• Kasusuwa
• Tsoka
• Jijiyoyi
• Fata

Matsaloli da ka iya haddasa CRPS:

• Rauni kai tsaye zuwa jijiya
• Rauni ko kamuwa da cuta a hannu ko kafa

A cikin al'amuran da ba safai ba, cututtukan kwatsam kamar ciwon zuciya ko bugun jini na iya haifar da CRPS. Yanayin a wasu lokuta yakan bayyana ba tare da wani rauni a bayyane ga gabar da ya shafa ba.

Wannan yanayin ya fi zama ruwan dare a cikin mutane masu shekaru 40 zuwa 60, amma matasa ma na iya inganta shi, suma.

Babban alama shine ciwo cewa:

• Yana da ƙarfi da ƙonewa kuma ya fi ƙarfi fiye da yadda za a yi tsammanin irin raunin da ya faru.
• Ya zama mafi muni, maimakon mafi kyau akan lokaci.
• Zai fara a wurin rauni, amma zai iya yaduwa zuwa dukkan gaɓoɓi, ko zuwa hannu ko ƙafa a kishiyar sashin jiki.

A mafi yawan lokuta, CRPS yana da matakai guda uku. Amma, CRPS ba koyaushe ke bin wannan tsarin ba. Wasu mutane suna haifar da mummunan bayyanar cututtuka nan da nan. Wasu kuma suna tsayawa a matakin farko.

Mataki na 1 (yana ɗaukar watanni 1 zuwa 3):

• Canje-canje a cikin zafin jiki na fata, sauyawa tsakanin dumi ko sanyi
• Saurin girma na kusoshi da gashi
• Magungunan tsoka da haɗin gwiwa
• Burningarfi mai tsanani, ciwo mai zafi wanda ke kara damuwa tare da ɗan taɓawa ko iska
• Fata da sannu a hankali take zama mai kumbura, purple, kodadde, ko ja; siriri da haske; kumbura; karin zufa

Mataki na 2 (yana ɗaukar watanni 3 zuwa 6):

• Ci gaba da canje-canje a cikin fata
• Nausoshin ƙusa waɗanda suke fashewa da sauƙi
• Ciwon da yake ƙara zama mai muni
• Sannu a hankali girma gashi
• Jointsunƙun gaɓa da tsokoki marasa ƙarfi

Mataki na 3 (ana iya ganin canje-canje da ba za a iya sauyawa ba)

• Limiteduntataccen motsi a cikin gaɓa saboda tsananin tsokoki da jijiyoyi (kwangila)
• Rashin tsoka
• Jin zafi a cikin duka gabar

Idan ciwo da sauran alamu sun kasance masu tsanani ko na dogon lokaci, mutane da yawa na iya fuskantar baƙin ciki ko damuwa.

Yin bincike akan CRPS na iya zama da wahala, amma ganewar wuri yana da mahimmanci.

Mai ba da sabis na kiwon lafiya zai ɗauki tarihin likita kuma ya yi gwajin jiki. Sauran gwaje-gwaje na iya haɗawa da:

• Gwaji don nuna canjin yanayin zafin jiki da rashin wadataccen jini a gabobin da abin ya shafa (thermography)
• Binciken ƙashi
• Nazarin motsa jiki da ilimin lantarki (yawanci ana yin su tare)
• X-haskoki
• Gwajin jijiyoyin kai (matakan gumi da hawan jini)

Cutar CRPS ba ta da magani, amma cutar na iya yin tafiyar hawainiya. Babban abin da ya fi mayar da hankali shi ne kan sauƙaƙe alamomin da taimaka wa mutane da wannan cuta ta rayuwa cikin rayuwa daidai gwargwado.

Yakamata a fara maganin jiki da na aiki da wuri-wuri. Fara shirin motsa jiki da koyon kiyaye gabobi da jijiyoyin jiki na iya hana cutar yin muni. Hakanan zai iya taimaka maka yin ayyukan yau da kullun.

Za a iya amfani da magunguna, gami da magungunan ciwo, corticosteroids, wasu magungunan hawan jini, magungunan ƙashin kashi da magungunan rage damuwa.

Wasu nau'ikan maganin maganganu, kamar ilimin halayyar halayyar mutum ko halayyar kwakwalwa, na iya taimakawa koyar da ƙwarewar da ake buƙata don rayuwa tare da ciwo mai ɗorewa (na kullum).

M ko dabaru masu cin zali wanda za a iya gwadawa:

• Magungunan allura wanda yake narkar da jijiyoyin da abin ya shafa ko kuma zarurrukan ciwo a kewayen sashin kashin baya (jijiyoyin jijiyoyin).
• Pampo mai ciwo na ciki wanda kai tsaye ke ba da magunguna zuwa lakar kashin baya (fam ɗin ƙwayoyin cuta ta intrathecal).
• Ulatorarfafa ƙwayoyin cuta, wanda ya haɗa da sanya wutan lantarki (jagororin lantarki) kusa da layin baya. Ana amfani da ƙarancin lantarki mai ƙarancin ƙarfi don ƙirƙirar daɗi ko ƙwanƙwasawa a cikin yankin mai raɗaɗi shine hanya mafi kyau don rage ciwo a cikin wasu mutane.
• Yin aikin tiyata wanda ke yanke jijiyoyi don lalata ciwo (tiyatar jinƙai), kodayake ba a san yawan mutanen da wannan ke taimakawa ba. Hakanan yana iya haifar da bayyanar cututtuka mafi muni a cikin wasu mutane.

Hangen nesa ya fi kyau tare da ganewar asali. Idan likita ya binciko yanayin a matakin farko, wani lokacin alamun cutar na iya ɓacewa (gafara) kuma motsi na al'ada yana yiwuwa.

Idan ba a bincikar yanayin ba da sauri, canje-canje ga kashi da tsoka na iya zama mafi muni kuma bazai zama mai juyawa ba.

A wasu mutane, alamomin cutar kan tafi da kansu. A wasu mutane, koda da magani ciwon yana ci gaba kuma yanayin yana haifar da nakasa, canje-canje da ba za a iya sauyawa ba.

Matsalolin da zasu iya haifar sun hada da:

• Matsaloli tare da tunani da yanke hukunci
• Bacin rai
• Rashin girman tsoka ko ƙarfi a cikin ɓangaren da abin ya shafa
• Yada cutar zuwa wani sashin jiki
• Mafi munin ɓangaren da abin ya shafa

Har ila yau, rikitarwa na iya faruwa tare da wasu jijiyoyi da jiyya.

Tuntuɓi mai ba ka sabis idan ka ci gaba da ci gaba, zafi mai zafi a hannu, ƙafa, hannu, ko ƙafa.

Babu sanannun rigakafin a wannan lokacin. Kulawa da wuri shine mabuɗin don rage ci gaban cutar.

CRPS; RSDS; Causalgia - RSD; Ciwon hannu-na hannu; Lexwayar cututtukan dystrophy mai tausayi; Sudeck atrophy; Jin zafi - CRPS

Aburahma AF. Syndromeungiyoyin ciwo na yanki mai rikitarwa. A cikin: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery da Endovascular Far. 9th ed. Philadelphia, PA: Elsevier; 2019: babi na 192.

Gorodkin R. Ciwo mai ciwo na yanki na yanki (mai saurin damuwa dystrophy). A cikin: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7th ed. Philadelphia, PA: Elsevier; 2019: babi na 90.

Stanos SP, Tyburski MD, Harden RN. Jin zafi na kullum. A cikin: Cifu DX, ed. Braddom ta Magungunan Jiki da Gyarawa. 5th ed. Philadelphia, PA: Elsevier; 2016: babi na 37.