Nā Maʻi ʻeha ʻāpana Ākea

ʻO ka maʻi ʻeha ʻāpana ākea paʻakikī (CRPS) kahi ʻano o ka ʻeha mau loa e pili pinepine ana i ka lima a i ʻole ka wāwae. Hoʻomaka pinepine ka maʻi ʻeha ʻāpana ākea paʻakikī (CRPS) ma hope o ka hōʻeha, ka ʻoki kino, ka hahau a i ʻole ka puʻuwai. ʻOi aku ka nui o ka ʻeha ma mua o ka nui o ka hōʻeha mua.

He mea maʻamau ʻole ka CRPS, a ʻaʻole maopopo ka kumu. ʻOi aku ka maikaʻi o ka mālama ʻana i ka hoʻomaka koke ʻana. I kēlā mau hihia, hiki ke hoʻomaikaʻi a hiki i ka hoʻōla piha.

Nā hōʻailona a me nā hōʻailona o ka CRPS e komo pū ana me:

• ʻEha kuni mau a i ʻole ʻeha hāhā, ma ka lima, wāwae, lima a i ʻole kapuaʻi maʻamau
• Mānoanoa i ka pā a i ʻole ke anu
• Pehu o ka wahi ʻeha
• Hoʻololi i ka mahana o ka ʻili - e hoʻololi ana ma waena o ka hou a me ke anu
• Hoʻololi i ke kala o ka ʻili, mai ke keʻokeʻo a me ka ʻāpana a i ka ʻulaʻula a i ʻole ka uliuli
• Hoʻololi i ka ʻano o ka ʻili, e lilo paha i palupalu, lahilahi a i ʻole ʻālohilohi i ka wahi i pilikia
• Hoʻololi i ka ulu ʻana o ka lauoho a me nā kui
• Paʻa o nā hono, pehu a me ka poino
• Nā spasms o nā ʻiʻo, nā haʻalulu a me ka nāwaliwali (atrophy)
• emi iho ka hiki ke hoʻoneʻe i ka ʻāpana kino i pilikia

Hiki i nā hōʻailona ke loli i ka manawa a ʻokoʻa mai ke kanaka a i ke kanaka. ʻO ka ʻeha, ka pehu, ka ʻulaʻula, nā loli i ʻike ʻia i ka mahana a me ka hypersensitivity (ʻoi aku hoʻi i ke anu a me ka pā) e kū mua ana.

Ma hope o kekahi manawa, hiki i ka lālā i pilikia ke lilo i anu a me ka palupalu. Hiki iā ia ke hoʻololi i ka ʻili a me nā kui a me nā spasms o nā ʻiʻo a me ka paʻa. Ke hana ʻia kēia mau loli, pinepine ʻia ka kūlana i hiki ʻole ke hoʻololi.

Hiki i ka CRPS ke pālahalaha mai kona kumu a i nā wahi ʻē aʻe o ke kino, e like me ka lālā ʻē aʻe.

I kekahi poʻe, nalowale nā ​​hōʻailona a me nā hōʻailona o ka CRPS ma o lākou iho. I nā poʻe ʻē aʻe, hiki ke mau nā hōʻailona a me nā hōʻailona no nā mahina a i nā makahiki. He mea nui ka mālama ʻana i ka hoʻomaka koke ʻana i ka maʻi.

Inā ʻike ʻoe i ka ʻeha mau loa a nui loa e pili ana i kahi lālā a hoʻolilo i ka pā ʻana a i ʻole ka hoʻoneʻe ʻana i kēlā lālā he mea hiki ʻole ke ʻae ʻia, e ʻike i kāu mea lawelawe ola e hoʻoholo i ke kumu. He mea nui ka mālama koke ʻana i ka CRPS.

ʻAʻole maopopo loa ke kumu o ka CRPS. Manaʻo ʻia ua hoʻokumu ʻia e ka hōʻeha a i ʻole ka ʻokoʻa ma nā ʻōnaehana hoʻoikaika peripheral a me ke kikowaena. Hoʻomaka pinepine ka CRPS ma muli o kahi hōʻeha a i ʻole kahi pōʻino.

Hoʻokumu ʻia ka CRPS i ʻelua ʻano, me nā hōʻailona a me nā hōʻailona like, akā ʻokoʻa nā kumu:

• ʻAno 1. I ʻike ʻia hoʻi ʻo ka reflex sympathetic dystrophy (RSD), hele mai kēia ʻano ma hope o kahi maʻi a i ʻole ka hōʻeha i ʻole i hōʻino pololei i nā aʻalolo i ka lālā i pilikia. Ma kahi o 90% o nā kānaka me ka CRPS loaʻa iā lākou ke ʻano 1.
• ʻAno 2. I kapa ʻia ma mua ʻo ka causalgia, loaʻa i kēia ʻano nā hōʻailona e like me nā hōʻailona o ke ʻano 1. Akā hele mai ka CRPS ʻano 2 ma hope o kahi hōʻeha aʻalolo kūikawā.

He nui nā hihia o ka CRPS e hele mai ma hope o kahi hōʻeha ikaika i ka lima a i ʻole ka wāwae. Hiki ke komo pū me kahi hōʻeha kuʻi a i ʻole ka haki.

ʻO nā hōʻeha nui a me nā liʻiliʻi ʻē aʻe - e like me ka ʻoki kino, nā hōʻeha naʻau, nā maʻi a me nā kuʻekuʻe wāwae - hiki ke alakaʻi i ka CRPS.

ʻAʻole maopopo ka mea e hoʻonāukiuki ai kēia mau hōʻeha i ka CRPS. ʻAʻole nā ​​​​kānaka a pau i loaʻa i kēlā hōʻeha e hoʻomohala i ka CRPS. Hiki paha ia ma muli o kahi launa ma waena o kāu mau ʻōnaehana hoʻoikaika kikowaena a me nā peripheral i ʻole ka maʻamau a me nā pane inflammatory ʻokoʻa.

Inā ʻaʻole i ʻike ʻia a mālama ʻia koke ka CRPS, hiki ke holomua ka maʻi i nā hōʻailona a me nā hōʻailona ʻoi aku ka hōʻino.

• Ka hoʻoemi ʻana o nā pūnaewele (atrophy). Hiki ke hoʻomaka ke hoʻoemi a nāwaliwali nā ʻili, nā iwi a me nā ʻiʻo inā hōʻalo ʻoe a i ʻole pilikia ʻoe i ka hoʻoneʻe ʻana i ka lima a i ka wāwae ma muli o ka ʻeha a i ʻole ka paʻakikī.
• Ka wili ʻana o nā ʻiʻo (contracture). Hiki nō hoʻi iā ʻoe ke ʻike i ka wili ʻana o nā ʻiʻo. Hiki kēia ke alakaʻi i kahi kūlana kahi e hoʻopaʻa ʻia ai ka lima a me nā manamana lima a i ʻole ka wāwae a me nā manamana wāwae i kahi kūlana paʻa.

Hiki i kēia mau ʻanuʻu ke kōkua i ka hōʻemi ʻana i ka pilikia o ka loaʻa ʻana o ka CRPS:

• Ka lawe ʻana i ka wikamina C ma hope o ka haki ʻana o ka lima. Ua hōʻike nā haʻawina ua emi ka pilikia o ka loaʻa ʻana o ka CRPS i nā kānaka e lawe ana i ka nui o ka wikamina C ma hope o ka haki ʻana o ka lima, i hoʻohālikelike ʻia me ka poʻe ʻaʻole i lawe i ka wikamina C.
• Ka neʻe koke ʻana ma hope o ka hahau ʻana. Ke manaʻo nei kekahi mau noiʻi e emi ka pilikia o ka loaʻa ʻana o ka CRPS i nā kānaka e ala a hele koke ma hope o ka hahau ʻana (ka neʻe koke ʻana).

Hoʻoholo ʻia ka maʻi ʻeha ʻāpana ʻāpana paʻakikī (CRPS) ma muli o ka nānā kino a me kou moʻolelo lapaʻau. ʻAʻohe hoʻokolohua hoʻokahi e hiki ke hoʻoholo pono i ka CRPS, akā hiki i kēia mau kaʻina hana ke hāʻawi i nā ʻōlelo aʻoaʻo nui:

• Bone scan. Hiki i kēia kaʻina hana ke kōkua i ka loaʻa ʻana o nā loli iwi. Hoʻokomo ʻia kahi mea radioactive i loko o kekahi o kou mau veins e ʻike ʻia ai kou mau iwi me kahi kāmela kūikawā.
• Nānā hana hou sweat. Hiki i kekahi mau hoʻokolohua ke ana i ka nui o ka hou sweat ma nā lālā ʻelua. Hiki i nā hopena like ʻole ke hōʻike i ka CRPS.
• X-rays. Hiki i ka nalowale o nā minelala mai kou mau iwi ke hōʻike ʻia ma kahi X-ray i nā pae hope o ka maʻi.
• Magnetic resonance imaging (MRI). Hiki i nā kiʻi i kiʻi ʻia me kahi Magnetic resonance imaging (MRI) hoʻokolohua ke hōʻike i nā loli pūnaewele e kāpae i nā kūlana ʻē aʻe.

Aia kekahi hōʻike e hiki paha i ka mālama koke ke kōkua i ka hoʻomaikaʻi ʻana i nā hōʻailona o ka CRPS. I ka manawa pinepine, pono ka hui ʻana o nā ʻano mālama like ʻole, i hoʻopilikino ʻia i kāu hihia kikoʻī. ʻO nā koho mālama e komo pū ana me:

Hoʻohana nā kauka i nā lāʻau lapaʻau like ʻole e mālama ai i nā hōʻailona o ka CRPS.

Nā mea hoʻoemi ʻeha. Hiki i nā mea hoʻoemi ʻeha i loaʻa me ka ʻole o ka kuhikuhi - e like me ka aspirin, ibuprofen (Advil, Motrin IB, a me nā mea ʻē aʻe) a me ka naproxen sodium (Aleve) - ke hoʻoemi i ka ʻeha māmā a me ka mumū.

Hiki i kāu kauka ke kuhikuhi i nā mea hoʻoemi ʻeha ikaika inā ʻaʻole kōkua nā mea over-the-counter (OTC). Hiki paha ke lilo nā lāʻau opioid i koho. I ka lawe ʻana i nā nui liʻiliʻi, hiki iā lākou ke kōkua i ka kaohi ʻana i ka ʻeha.

He hiki ke hoʻi hou mai ka CRPS, i kekahi manawa ma muli o ka mea hoʻoulu e like me ka hōʻike ʻana i ke anu a i ʻole ka pilikia manaʻo ikaika. Hiki ke mālama ʻia nā hoʻi hou ʻana me nā nui liʻiliʻi o ka lāʻau hoʻoemi kaumaha a i ʻole nā ​​lāʻau ʻē aʻe.

• Nā mea hoʻoemi ʻeha. Hiki i nā mea hoʻoemi ʻeha i loaʻa me ka ʻole o ka kuhikuhi - e like me ka aspirin, ibuprofen (Advil, Motrin IB, a me nā mea ʻē aʻe) a me ka naproxen sodium (Aleve) - ke hoʻoemi i ka ʻeha māmā a me ka mumū.

  Hiki i kāu kauka ke kuhikuhi i nā mea hoʻoemi ʻeha ikaika inā ʻaʻole kōkua nā mea over-the-counter (OTC). Hiki paha ke lilo nā lāʻau opioid i koho. I ka lawe ʻana i nā nui liʻiliʻi, hiki iā lākou ke kōkua i ka kaohi ʻana i ka ʻeha.

• Nā mea hoʻoemi kaumaha a me nā mea anticonvulsants. I kekahi manawa, hoʻohana ʻia nā mea hoʻoemi kaumaha, e like me ka amitriptyline, a me nā mea anticonvulsants, e like me ka gabapentin (Gralise, Neurontin), e mālama ai i ka ʻeha mai ka nerve i hōʻino ʻia (ʻeha neuropathic).

• Corticosteroids. Hiki i nā lāʻau steroid, e like me ka prednisone, ke hoʻoemi i ka mumū a hoʻomaikaʻi i ka neʻe ʻana o ka lālā i pilikia.

• Nā lāʻau lapaʻau i ka nalowale o ka iwi. Hiki i kāu mea hoʻolako ke manaʻo i nā lāʻau lapaʻau e pale ai a i ʻole ke kāohi i ka nalowale o ka iwi, e like me ka alendronate (Binosto, Fosamax) a me ka calcitonin (Miacalcin).

• Lāʻau lapaʻau pale ʻana i nā nerve sympathetic. Hiki i ka inikini ʻana o ka anesthetic e pale i nā kaula ʻeha i nā nerve i pilikia ke hoʻoemi i ka ʻeha i kekahi poʻe.

• Ketamine intravenous. Hōʻike kekahi mau haʻawina e hiki i nā nui liʻiliʻi o ka ketamine intravenous, kahi anesthetic ikaika, ke hoʻoemi nui i ka ʻeha.

• Nā lāʻau lapaʻau e hoʻoemi ai i ke koko kiʻekiʻe. I kekahi manawa, hiki i nā lāʻau lapaʻau koko kiʻekiʻe, me ka prazosin (Minipress), phenoxybenzamine (Dibenzyline) a me ka clonidine ke kōkua i ka kaohi ʻana i ka ʻeha.

• Ka hoʻomehana wela. Hiki i ka hoʻopili ʻana i ka wela ke hāʻawi i ka hoʻomaha ʻana i ka pehu a me ka ʻoluʻolu ʻole ma ka ʻili e ʻoluʻolu anu.

• Topical analgesics. Loaʻa nā ʻano mālama topical like ʻole e hiki ke hoʻoemi i ka hypersensitivity, e like me ka capsaicin cream i loaʻa me ka ʻole o ka kuhikuhi, a i ʻole ka lidocaine cream a i ʻole nā ​​palaki (Lidoderm, ZTlido, a me nā mea ʻē aʻe).

• Ka hoʻomaʻamaʻa kino a i ʻole ka hana. Hiki i ka hoʻomaʻamaʻa mālie, alakaʻi ʻia o nā lālā i pilikia a i ʻole ka hoʻololi ʻana i nā hana o kēlā me kēia lā ke kōkua i ka hoʻoemi ʻana i ka ʻeha a hoʻomaikaʻi i ka laulā o ka neʻe ʻana a me ka ikaika. ʻO ka mua o ka ʻike ʻia ʻana o ka maʻi, ʻoi aku ka maikaʻi o nā hana hoʻomaʻamaʻa.

• Mirror therapy. Hoʻohana kēia ʻano mālama i ke aniani e kōkua i ka hoʻopunipuni ʻana i ka lolo. Ke noho nei ma mua o ke aniani a i ʻole ka pahu aniani, hoʻoneʻe ʻoe i ka lālā olakino i ʻike ai ka lolo iā ia he lālā i pilikia e ka CRPS. Hōʻike ka noiʻi e hiki i kēia ʻano mālama ke kōkua i ka hoʻomaikaʻi ʻana i ka hana a hoʻoemi i ka ʻeha no ka poʻe me ka CRPS.

• Transcutaneous electrical nerve stimulation (TENS). I kekahi manawa, hoʻoemi ʻia ka ʻeha lōʻihi ma ka hoʻopili ʻana i nā impulse uila i nā hopena nerve.

• Biofeedback. I kekahi mau hihia, hiki ke kōkua i ke aʻo ʻana i nā ʻenehana biofeedback. I ka biofeedback, aʻo ʻoe e ʻike hou aku i kou kino i hiki ai iā ʻoe ke hoʻomaha i kou kino a hoʻoemi i ka ʻeha.

• Spinal cord stimulation. Hoʻokomo kāu mea hoʻolako i nā electrodes liʻiliʻi ma kou spinal cord. ʻO kahi kahe uila liʻiliʻi i hoʻolako ʻia i ka spinal cord e hopena i ka hoʻoemi ʻana i ka ʻeha.

• Intrathecal drug pumps. I kēia mālama, hoʻopuka ʻia nā lāʻau lapaʻau e hoʻoemi i ka ʻeha i loko o ka wai spinal cord.

• Acupuncture. Hiki i ka hoʻokomo ʻana i nā nila lōʻihi, lahilahi ke kōkua i ka hoʻoulu ʻana i nā nerve, nā ʻiʻo a me nā pūnaewele hoʻohui e hoʻonui i ke kahe koko a hoʻoemi i ka ʻeha.