ʻO ka maʻi ʻeha ʻeha ʻāina

ʻO ka maʻi ʻeha ʻāpana kūpanaha (CRPS) kahi manawa ʻeha (lōʻihi) ʻeha e hiki ai ke hoʻopili i nā wahi o ke kino, akā pili pinepine i ka lima a me ka wāwae.

ʻAʻole maopopo i nā kauka nā kumu o CRPS. I kekahi mau hihia, he mea nui ka ʻōnaehana hopohopo i ka ʻeha. ʻO kekahi kumumanaʻo ʻo CRPS ka mea i hoʻokumu ʻia e ka pane pale pale, i hiki ai i nā ʻōuli ʻōniʻoniʻo o ka ʻulaʻula, ka mehana, a me ka pehu ʻana o ka wahi i hoʻopilikia ʻia.

ʻElua ʻano o ka CRPS:

• ʻO CRPS 1 kahi maʻi nerve lōʻihi (lōʻihi) e kū pinepine i nā lima a me nā wāwae ma hope o kahi hōʻeha liʻiliʻi.
• Hoʻokumu ʻia ka CRPS 2 e kahi ʻeha i ke aʻalolo.

Manaʻo ʻia ʻo CRPS ka hopena o ka hōʻino ʻana i ka ʻōnaehana hopohopo. Hoʻopili kēia i nā aʻalolo e mālama i nā kīʻaha koko a me nā aʻa o ka hou.

ʻAʻole hiki i nā aʻalolo hōʻino ke hiki pono ke kaohi pono i ke kahe o ke koko, ka manaʻo (sensation), a me ka mahana i ka wahi i hoʻopilikia ʻia. Kuhi kēia i nā pilikia i ka:

• Nā kīʻaha koko
• Iwi
• Nā mākala
• Nā koʻo
• ʻIli

Nā kumu kūpono o CRPS:

• Hoʻopilikia pololei i kahi aʻalolo
• ʻO ka hōʻeha a maʻi paha i ka lima a me ka wāwae

I nā hihia maʻamau, hiki i nā maʻi kūlohelohe e like me ka puʻuwai puʻuwai a i ʻole hahau paha ke kumu iā CRPS. Hiki ke ʻike ʻia ke ʻano i kekahi manawa me ka maopopo ʻole o ka ʻeha o ka lālā i hoʻopilikia ʻia.

ʻOi aku ka maʻamau o kēia ʻano i ka poʻe mai 40 a 60 mau makahiki, akā hiki i ka poʻe ʻōpio ke hoʻomohala iā ia.

ʻO ka hōʻailona koʻikoʻi ka ʻeha e:

• Ikaika a wela hoʻi a ʻoi aku ka ikaika ma mua o ka mea i manaʻo ʻia no ke ʻano o ka ʻeha i kū.
• Loaʻa maikaʻi ʻole, ma mua o ka maikaʻi o ka manawa.
• Hoʻomaka ma kahi o ka ʻeha, akā hiki ke pālahalaha i ka lālā holoʻokoʻa, a i ka lima a i ʻole ka wāwae i ka ʻaoʻao ʻē aʻe o ke kino.

I ka hapanui o nā hihia, ʻekolu pae o CRPS. Akā, ʻaʻole pili mau ʻo CRPS i kēia kumu. Hoʻomohala koke kekahi poʻe i nā ʻōuli koʻikoʻi. Noho nā mea ʻē aʻe i ka pae mua.

Kahua 1 (hala 1 a 3 mau mahina):

• Hoʻololi i ka mahana o ka ʻili, ka hoʻololi ʻana ma waena o ka mehana a anuanu hoʻi
• ʻO ka ulu wikiwiki ʻana o nā kui a me ka lauoho
• Nā spasms Muscle a me ka ʻeha pū
• Wela loa, ʻeha ʻeha e worsens me ka pā iki a i ʻole ka makani
• ʻIli e hele lohi a lilo i blotchy, poni, pale, a i ʻulaʻula; lahilahi a hinuhinu; pehu; hou sweaty

Kahua 2 (hala 3 a 6 mau mahina):

• Hoʻololi mau i ka ʻili
• ʻO nā kui kuʻi a haki ʻoi aku ka maʻalahi
• ʻEha e ʻinoʻino ana
• Lohi ka ulu ʻana o ka lauoho
• Pākuʻi nā hono a me nā mākala nāwaliwali

Kahua 3 (hiki ke ʻike ʻia nā hoʻololi i hiki ʻole ke hoʻohuli ʻia)

• ʻO ka neʻe palena ʻia i ka lālā no ka mea ua hoʻopaʻa ʻia nā mākala a me nā uaua (contracture)
• Hoʻowau wale nā ​​mākala
• ʻEha ma ka lālā holoʻokoʻa

Inā ʻeha a lōʻihi paha ka ʻeha a me nā hōʻailona ʻē aʻe, hiki i ka poʻe he nui ke ʻehaʻeha a hopohopo paha.

Hiki ke paʻakikī ka hōʻoia ʻana i ka CRPS, akā he mea nui ka ʻike mua ʻana.

E lawe ka mea mālama ola i ka mōʻaukala olakino a hana i kahi nānā kino. Hiki i nā hoʻokolohua ʻē aʻe ke:

• Hōʻike e hōʻike i nā loli o ka mahana a me ka nele o ka lako o ke koko i ka lālā i hoʻopili ʻia (thermography)
• Nānā iwi
• Nā haʻawina conduction nerve a me ka electromyography (hana mau ʻia)
• Nā kukuna X
• Ke hoʻāʻo ʻana o ke aʻalolo Autonomic (ana i ka sweating a me ke koko

ʻAʻohe mea ola no CRPS, akā hiki ke hoʻolohi i ka maʻi. ʻO ka nānā nui ka hoʻomaha ʻana i nā ʻōuli a me ke kōkua ʻana i ka poʻe me kēia maʻi e ola e like me ke ola maʻamau i hiki.

Pono e hoʻomaka i ke olakino a me ka ʻoihana hana i ka wā hiki. Ke hoʻomaka nei i kahi papahana hoʻoikaika kino a me ke aʻo ʻana e mālama i nā hono a me nā mākala e neʻe paha e pale i ka maʻi mai ka ʻino. Hiki iā ia ke kōkua iā ʻoe e hana i nā hana o kēlā me kēia lā.

Hiki ke hoʻohana ʻia nā lāʻau, e laʻa me nā lāʻau ʻeha, corticosteroids, kekahi mau lāʻau kaomi koko, nā lāʻau pohō iwi a me nā antidepressants.

ʻO kekahi ʻano o ke kamaʻilio kamaʻilio ʻana, e like me ka conductive behavioral therapy a i ʻole psychotherapy, hiki ke kōkua i ke aʻo ʻana i nā mākau e pono ai ke ola me ka ʻeha mau loa (mau).

Nā hana ʻoki lāʻau a i ʻole invasive paha e hoʻāʻo ʻia:

• ʻO ka lāʻau lapaʻau i hōʻeha ʻia e hoʻopili ai i nā ʻalolo i hoʻopili ʻia a i ʻole nā ​​ʻehaʻeha a puni ke kolamu o ka iwi (block nerve).
• ʻO ka pauma ʻeha o loko e hāʻawi pololei i nā lāʻau i ka iwi kuamoʻo (poma lāʻau intrathecal).
• Spinal cord stimulator, e pili ana i ke kau ʻana i nā electrodes (nā alakaʻi uila) ma ka ʻaoʻao o ka iwi kuamoʻo. Hoʻohana ʻia kahi uila uila haʻahaʻa e hana i kahi leʻaleʻa a i ʻole tingling sensation i ka ʻehaʻeha ke ala maikaʻi loa e hōʻemi i ka ʻeha i kekahi poʻe.
• ʻO ke ʻoki e ʻoki ai i nā aʻalolo e luku ai i ka ʻeha (sympathectomy ʻoki kino), akā maopopo ʻole i ka nui o ka poʻe e kōkua ana. Hiki paha iā ia ke hōʻino i nā ʻōuli i kekahi poʻe.

ʻOi aku ka maikaʻi o ka nānā aku me kahi hōʻailona mua. Inā kuhi ke kauka i ke kūlana i ka pae mua, i kekahi manawa e nalo nā hōʻailona o ka maʻi (remission) a hiki ke neʻe maʻamau.

Inā ʻaʻole e hōʻike koke ʻia ke ʻano, hoʻololi paha ka iwi a me nā mākala a ʻaʻole hoʻi e hoʻi hou.

I kekahi poʻe, hele aku nā ʻōuli ma kā lākou iho iho. I nā poʻe ʻē aʻe, ʻoiai me ka lapaʻau e hoʻomau ka ʻeha a ʻo ke kumu ke kumu o ka hōʻino ʻana, nā loli hiki ʻole ke hoʻololi.

Nā pilikia e hopena paha me:

• Nā pilikia me ka noʻonoʻo a me ka hoʻokolokolo
• Kaumaha
• Ka nalowale ʻana o ka nui o ka mākala a i ʻole ka ikaika i ka lālā i hoʻopili ʻia
• Hoʻolahalaha ka maʻi i kekahi ʻāpana o ke kino
• Wensening o ka lālā pili

Hiki pū kekahi i nā pilikia me kekahi o nā aʻa a me nā lāʻau lapaʻau.

Kāhea aku i kāu mea hāʻawi inā hoʻomōhala ʻoe i ka ʻeha mau o ka lima, ka wāwae, ka lima a me ka wāwae.

ʻAʻohe pale e ʻike ʻia i kēia manawa. ʻO ka mālama mua ke kī i ka hoʻolōʻihi i ka holomua o ka maʻi.

CRPS; RSDS; Causalgia - RSD; Pākuʻi lima poʻohiwi; Reflex sympathetic dystrophy maʻi pale; Hoʻopiʻi Sudeck; ʻEha - CRPS

Aburahma AF. ʻO ka maʻi ʻeha ʻeha ʻāina. I: Sidawy AN, Perler BA, hua. ʻO Rutherford's Vascular Surgery a me Endotherapy Therapy. 9th ed. Piladelapia, PA: Elsevier; 2019: chap 192.

ʻO Gorodkin R. ʻĀpana ʻeha ʻeha ʻāina (reflex sympathetic dystrophy). I: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 90.

ʻO Stanos SP, Tyburski MD, Harden RN. ʻEha mau. I: Cifu DX, hoʻoponopono. ʻO Braddom's Physical Medicine and Rehabilitation. 5th lā. Piladelapia, PA: Elsevier; 2016: chap 37.