Ciwon ciwo na yanki mai rikitarwa

**Ciwon ciwo na yanki mai rikitarwa** (**CRPS nau'in 1 da nau'in 2**), wani lokacin ana kiransa da hyponyms reflex sympathetic dystrophy (**RSD**) ko reflex neurovascular dystrophy, wani nau'i ne mai wuya da tsanani na Neuroinflammatory da dysautonomic wanda ke haifar da ciwo mai tsanani, neurovascular, da alamun Neuropathic. Kodayake yana iya bambanta sosai, gabatarwar gargajiya tana faruwa ne lokacin da ciwo mai tsanani daga rauni na jiki ko kamuwa da kwayar cuta ta neurotropic  ya wuce lokacin da ake tsammani na warkewa, kuma daga baya yana iya yaduwa zuwa wuraren da ba a ji rauni ba. Alamomin nau'ikan 1 da 2 iri ɗaya ne, sai dai nau'in 2 yana da alaƙa da raunin jijiya.

Yawancin lokaci farawa a cikin guda ɗaya, CRPS sau da yawa yakan fara bayyana a matsayin ciwo, kumburi, iyakantaccen motsi, ko guraguwa, da / ko canje-canje ga fata da ƙasusuwa. Zai iya shafar wani gaɓoɓin sa'an nan kuma ya bazu a cikin jiki; 35% na mutanen da abin ya shafa sun ba da rahoton alamun a cikin jiki. Ana zaton akwai nau'o'i biyu: CRPS nau'in 1 (wanda aka fi sani da reflex sympathetic dystrophy) da CRPS nau-in 2 (wanda aka yi amfani da shi a matsayin *causalgia*). Yana yiwuwa a sami nau'ikan biyu.

Ciwon ciwon tsoka da ƙwayoyin cuta, yanayin da ya yi kama da CRPS, da farko yana shafar marasa lafiya na yara, ya fada ƙarƙashin rheumatology da pediatrics, kuma galibi ana ɗaukarsa a matsayin ɓangaren CRPS nau'in I.

## Rarraba
Tsarin rarrabuwa da Ƙungiyar Duniya don Nazarin Ciwo (IASP) ke amfani da shi ya raba CRPS zuwa nau'i biyu bisa ga kasancewar ko rashin ilimin jijiya mai auna.

## Alamomi da alamomi

An gano siffofin asibiti na CRPS su zama kumburi wanda ya haifar da sakin wasu siginar sinadarai masu kumburi daga ƙwayoyin jijiyoyi da ke kewaye da su; hypersensitization na masu karɓar ciwo; dysfunction na vasoconstriction na gida da vasodilation; da kuma Neuroplasticity maradaptive.

Alamomi da alamun CRPS yawanci suna bayyana a kusa da wurin rauni. Alamomin da aka fi sani da su sune matsanancin zafi, gami da ƙonewa, wuka, niƙa, da kuma fashewa. Ciwon bai dace da tsananin raunin farko ba. Motsawa ko taɓa gaɓoɓin yana da zafi sosai (allodynia). Sauran binciken sune fannoni na rashin amfani ciki har da kumburi, tsananin (ƙayyadadden kewayon motsi), da kuma rashin amfani da canje-canje masu alaƙa da fata (zazzabi, launi, gumi, ƙanshi) da ƙasusuwa (rashin amfani da osteoporosis).  

Wani ra'ayi na baya na CRPS da ke da matakai uku ba a amfani da shi sosai ba. Halin yanzu shine yin la'akari da nau'ikan CRPS daban-daban.

## Dalilin da ya sa
Ciwon ciwo mai rikitarwa na yanki ba sabon abu bane, kuma ba a san dalilinsa ba. CRPS yawanci yana tasowa bayan rauni, tiyata, bugun zuciya, ko bugun jini .  Masu bincike sun kiyasta cewa 2-5% na wadanda ke da raunin jijiya na gefe,  da 13-70% na wadanda ke da hemiplegia (paralysis na gefe daya na jiki) zai bunkasa CRPS. Bugu da kari, wasu karatu  sun nuna cewa shan taba ya fi sau da yawa a cikin marasa lafiya na CRPS. Shan taba yana iya shiga cikin ilimin halittar jiki a tsakanin masu amfani da taba ta hanyar haɓaka ayyukan tausayi, vasoconstriction, ko wasu hanyoyin da ba a sani ba game da neurotransmitter. Wannan hasashe ya dogara ne akan wani ɗan ƙaramin bincike na 1993 na marasa lafiya na 53 tare da RSD, wanda ya nuna cewa 68% na marasa lafiya sun kasance masu shan taba, idan aka kwatanta da 37% kawai na yawan jama'a. Sakamako na farko ne kuma an iyakance su ta yanayin dawowar su. Wasu tsiraru (7%) na mutanen da ke da CRPS a cikin hannu ɗaya suna ci gaba da haɓaka ta a wani. 

## Ilimin jiki
Ana ba da shawarar kumburi da canjin ra'ayi na ciwo a cikin tsarin juyayi na tsakiya don taka muhimmiyar rawa. Ciwo mai ɗorewa da fahimtar abubuwan da ba su da zafi kamar yadda suke da zafi ana zaton suna haifar da kwayoyin kumburi (IL-1, IL-2, TNF-alpha) da neuropeptides (substance P) da aka saki daga jijiyoyin gefe. Wannan saki na iya haifar da maganganun da ba su dace ba tsakanin jijiyoyi da motsi a shafin da ya shafa. CRPS ba cuta ce ta tunani ba, duk da haka ciwo na iya haifar da matsalolin tunani, kamar damuwa da baƙin ciki. Sau da yawa, rashin aiki na zamantakewa da na sana'a yana faruwa.

## Binciken ganewa
Binciken ya dogara ne akan binciken asibiti. Ka'idodin bincike na asali don CRPS da Ƙungiyar Duniya don Nazarin Ciwo (IASP) ta karɓa a cikin 1994 yanzu an maye gurbinsu a cikin aikin asibiti da bincike ta hanyar "Budapest Criteria" waɗanda aka kirkira a cikin 2003 kuma an gano sun fi dacewa da takamaiman. Tun daga wannan lokacin ne IASP ta karbe su. Ka'idodin suna buƙatar a sami ciwo da kuma tarihin da shaidar asibiti na canje-canje na ji, vasomotor, sudomotor, da motsi ko trophic. An kuma bayyana cewa ganewar asali ne na warewa.

## Manazarta