Matenda opweteka a m'magazi (IBD) ndi matenda ambirimbiri omwe amadziwika ndi kutupa m'mimba ya ululu (ulcerative colitis). Njira yotupa, yomwe imasiyana mosiyana ndi munthu, imatha kupanga zizindikiro zosiyanasiyana m'matumbo ndi thupi lonse.
Ulcerative colitis imagawidwa ndi kuuma kwa zizindikiro. Kugawana magulu kumathandizanso odwala komanso madokotala akuyembekezera zotsatira za mankhwala ena, ndipo amathandiza odwala amene sangachitepo kanthu kwa mankhwala omwe angapindule ndi opaleshoni.
Chaka chilichonse, pafupifupi 10 mpaka 12 matenda atsopano a ulcerative colitis amapezeka mwa anthu 100,000. Ambiri mwa milanduyi ndi ofatsa kapena ovuta. Komabe, asanu ndi asanu ndi atatu mphambu asanu ndi atatu aliwonse ali ndi matenda otsekemera, omwe amatchedwanso "acute colitis".
Zizindikiro za matenda otuluka m'mimba zimaphatikizapo:
- Zitsulo zopitirira 10 patsiku
- Kutuluka magazi tsiku ndi tsiku
- Akufunika kuikidwa magazi
- Kupweteka m'mimba ndi kuponda
- Zokwera zamakono zotupa m'magazi
- Kuwonjezeka kwa mtima (kupitirira 90 kugunda pa mphindi)
Pokhapokha ngati kutupa kukuyendetsedwe, odwala omwe ali ndi matenda opatsirana amakhala pachiopsezo chotchedwa megacolon, mtundu woopsa kwambiri wa colitis. Mu megacolon yoopsa , ndondomeko yotupa yotentha imapangitsa makoma a mitsempha yamtunduwu kuti asokoneze. Izi zimapangitsa chiopsezo kuti colon idzaphwanya (kupatulidwa) ndikutsanulira zomwe zili m'matumbo m'mimba.
Izi ndi zoopsa zowopsa.
Momwe Kupsera Kumakhudzira Thupi
Kuti mumvetsetse zotsatira za matenda a kutupa kwa ubongo, m'pofunika kumvetsetsa momwe kutupa kumakhudzira thupi. Pamene kutupa mu colon kulipo pakapita nthawi, kapena ndiukali komanso koopsa, kumasokoneza umphumphu wa maselo ndi maselo.
Choncho, pamene maselowa ndi maselo osagwira ntchito, zotsatira zake zikhoza kukhala zowonongeka, nthawi zambiri zotayirira, kutuluka m'magazi, kapena kutsekedwa.
Popeza kutentha kwa thupi kulikonse kumakhudza thupi lonse, odwala omwe ali ndi matenda a colitis angathenso kusowa chakudya, kutopa, thupi, kutaya mtima, kuperewera kwa zakudya, kuchepa kwa thupi, kuvutika kuchiritsa, kufooka, ndipo, poipa kwambiri, kulephereka. Zoonadi, kuopsa kwake kwa zizindikiro kudzafanana ndi kuuma kwa kutupa ndi momwe munthu angakwanitse kulekerera nkhawa.
Pamene kutupa kulipo, thupi limayendetsa zinthu zomwe zimathandiza kuti chitetezo cha mthupi chitetezeke komanso kumenyana ndi magwero a kutupa. Apa ndi pamene chiwindi chimabwera. Kuwonjezera pa kugwiritsa ntchito zakudya kuchokera ku chakudya kuti apange mapuloteni ndi kupaka thupi lathu kuti likhale ndi moyo, kugwira ntchito, kukula, ndi kuchiza, chiwindi chimagwiritsanso ntchito zida zothandizira kumanga thupi lathu.
Pamaso pa kutupa, chiwindi chimayamba kuphwanya mapuloteni otsika kuti mupeze zina zigawo zomwe zimayenera kulimbana ndi kutupa. Izi zimatchedwa oyimbira oyimira. Pamaso pa kutupa nthawi zonse, chiwindi chimagwiritsa ntchito masitolo ambiri a mkati mwa mapulotini.
Ngati kutupa sikulephereka, ndondomekoyi imatha kuthamanga ndipo kuwonjezereka kwa omvera opweteka tsopano kumavulaza thupi kusiyana ndi kuteteza. Kutentha kotereku kumatchedwa "poizoni."
Kuletsa Kutupa
Kuphatikizidwa kwa kachipatala, biochemical, endoscopic, ndi miyezo ya radiographic amagwiritsidwa ntchito kutsimikizira kuti matenda a ulcerative, amakhala ovuta kwambiri, komanso amachititsa kuti zizindikiro zina zowonongeka, monga mabakiteriya kapena mavairasi kapena kutuluka kwa magazi.
Katemera atatsimikiziridwa, intravenous steroid therapy yayamba kuimitsa njira yotupa poyembekeza kubwezeretsa koloni ku ntchito yachibadwa.
Kuthetsa kutupa kudzasiya zizindikirozo ndikuletsa kutsika kumbali yoperewera kwa colon.
Komabe, pafupifupi 40 peresenti ya odwala-makamaka omwe ali ndi chifuwa chachikulu chotchedwa megacolon-adzafunikanso kuchitidwa opaleshoni yofulumira kapena yowopsa chifukwa cha kuwonongeka kwakukulu kwa kuchepa kwa magazi kapena kupopera kwa mankhwala , kapena chifukwa mankhwala achipatala sangathe kulamulira matendawa.
Kusankha Njira Yothandizira
Kuyeza tsiku ndi tsiku ndi kuyezetsa magazi kwa zizindikiro za kutupa pamene odwala akulandira chithandizo chamagetsi angathandize madokotala kufotokoza momwe angayankhire kuchipatala. Ngati wodwalayo sanapindule atalandira steroid masiku atatu kapena kuposerapo ndipo akudutsa m'magazi ambiri, akuwonetsa malungo, kusonyeza kumimba kwa mimba ndi kuwonjezeka kwa mtima, mankhwala akulephera ndipo opaleshoni amafunika. Panthawi imeneyi, opaleshoni ya opaleshoni yapamwamba adzafunsidwa kukambirana za opaleshoni ndi wodwalayo.
Ngakhale odwala ambiri akuyembekeza kuti asamayambe opaleshoni, kupitiriza kupatsa ogwiritsira ntchito ma immunosuppressants kwa wodwalayo amene sanayankhepo mankhwalawa amachititsa kuti pakhale mavuto omwe angakhale nawo popanda phindu. Komanso, ngati kutupa sikungayankhidwe panthaŵi yake, wodwalayo ali pangozi ya mavuto aakulu kuchokera ku colitis, kuphatikizapo megacolon yoopsa.
Opaleshoni ya Fulminant Colitis
Kuchita opaleshoni ya matenda opatsirana kumaphatikizapo kuchotsa phuloni ndi phulusa kuti zithetse gwero la kutupa kwa poizoni. Ambiri mwa odwala ndi omwe amafunikiranso kuti azitsatira ndondomeko ya chikho, zomwe zimawathandiza kusunga mimba yawo ndikugwiritsa ntchito njira yowonongeka yakuwononga thupi.
Ndondomekoyi imachitidwa muzinyendo zitatu:
- Ng'ombeyo imachotsedwa ndipo wodwalayo amapatsidwa ileostomy yaifupi. Ili ndi dzenje m'mimba momwe chimbudzi chimalowa mu thumba lakunja. Chifukwa chachikulu cha kutupa chachoka, thupi limayamba kuchiza ndipo wodwalayo amatha kumanga nkhokwe za zakudya.
- Pambuyo pa miyezi isanu ndi umodzi kapena 12, kachilomboka kamachotsedwa ndipo j-pouch ndondomeko imachitidwa. Mu njira yatsopanoyi, gawo lomalizira la kabowo kakang'ono kamadzipangidwira pokhakha kuti likhale ndi j "yofanana ndi yomwe imayika ndi kudutsa. The ileostomy yachisawawa imatsalapo mpaka thumba lichiza.
- Patatha miyezi iwiri kapena itatu, ileostomy imatsekedwa ndipo matumbo abwino amatumizidwa ku anus.
> Zotsatira:
> Strong SA. Kusamala kwa chifuwa chachikulu ndi megacolon. Chipatala cha Clinol Chikulire Chokwanira. 2010; 23 (4): 274-284.
> Metcalf AM. Kusankha komanso kusankha njira zothandizira ulcerative colitis. Kliniki Yopaleshoni North Am. 2007; 87 (3): 633-631.
> Arnell TD. Kusamalira opaleshoni ya ululu wa ululu ndi megacolon yoopsa. Chipatala cha Clinol Chikulire Chokwanira. 2004; 17 (1): 71-74.
> Grieco MB, Bordan DL, Geiss AC, Mphika AR Jr. Madzi owopsa amachititsa kuti Crohn awonongeke. Ann Surg. 1980; 191 (1): 75-80.