Matendawa amayamba chifukwa cha kusowa kwa magazi mpaka m'matumbo akuluakulu
Ischemic colitis ndi pamene magazi akuthamangira m'matumbo akulu atsekedwa . Kuyenda kwa magazi nthawi zonse m'matumbo n'kofunika kuti ziwalozo zikhale zathanzi, ndipo pamene matenda kapena kuvulala zimayambitsa mitsempha ya mitsempha kapena yowonjezereka, ikhoza kuyambitsa ischemic colitis. Ischemic colitis ikhoza kuchitika pa msinkhu uliwonse koma ndi wamba kwambiri kwa anthu oposa zaka 60.
Ischemic colitis nthawi zambiri amachiritsidwa kuchipatala ndi zothandizira, koma nthawi zina opaleshoni angafunike. Nthawi zambiri, ischemic colitis imachitika pang'onopang'ono pakapita nthawi, koma nthawi zina imatha kuyamba mwadzidzidzi (khalani ovuta). Kuchuluka kwa ischemic colitis ndi matenda ofulumira kwachipatala, chifukwa chake ndikofunikira kuwona dokotala nthawi yomweyo pamene muli ndi ululu waukulu m'mimba.
Ischemic colitis si yokhudzana ndi ulcerative kolitis, mtundu wa kutupa matumbo (IBD) . "Colitis" ndilo liwu limene limatanthauza kutupa mu coloni, zomwe zingayambidwe ndi matenda osiyanasiyana. Komabe, Ischemic colitis ndi yogwirizana ndi matenda a mtima, komanso kukhala ndi moyo wathanzi kudzera mwa zakudya ndi masewera olimbitsa thupi ndikofunika kuchepetsa chiopsezo. Nthaŵi zambiri, ischemic colitis imachiritsidwa bwino ndipo imathetsa masiku angapo opanda mavuto. Ischemic colitis nthawi zambiri sachitika kachiwiri ndipo anthu amachira bwino.
Zifukwa za Ischemic Colitis
Pali mitsempha itatu yomwe imabweretsa magazi m'matumbo, otchedwa mitsempha ya mesenteric. Magazi ochuluka a okosijeni amafunika ndi ziwalo zonse m'thupi kuti zigwire bwino, ndipo mitsempha ya mesenteric ndiyo njira yoperekera magazi m'matumbo. Ngati mitsempha imeneyi imakhala yotsekedwa kapena yotsekedwa, magazi amachepetsedwa (zomwe zimatchedwa infarction), ndipo maselo amatha kuyamba kuchitika m'matumbo akuluakulu (ndi nthawi zina).
Pali zifukwa zingapo zosiyana zomwe mitsempha ya mesenteric ikhoza kutsekedwa:
- Cholesterol Wapamwamba : Mitsempha ya mesenteric ikhoza kutsekedwa ngati muli ndi chikhomo mkati mwake. Chidebecho chimapangidwa ndi mafuta a kolesterolini, mafuta, zowonongeka zam'manja, calcium ndi fibrin. Pamene chipika chimatsetsa mitsempha ndi chikhalidwe chotchedwa atherosclerosis. Kwa anthu omwe ali ndi matenda a mitsempha kapena pakhosi, matenda a atherosclerosis ndi omwe amachititsa kuti aschemic colitis iwonongeke.
- Magazi a Magazi : Chifukwa china cha ischemic colitis ndi magazi. Pamene mapuloteni ndi mapuloteni a plasma m'magazi amamatirana pamodzi, amatha kupanga chovala chomwe chimakhala chokwanira kuti chilepheretsa zonse kapena gawo la mitsempha. Magazi amagazi amatha kuchitika pambuyo povulazidwa koma amakhalanso ndi zovuta za matenda ena ndi zizindikiro zina komanso monga mankhwala osokoneza bongo.
- Opaleshoni: Opaleshoni pa mitsempha imatha kuyambitsa minofu yofiira. Nthaŵi zina, minofu yofiira ikhoza kuchitika mpaka imalowa mkati mwa mitsempha ya magazi.
- Kugwiritsa ntchito mankhwala osokoneza bongo: Onse a cocaine ndi methamphetamine amagwirizana ndi ischemic colitis. Izi ndi chifukwa mankhwalawa amachititsa kuti mitsempha ya magazi ichepetse.
Zowopsa
Zina mwaziopsezo za ischemic colitis zimaphatikizapo:
- Ali ndi zaka zoposa 60
- Kusokonezeka mtima kwa mtima
- Matenda a shuga
- Kuthamanga kwa magazi
- Mankhwala (ngakhale kuti ndi osowa), kuphatikizapo antibiotic, chemotherapy, mahomoni (estrogen), mankhwala ovomerezeka okhudza IBS, ndi pseudoephedrine
- Opaleshoni yapadera pa aorta
Zizindikiro za Ischemic Colitis
Kawirikawiri, chizindikiro chimene anthu ambiri ali nacho ndi matenda a ischemic ali ndi kupweteka kwa m'mimba mwadzidzidzi. Kupweteka kumeneku kungakhale koonekera kwambiri mutatha kudya ndipo pangakhale kukhala ndi chikondi m'mimba. Nthawi zambiri ululu ndi wochepa, koma ngati mitsempha yotsekedwa ili pambali ya pamimba, ululu ukhoza kukhala wovuta. Mitsempha imeneyi imakhala yaikulu m'matumbo komanso m'mimba .
Pamene pali ubongo wambiri wamatumbo, vutoli likhoza kukhala lopweteka kwambiri komanso limakhala ndi chiopsezo chachikulu.
Ischemic colitis ingayambitsenso mitsempha yamagazi, ndipo magazi ali pamtundu wofiira wofiira mpaka maroon. Mphuno, kutsegula m'mimba, kusanza, malungo, ndi nthawi yofunikira, nthawi zambiri amafunika kugwiritsa ntchito chimbuzi ndi zizindikiro zina zomwe zimakhala zizindikiro za kupwetekedwa kwa ischemic.
Kuzindikira Ischemic Colitis
Dokotala angadziwe kuti ischemic colitis imachokera pa zinthu zingapo, kuphatikizapo mbiri yeniyeni yomwenso ndi zotsatira za mayesero ena. Chifukwa chakuti kupwetekedwa kwachisokonezo kumayambitsa zizindikiro zina zofanana za IBD (mitundu ikuluikulu ndiyo Crohn's disease ndi ulcerative colitis), chisamaliro chiyenera kuthandizidwa kusiyanitsa pakati pa izi. Nthaŵi zina, kupeza matenda a ischemic colitis kungakhale kovuta chifukwa zizindikiro zimakhala zofanana ndi zina.
Mayesero ena omwe angagwiritsidwe ntchito pofufuza matendawa ndi awa:
- Colonoscopy : Colonoscopy ndi mayeso pamene chubu yomwe ili ndi kuwala pamapeto imayikidwa mu anus kuti ione mkati mwa matumbo akulu.
- Kujambula kwa tomato (CT) : CT scan ndi mtundu wa x-ray umene amagwiritsidwa ntchito poona ziwalo ndi ziwalo m'mimba.
- Mesenteric angiogram: Pakati pa yesewero ili, daya wosiyana imayikidwa mu imodzi mwa mitsempha ya mesenteric, kudera lamapiri. Kenako amajambula ma X-ray kuti awone mkati mwake.
- Nambala yoyera ya magazi (WBC) : Nambala yoyera ya magazi yomwe ili pamwamba kuposa njira zowoneka kuti pali kutupa m'thupi lomwe lingagwirizane ndi ischemic colitis.
Kuchiza Ischemic Colitis
Chithandizo cha matenda a ischemic colitis chimadalira kukula kwa chikhalidwe, ndi matenda aakulu omwe akusowa mankhwala oopsa kwambiri. Zikakhala kuti vutoli limakhala lofatsa, mankhwala amatha kukhala ndi mankhwala osokoneza bongo, zakudya zamadzimadzi, zamadzimadzi, ndi ululu. Ngati matendawa amayamba chifukwa cha vuto linalake, vutoli lifunikiranso chithandizo. Maphunziro ena omwe amagwiritsidwa ntchito popanga migraine kapena matenda a mtima angapangitse mitsempha ya magazi ndipo angafunikire kuti asiye kwa nthawi. M'milandu yowopsyayi, vutoli limatha kuthetsa masiku angapo.
Mu zina, milandu yowopsa kwambiri, mankhwala omwe amachititsa kuti magazi asokonezeke (thrombolytics) ndi kukulitsa mitsempha (vasodilators) ingagwiritsidwe ntchito. Ngati mitsempha siyimitsa, kuchitidwa opaleshoni kuchotsa kutsekedwa ndi njira ina yothandizira, koma izi zimachitika kokha ngati mankhwala ena sakugwira ntchito. Ngati pali phokoso mu dzenje , kapena gawo lochepetsetsa (kugwiritsidwa ntchito) , opaleshoni angafunike kuthetsa mavutowa. Ngati pali minofu mu colon yomwe yafa, opaleshoni idzachitidwa kuchotsa gawolo la matumbo ( resection ).
Mawu Ochokera
Ischemic colitis imawopsya koma nthawi zambiri zimakhala zovuta masiku angapo popanda kuzunza. Milandu yowopsya ingafunike opaleshoni koma anthu ambiri amachira bwinobwino popanda mavuto. Nthawi iliyonse pamakhala kusintha kwa ziwalo, monga kupita kuchimbudzi kawirikawiri kapena kawirikawiri, ziyenera kukambidwa ndi dokotala. Magazi m'mimba kapena kupweteka kwa m'mimba, ndi momwe matenda a shuga amayamba nthawi zambiri, nthawi zonse ayenera kuyendera dokotala kuti apeze zomwe zimayambitsa zizindikiro.
> Zotsatira:
> Beck DE, de Aguilar-Nascimento JE. "Kupanga Opaleshoni ndi Zotsatira za Pulogalamu Yopweteketsa Ischemic Colitis." Ochsner J. 2011; 11: 282-285.
> Rania H, Mériam S, Rym E, Hyafa R, Amine A, Najet BH, Lassad G, Mohamed TK. "Ischemic colitis mu mfundo zisanu: zosintha 2013." Tunis Med 2014, 92: 299-303.