Megacolon yoopsa (yomwe imadziwika kuti kuchepa kwa poizoni) ingakhale vuto lalikulu la matenda opatsirana a m'magazi (IBD) . Ichi ndi vuto lomwe limapezeka nthawi zambiri ndi ulcerative colitis kusiyana ndi momwe imakhudzira matenda a Crohn. Nkhani yabwino ndi yakuti megacolon yosaopsa ndi yosawerengeka ndipo imapezeka m'mabuku osachepera 5% a IBD. Matendawa amapezeka pamene coloni imasokonezeka kwambiri, kapena imakhudzidwa, ndipo kenako imataya magazi okwanira.
Popanda magazi okwanira kupita ku coloni, minofu ikhoza kukhala ischemic, yomwe imatanthauza kufa.
Kuchiza matenda a IBD asanakhale oopsa kumathandiza kupewa megacolon. Nthaŵi zambiri, anthu omwe ali ndi zilonda zam'mimba amalangizidwa kuti azikhala osamala ndi mankhwala oletsa kutsekula m'mimba chifukwa adalumikizidwa ndi megacolon ya poizoni. Aliyense amene ali ndi IBD amene amamva kupweteka kwambiri m'mimba, mimba yotupa, ndi malungo, ayenera kupita kuchipatala mwamsanga.
Zimayambitsa
Megacolon yoopsa ikhoza kukhala mwachangu kwa anthu omwe ali ndi IBD kwambiri. Nthawi zina, zimatha chifukwa chogwiritsa ntchito mankhwala osokoneza bongo, kuphatikizapo mankhwala osokoneza bongo; mankhwala ogwiritsidwa ntchito popuma kupweteka, anticholinergics; mankhwala osokoneza bongo, nkhawa ndi mantha; ndi antidiarrheals, monga loperamide. Pachifukwachi, nthawi zambiri amalimbikitsa kuti anthu omwe ali ndi zilonda zam'mimba asatenge mankhwala osamalidwa ndi mankhwala popanda chilolezo chochokera, komanso kuyang'anitsitsa pafupi ndi gastroenterologist yomwe imakhalapo pochiza odwala ndi IBD.
Zizindikiro
Ndemanga za megacolon zowopsa zimaphatikizapo:
- Kupweteka m'mimba ndi chifundo
- Mimba yosokonezeka
- Kuthamanga kwa mtima mwamsanga
- Kuchepetsa kuthamanga kwa magazi
- Leukocytosis (kuchuluka kwa maselo oyera a magazi )
- Umboni wa kutalika kwa colonic pa mimba x-ray
- Kutentha kwambiri (madigiri 104 ° F)
- Kutaya madzi m'thupi
Anthu omwe ali ndi megacolon ya poizoni amawoneka akudwala kwambiri ndipo amakhala ndi mbiri ya masiku otsekula m'mimba komanso kupweteka m'mimba.
Chithandizo
Mankhwala oyambirira ndi ofunika ku megacolon pofuna kupewa mavuto owopsya, monga mantha, colon perforation (kupukuta mu khola la colon), peritonitis (matenda m'mimba) ndi septicemia (matenda m'magazi). Kuchokera kumalo osatulutsidwa, phulusa likhoza kutha, vuto limene limapha 30%. Mukapatsidwa chithandizo mwamsanga, megacolon ya poizoni imakhala yochepa kwambiri kuposa 4%. Ichi ndi chifukwa chake nkofunika kupeza zizindikiro zatsopano zomwe apeza ndi dokotala, ndikupeza zizindikiro zoopsa zomwe zimagwiritsidwa ntchito mwamsanga.
Matumbowa ayenera kutayidwa, omwe kawirikawiri amakwaniritsidwa mwa kupititsa chubu kuchokera kunja kwa thupi kulowa mu colon. Ngati wodwalayo atha madzi kapena asokonezeka, mankhwala a IV angagwiritsidwe ntchito m'malo mwa electrolyte ndi madzi. Popeza kupweteka kungayambitse matenda aakulu, antibiotics angaperekedwe. Corticosteroids ingathandize kuthana ndi kutupa mu colon.
Pa milandu yovuta yomwe silingayankhe pakamwa, khungu ladzidzidzi kapena colectomy lonse lingakhale lofunikira. Mu colectomy yochuluka, yotchedwanso proctocolectomy, khola limachotsedwa. A proctocolectomy angakhale okondedwa kwa anthu omwe ali ndi zilonda zam'mimba, monga j-pouch amatha kulengedwa pa opaleshoni yachiwiri, atatha kuchira kwa megacolon.
Njira ya j-pouch idzathetsa kufunika kwa ileostomy yosatha. Popeza proctocolectomy ndi chithandizo cha opaleshoni cha ulcerative colitis, ulcerative colitis siidzakhalanso opaleshoni. Sikovomerezeka pa matenda a Crohn, monga momwe matenda a Crohn amatha kukhalira m'thumba lachile.
Kawirikawiri, nthawi yomwe megacolon yowopsa imachitidwa bwino, zizindikirozi ndi zabwino kwambiri.
Zotsatira:
ADAM "Megacolon yoopsa." ADAM, Inc 2004. 30 Jul 2009.