Zizindikiro Zingayambe Kuchokera Pang'ono Kufikira Kuopseza Moyo
Kutsekula m'mimba kumakhalabe kofala kwa anthu omwe ali ndi kachilombo ka HIV, omwe ali ndi 60 peresenti yokhala ndi matenda atatu kapena oposa omwe amatuluka pamtunda tsiku lililonse chifukwa cha zifukwa zilizonse zomwe zingayambitse, kuphatikizapo:
- m'mimba
- zotsatira za mankhwala opatsirana pogonana (ART)
- Zotsatira za kachilombo ka HIV pamatumbo
- mankhwala ena
- nkhawa
Kutsekula m'mimba (kutanthauza kuti kupitirira kwa milungu iwiri) kungakhudze kwambiri moyo wa anthu omwe ali ndi kachilombo ka HIV, zomwe zimapangitsa kukayikira ndi mantha za mankhwala, kuwonjezera kukhumudwa ndi nkhawa, komanso kusokoneza mphamvu ya munthu kusamalidwa kosamalidwa kwa mankhwala .
Mofanana ndi anthu onse, kachilombo ka HIV kapena ayi, kutsekula m'mimba kumayambitsa kutaya thupi kwa madzi komanso kuchepetsa zakudya zamtundu ndi electrolyte, kuphatikizapo potaziyamu ndi sodium. Komabe, kwa anthu omwe ali ndi kachilombo ka HIV, matenda otsekula m'mimba nthawi zambiri amaletsa kuyamwa kwa mankhwala ena opatsirana pogonana , zomwe zimawathandiza kuti asatenge kachilombo koyambitsa matendawa , ndipo nthawi zina amayamba kusamalidwa .
Kutaya madzi kwambiri kumakhala koopsa kwa anthu omwe ali ndi mphamvu zowonongeka, makamaka omwe ali ndi kuwonongeka (mwachitsanzo, kulemera kwa 10% kapena kuposa).
Matenda a m'mimba
Kutsekula m'mimba kungayambitsidwe ndi tizilombo toyambitsa matenda, monga mabakiteriya, bowa kapena mavairasi. Matendawa amawonjezeka ngati chitetezo cha munthu chitatha, monga momwe kawirikawiri zimayesedwa ndi CD4 ya munthu. Ngakhale matenda a m'mimba amapezeka pamtundu uliwonse wa kachilombo ka HIV, kuchuluka kwa matenda oterewa kumawonjezeka pamene CD4 count imagwa pansi pa maselo 200 / mL.
Zina mwazofala kwambiri ndi zotsegula m'mimba za Clostridium difficile , kutsekula m'mimba komwe kumachitika nthawi zambiri kuti anthu omwe ali ndi kachilombo ka HIV amveke kuposa omwe ali ndi anthu ambiri. Zowononga zina zotsekula m'mimba zimaphatikizapo:
Ngakhale zikuchitika mobwerezabwereza, zifukwa zina zomwe zingayambitse matendawa ndi kuphwanya, zilonda za m'mimba, komanso matenda ena opatsirana pogonana omwe angayambitse proctitis (kutupa kwa mankhwala opatsirana pogonana) kapena zilonda zam'mimba.
Zotsatira zoyipa za mankhwala opatsirana pogonana
Kutsekula m'mimba ndi zotsatira zowopsa kwa mankhwala angapo ochepetsa ma ARV, ngakhale kuti nthawi zambiri amadzipatula ndipo amadzipangitsa yekha kuti athandize. Ndipotu, kafukufuku wochitika mchaka cha 2012 adanena kuti pafupifupi 20 peresenti ya anthu omwe ali pa ART adzakhala ndi matenda otsekula m'mimba chifukwa cha mankhwalawa.
Ngakhale kutsekula m'mimba kungayambitsidwe ndi ma antiretroviral a magulu onse, ritonavir-containing protease inhibitors (PIs) ndi mankhwala omwe amapezeka kwambiri ndi chikhalidwe. Amanenedwa kuti mankhwalawa akhoza kuthandizira kwambiri maselo apakati omwe amayendera matumbo, zomwe zimayambitsa kutaya kwa madzi. Ena amanena kuti mankhwalawa amachititsa kuti mankhwala a chloride ayambe kusungunuka, zomwe zimapangitsa kuti madzi ambiri asatuluke m'mimba.
Pa milandu yoopsa ya kutsekula m'mimba kwa ART, osakayikira mankhwala kapena mankhwalawa amafunika kuti alowe m'malo ngati chithandizo cha mankhwala sichikuyenda bwino.
Zotsatira za HIV pa tsamba la m'mimba
HIV yakhala ikudziwikiratu kuti imayambitsa kuwonongeka kwa chitetezo cha m'mimba, makamaka kwa maselo omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda (GALT). GALT ndi malo oyambirira a kubwereza kachilombo ka HIV ndi kuchepa kwa maselo a CD4 kamodzi kachilombo kamapezeka. Ngati sichikutsatiridwa, kachilombo ka HIV kangabweretse vuto losasinthika ku matendawa ngakhale ART itayamba.
Kutupa kosatha komwe kumakhudzana ndi matenda a nthawi yayitali kungasokonezenso ntchito mucosal ya matumbo, kuwonetsa ndi zizindikiro zowononga matumbo .
Nthawi zina, ngakhale m'mimba mwa mitsempha imakhudzidwa, kuwonongeka kwa thupi komwe kumathandiza kuti m'mimba mulowe m'mimba.
Zina Zopanda HIV
Ngakhale kuti nthawi zambiri amaika mankhwala ochepetsa kachilombo ka HIV pakadutsa matenda otsegula m'mimba, othandizira ena angathe kuwathandiza.
Mwachitsanzo, mankhwala opha tizilombo amatha kupha mabakiteriya ena m'matumbo omwe ndi ofunikira kwambiri kuti thupi likhale labwino. Mankhwalawa akuphatikizapo Bactrim (trimethoprim / sulfamethoxazole), omwe amagwiritsidwa ntchito monga prophylaxis kwa pneumocystis jirovecii chibayo (PCP); ndipo rifampin amagwiritsidwa ntchito pochiza matenda a chifuwa chachikulu cha TB.
Mofananamo, mankhwala ophera tizilombo toyambitsa matenda omwe ali ndi magnesium amatha kuyambitsa kutsegula m'mimba kapena kuipitsa, komanso mankhwala otchuka monga Tagamet (cimetidine), Nexium (esomeprazole), ndi Prilosec (asomeprazole).
Matenda a zitsamba omwe ali ndi senna , omwe amagwiritsidwa ntchito poti "detoxification" ndi kulemera kwake, amadziwikanso kuti ali ndi mankhwala ofewa.
Kuzindikira ndi Chithandizo
Kwa anthu omwe akutsegula m'mimba mochepa, amatha kupezetsa mankhwala. Izi zikuphatikizanso Imodium (yomwe ilipo ponseponse pompano ndi mphamvu ya mankhwala), Lomotil (mankhwala), ndi Sandostatin (mankhwala).
Mu December 2012, US Food and Drug Administration (FDA) inavomereza mankhwala a Mytesi (crofelemer) makamaka kuti athetse zizindikiro za matenda otsekula m'mimba mwa anthu omwe ali ndi kachilombo koyambitsa matenda opatsirana pogonana.
Kwa odwala omwe akudwala matenda otsegula m'mimba, akuyenera kuyanjana pamodzi ndi katswiri wodziwa HIV . Kuyezetsa kuyenera kumaphatikizapo kupenda mozama mbiri ya chithandizo cha mankhwala ndi kachilombo ka HIV, komanso kuunika kwa thupi.
Chitsanzo cha sitolo chimalimbikitsidwa kuti ayambe kuyeza mayeso. Ngati palibe chifukwa chowopsa chomwe chikudziwika, ndiye kuti kuyeza kosatha kumaganiziridwa. Izi ndi zowona makamaka kwa odwala otsekula m'mimba (ie, 10 kapena kuposa masentimita pa tsiku) kapena mwa anthu omwe ali ndi vuto lalikulu la kuteteza thupi kapena kuteteza kachilombo ka HIV . Kuyezetsa magazi ndizolimbikitsa kwa odwala omwe akuganiza kuti ndi amwano.
Malingaliro a zakudya ayenera kuphatikizapo kuchepetsa kapena kupeĊµa zakudya zamphongo kapena zonunkhira; caffeine (kuphatikizapo khofi, tiyi, ndi chokoleti); zofiira ("roughage"); zakudya za shuga zazikulu (makamaka zomwe zili ndi madzi a chimanga a fructose); ndi zakudya zakuda kapena zosaphika.
Mapulojekiti - chikhalidwe chothandiza, chokhala ndi moyo cha mabakiteriya omwe amapezeka mkaka, yogurt, ndi keffir-nthawi zambiri amatsutsana ndi kutsekula m'mimba kumene kumayambitsa maantibayotiki mwa kukhazikitsanso zomera zachilengedwe za m'matumbo. Ngati lactose osakanikirana, mapiritsi kapena mapuloteni akupezeka.
Mukakhala ndi kutsekula m'mimba, onetsetsani kuti madzi ambiri akumwa, ndikuyamwa madzi, ndikuyang'ana m'malo omwe mumataya electrolyte (mwina kudzera mu zakudya zamagetsi , zakudya zowonjezera shuga). Zakudya zochepetsetsa, zomwe nthawi zambiri zimapangitsa kuti matumbo asamapanikizidwe kwambiri m'mimba.
> Zotsatira:
> MacArthur, R. ndi DuPont, H. "Etiology ndi Pharmacological Management of N okhudzana ndi matenda opatsirana pogonana omwe ali ndi kachilombo ka HIV Anthu omwe ali ndi kachilombo koyambitsa matenda a Antiretroviral Era." Matenda opatsirana pogonana. September 2012; 55 (6): 860-867.
> Lima, A .; Kashuba, A .; Bushen, O .; et al. "Kutsekula m'mimba ndi Mipata Yachepetsa Matenda a Antiretroviral: Kupititsa patsogolo ndi Glutamine ndi Alanyl-Glutamine M'kuyesedwa kosalamulirika kumpoto kwa kum'mawa kwa Brazil." Matenda opatsirana pogonana. December 31, 2003; 38: 1764-1770.
> Sanchez, T .; Brooks, J ;; Sullivan, P .; et al. "Bacterial Diarrhea kwa Anthu Amene Ali ndi HIV, 1992-2002." Matenda opatsirana pogonana. 2005; 41 (11): 1621-1627.