Ðe dɔgbo aɖe ve wò le dɔlékuiwutikewo nono vɔ megbea? Mina míasrɔ̃ nu tso Pseudomembranous Colitis ŋu!

Ðe dɔgbo veve alo dɔgbo me dɔlékui aɖe nɔ ŋuwò kpɔ le dɔlékuiwutikewo nono vɔ megbea? Zi geɖe la, edzona le ŋkeke ɖeka alo eve megbe. Gake ɣeaɖewoɣi la, nɔnɔme sia ate ŋu asẽ vie wu. Egbea míele nu ƒom tso nɔnɔme sesẽ mawo dometɔ ɖeka si ate ŋu ado ƒome kple dɔlékuiwutikewo zazã ŋu. Míeyɔa esia be Pseudomembranous Colitis. Togbɔ be ŋkɔa aɖi nusi wɔ nuku vie hã la, ele vevie ŋutɔ be nànya nu tso eŋu.

Kpuie ko la, nukae nye Pseudomembranous Colitis?

Esia nye dɔdzẽ sesẽ aɖe (dɔgbo ƒe dɔléle sesẽ) si dzɔna le míaƒe dɔgbo gã (dɔgbo) me, si fia be míevuvu eye míexɔ abi. Tsɔe be nane gblẽa nu le míaƒe dɔgbo gã la ƒe lãkusi (mucosa) si le tsɛ la ŋu. Dɔlékui aɖe, aɖi si dɔlékui ma wɔna, alo dɔléle bubu aɖe ate ŋu agblẽ nu sia.

Ne nu sia gblẽ la, kpe gbadzɛ siwo le ƒuƒuie la dzɔna ɖe teƒe siwo woxɔ abi la dzi. Abe alesi ko ƒunukpeƒetetedɔ dzɔna ɖe míaƒe ŋutigbalẽ dzi ne abi le mía ŋu ene. Gake esiawo menye ƒuƒu ŋutɔŋutɔwo o. Lãmenugbagbevi kukuwo kple ʋumenugbagbevi ɣiwoe le wo me. Lãmetsi ɣi ɣi siawoe nye nusi ɖɔktawo yɔna be "aʋatso lãkusiwo." "Aʋatso" gɔmee nye "aʋatso." Ema fia be wonye alakpa lãkusiwo. Nɔnɔme siae nye nusi míeyɔna be pseudomembranous colitis.

Nukae nye nɔnɔme sia ƒe dzesiwo?

Ame si ŋu dɔléle sia le ate ŋu akpɔ dzesi vovovowo, gake nu vevi ʋɛ aɖewo li siwo woate ŋu akpɔ.

Nukatae dɔléle sia ƒomevi dzɔna? Nuka koŋ gbɔe wòtso?

Nusi koŋ gbɔ esia tsona wue nye dɔlékui si nye Clostridium difficile , si míeyɔna kpuie be C. diff, ƒe dɔléle. Esia gbɔe dɔléle siwo wu 90% tsona.

Fifia ɖewohĩ ànɔ ɖokuiwò biam be aleke C. diff dɔlékui sia ate ŋu ahe dɔléle sia tɔgbe vɛ hã. Ŋutinya la yi ale:

Dɔlékui miliɔn geɖe, nyui kple vɔ̃ siaa, nɔa míaƒe dɔgbowo me. Dɔlékui nyui siawo wɔa nu geɖe na míaƒe ŋutilã. Azɔ tsɔe be ɖɔkta aɖe na dɔlékuiwutikewo wò ɖe dɔléle bubu aɖe ta (le kpɔɖeŋu me, ŋɔti me dɔlékui aɖe). Dɔlékuiwutike siawo wua dɔlékui siwo le míaƒe ŋutilã me. Gake ne wowɔe nenema la, menye dɔlékui gbegblẽ siwo he dɔlélea vɛ koe wowuna o, ke wowua dɔlékui nyui gbogbo aɖewo hã le míaƒe dɔgbowo me.

C. diff dɔlékuiwo ƒe tsitsi fũ akpa sia dzea aɖi siwo gblẽa nu le míaƒe dɔgbo gã ƒe lãkusi ŋu la wɔwɔ gɔme. Aɖi siawo nana dɔgboa me lãmenugbagbeviwo kuna eye woxɔa abi, eye wowɔa aʋatso lãkusi siwo ŋu míeƒo nu tsoe va yi.

Dɔlékuiwutike siwo hea C. diff dɔlékui vɛ zi geɖe

Togbɔ be dɔlékuiwutike ɖesiaɖe ate ŋu ahe afɔku sia vɛ hã la, atike ƒomevi aɖewo ate ŋu ahe afɔku sia vɛ wu. Esiawo dometɔ aɖewoe nye:

• Clindamycin ƒe atike
• Cephalosporins Ƒomeviwo
• Penicillin Ƒomeviwo
• Fluoroquinolones ƒomeviwo

Ðe nu bubu aɖewo hã li siwo gbɔ wòtsona tsɔ kpe ɖe C. diff ŋua?

Ɛ̃. Togbɔ be C. diff dɔlékui koŋue hea dɔlélea vɛ hã la, nɔnɔme sia ate ŋu adzɔ le nu bubuwo hã ta, ƒã ŋutɔ.

• Dɔlékui bubuwo ƒe dɔléle (e.g. *Staphylococcus aureus*, *E. coli*) .
• Cytomegalovirus ƒe dɔléle
• Ʋu ƒe sisi yi dɔgboa me dzi ɖe kpɔtɔ (Ischemic colitis) .
• Atike aɖewo siwo wozãna tsɔ daa kansa
• Dɔléle aɖewo siwo dɔlélenutsiŋutete hena vɛ

Amekawoe le afɔku me wu be woaxɔ dɔléle sia?

Togbɔ be ame sia ame ate ŋu axɔ nɔnɔme sia hã la, ame aɖewo le afɔku me wu.

• Ame siwo le atike xɔm le kɔdziwo: Kɔdziwo nye teƒe siwo dɔlékuiwo abe C. diff ene ate ŋu akaka le bɔbɔe.
• Ame siwo no dɔlékuiwutikewo nyitsɔ laa: Abe alesi míeƒo nu tsoe va yi ene la, esiae nye afɔku vevitɔ.
• Ame siwo xɔ wu ƒe 65: Elabena ŋutilãa ƒe dɔlélenutsiŋutete dzi ɖena kpɔtɔna ne ame tsi.
• Ame siwo le ame tsitsiwo dzikpɔƒewo:
• Ame siwo ƒe dɔlélenutsiŋutete gbɔdzɔ: (e.g. amesiwo ŋu HIV dɔlékuia le, kansadɔnɔwo) .
• Ame siwo ŋu dɔlélenutsiŋutete ƒe dɔlélewo le: (e.g. Inflammatory Bowel Disease - IBD) .
• Ame siwo ŋu C. diff dɔlékui le va yi:

Kuxi kawoe ate ŋu ado mo ɖa ne esia va zu nu sesẽ?

Esia ate ŋu aɖi vɔvɔ̃ na wò vie. Gake ɖo ŋku edzi be zi geɖe la, ne dɔlélea nu sẽ eye womewɔ atike nyui aɖeke nɛ o ko hafi kuxi siawo doa mo ɖa. Esia tae míeɖo aɖaŋu be nàyi ɖɔkta gbɔ kaba ɖo.

• Tsikuɖiɖi kple elektrikŋusẽ ƒe masɔmasɔ: Ne èɖe aɖuɖɔ zi gbɔ zi 10-15 gbesiagbe la, tsi kple elektrikŋusẽ geɖe buna na wò. Ne esia va nu sẽ la, ate ŋu ahe nɔnɔme siwo me afɔku le abe ʋu ƒe sisi kple ayiku ƒe dɔmawɔmawɔ nyuie ene vɛ.
• Toxic Megacolon: Esia nye nɔnɔme si me afɔku le ŋutɔ. Nusi dzɔnae nye be dɔgboa ƒe dɔdzẽ nu sẽna ale gbegbe be dɔgboa megawɔa dɔ nyuie o, gas kple aɖuɖɔ tsia, eye dɔgboa lolona ale gbegbe be wòte ŋu gbãna.
• Dɔgbo ƒe ʋuʋu: Nuveviwɔame sesẽ ate ŋu ana do nado le dɔgboa ƒe gli me. Ne edzɔ alea la, dɔlékui siwo tso dɔgboa me ate ŋu age ɖe ƒodoa me eye woahe dɔlékui siwo ate ŋu ade ame ƒe agbe afɔku me (peritonitis, sepsis) vɛ.
• Sepsis: Nɔnɔme si ate ŋu ade ame ƒe agbe afɔku me si me dɔlékui aɖe kaka ɖe ŋutilã bliboa me eye ŋutilãa ƒe ŋutinuwo dzea dɔmawɔmawɔ gɔme.

Aleke ɖɔkta awɔ anya dɔléle sia pɛpɛpɛ?

Ne èyi ɖɔkta gbɔ la, abia wò dzesiwo, atike ɖesiaɖe si nèno nyitsɔ laa (vevietɔ dɔlékuiwutikewo), eye emegbe ate ŋu awɔ dodokpɔ aɖewo atsɔ aɖo kpe dɔlélea dzi.

1. Aɖuɖɔ dodokpɔ: Esiae nye dodokpɔ vevitɔ kekeake. Woɖea wò aɖuɖɔ ƒe kpɔɖeŋu aɖe hedonɛ kpɔna be C. diff dɔlékui alo aɖi siwo dɔlékuiawo wɔna hã le eme hã.

2. 2. .Ʋudodokpɔ: Esiawo kpena ɖe ame ŋu be woalé ŋku ɖe dɔlékuiwo ŋu eye ʋumenugbagbevi ɣiwo ƒe xexlẽme dzi ɖe edzi hã.

3. Dɔgbomekpɔkpɔ: Esia bia be woatsɔ mɔ̃ tsɛ aɖe si me fotoɖemɔ̃ le ade dɔgboa me be woatsɔ ado dɔgbo gã la ƒe eme. Esia wɔnɛ be míete ŋu tsɔa ŋku evea siaa kpɔa ne alakpa lãkusi aɖewo li siwo ŋu míeƒo nu tsoe. Ne ehiã la, woate ŋu atsɔ lãkusi sue aɖe (biopsy) adoe kpɔ.

Nukawoe nye atike siwo wozãna na esia?

Atikewɔwɔ nɔ te ɖe nusi gbɔ dɔlélea tso kple alesi wòsẽe dzi.

• Nusi gbɔ wòtso dada: Ne C. diff dɔlékui aɖe gbɔe wòtso la, wò ɖɔkta aŋlɔ dɔlékuiwutike aɖe koŋ si ate ŋu awu dɔlékuiawo na wò. Metronidazole, Vancomycin, kple Fidaxomicin nye atike siawo dometɔ aɖewo.
• Beléle si Kpena Ðe Ame Ŋu: Esia ate ŋu alɔ tsi si wodona ɖe ʋuka me nana be tsi nagage ɖe lãme na ame o kple nunyiame si wodona ɖe ʋuka me be wòana dɔgboa nagbɔ ɖe eme.
• Amekoko: Le nɔnɔme siwo nu sẽ ŋutɔ, abe kuxiwo abe aɖi megacolon ene me la, ate ŋu ahiã be woawɔ dɔ na amekoko be woaɖe dɔgboa ƒe akpa si gblẽ la ɖa (colectomy). Ke hã, esia mebɔ kura o.

Nukae wòle be míawɔ be míatsi agbe le nɔnɔme sia me?

Mɔxexe ɖe esia nu le vevie ŋutɔ, vevietɔ le teƒewo abe kɔdziwo kple ame tsitsiwo dzikpɔƒewo ene.

• Klɔ asi enuenu: C. diff te ŋu nɔa te ɖe asikɔklɔtike siwo me aha le nu, eyata asiklɔ nyuie kple adzalẽ kple tsie nye ametakpɔnu nyuitɔ kekeake.
• Amewo ɖeɖe ɖe aga: Le kɔdziwo la, wowɔa atike na dɔnɔ siwo ŋu C. diff dɔlékuia le le xɔ si le vovo me.
• Anyigbawo ŋu kɔklɔ: C. diff ate ŋu anɔ agbe le anyigba dzi ɣeyiɣi didi aɖe. Ele vevie be nàtsɔ dɔlékuiwutike si me chlorine le akɔ anyigba ŋu edziedzi.

Ɣekaɣie wòle be míayi ɖɔkta gbɔ kaba?

Ne dzesi siwo gbɔna dometɔ aɖe le ŋuwò la, yi ɖɔkta gbɔ enumake alo yi kɔdzi ƒe Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ (ETU).

Togbɔ be ebɔ be dɔgbo nate ɖe ame dzi le dɔlékuiwutikewo nono vɔ megbe hã la, menɔa bɔbɔe nenema ɣesiaɣi o. Ɣeaɖewoɣi la, ate ŋu anye nɔnɔme sesẽ aɖe abe Pseudomembranous Colitis ene ƒe gɔmedzedze. Esia tae wòle vevie ŋutɔ be nàɖo to wò ŋutilã. Ne ɖikeke aɖe le mewò le wò dzesiwo ŋu la, mègahe ɖe megbe le nuƒoƒo kple wò ɖɔkta me o. Ne wowɔ atike na wò nyuie la, àte ŋu ahaya tso nɔnɔme sia me keŋkeŋ.