Ðe wò dɔgbo le dzo dam alea? Mina míasrɔ̃ nu tso Pseudomembranous Colitis ŋu!

Ðe dɔgbo me vea wò vevie eye aɖuɖɔtoe le ŋuwò zi geɖe gbesiagbea? Ðewohĩ èsena le ɖokuiwò me hã be yeƒe lãme le ʋuʋum kpe ɖe asrã ŋua? Vevietɔ, ɖe dzesi siawo dze le esi nèno dɔlékuiwutikewo nyitsɔ laa ɖe dɔléle aɖe ta? Ne nenemae la, ke esia nye nusi ate ŋu anɔ vevie na wò. Egbea míaƒo nu tso nɔnɔme aɖe si woyɔna be ‘Pseudomembranous Colitis’ ŋu. Mègatsi dzi o, ne wona nyanya wò nyuie tso esia ŋu la, àte ŋu akpɔ atike eye nàhaya kaba.

Nukae nye Pseudomembranous Colitis ƒe dɔléle?

Kpuie ko la, ‘Pseudomembranous Colitis’ nye dɔdzẽ ƒe dɔléle sesẽ aɖe si dzɔna le míaƒe dɔgbo gã, alo dɔgbo me. Le esia me la, le susu aɖe ta (ate ŋu anye dɔlékui, aɖi, alo dɔléle bubu), wò dɔgbo gã ƒe gli ememetɔ, alo lãkusi (`mucosa`), gblẽna. Nusiwo gblẽ alea nana be kpe gbadzɛ siwo le ɣie, siwo le ɣie, siwo le ƒuƒuie la dzɔna le teƒe siwo nu gblẽ le. Ðɔktawo yɔa esiawo be ‘pseudomembranes’.

Nukae nye ‘pseudomembranes’?

Pseudomembranes ye nye nusiwo dzɔna ne lãmenugbagbevi siwo le dɔgbo gã la ƒe lãkusi me, abe dɔgbo gã ƒe lãkusi ene, ku. Bu eŋu ale: ne abi aɖe dzɔ la, míaƒe dɔlélenutsiŋutete ɖoa ʋumenugbagbevi ɣiwo ɖe teƒea. Nenema ke le afisia hã la, lãmenugbagbevi kuku kakɛwo ƒoa ƒu kple ʋumenugbagbevi ɣiwo (vevietɔ neutrophils) wɔa pseudomembranes. Esiawo keke abe sentimeta 2 ene, woƒe amadede nyea ɣie, eye woƒe gowo kɔ vie.

Nukae nye nɔnɔme sia ƒe dzesiwo?

Ame si ŋu pseudomembranous colitis le ate ŋu akpɔ dzesiwo abe:

• Ƒodo ƒe vevesese sesẽ.
• Dɔmetɔtrɔ. Esia ate ŋu adzɔ zi geɖe gbesiagbe, ɣeaɖewoɣi abe tsi ene.
• Asrã.
• Xeɖeɖe.
• Ɣeaɖewoɣi la, àte ŋu akpɔ ʋu alo ʋuʋudedi le dodom tso wò aɖuɖɔ me, gake esia medzɔna ɖe amesiame dzi o.

Nukae hea Pseudomembranous Colitis vɛ?

Nu vevitɔ si gbɔ esia tsona wue nye dɔlékui si nye `C. diff` (Klostridioides ƒe dɔléle si nye difficile). Aɖi siwo dɔlékui sia wɔna la gblẽa nu le dɔgbo gã la ƒe lãkusi ŋu. Anɔ abe 10% ene le `C. diff` dɔlékuiwo ate ŋu ayi ŋgɔ ava zu nɔnɔme si nu sẽ wu si woyɔna be `pseudomembranous colitis.` Le nyateƒe me la, dɔléle siawo ƒe 90% tso `C. diff` dɔlékuiwo. Gake dɔgbo ƒe dɔléle bubu siwo me dɔdzẽ le hã ate ŋu agblẽ nu sia ƒomevi.

Aleke C. difficile dɔlékuiwo kpɔa ŋusẽ ɖe esia dzii?

Dɔlékui si nye C. difficile wɔa aɖi siwo gblẽa lãmenugbagbevi siwo le míaƒe dɔgbo gã la me. Dɔlékui sia ate ŋu akaka kabakaba eye wòasẽ wu alesi nàsusui.

Zi geɖe la, C. diff dɔlékui aɖe xɔa wò elabena dɔléle bubu aɖe le ŋuwò.Le dɔlékuiwutikewo zazã vɔ megbe. Bu eŋu kpɔ, ne èno dɔlékuiwutikewo, dɔlékui "nyui" bubu siwo le míaƒe dɔgbo me siwo kpena ɖe mía ŋu míekuna. Ke hã, dɔlékuiwutike akpa gãtɔ mate ŋu awu `C. diff` dɔlékuiwo. Eyata ne dɔlékui nyui mawo nu yi la, `C. mɔnukpɔkpɔ sua diff` dɔlékuiwo si be woatsi ahakaka womakpɔ wo dzi o, si hea kuxi siawo vɛ hoʋiʋli aɖeke manɔmee.

Dɔlékuiwutike kawoe wɔa dɔ wu le nɔnɔme sia me?

Le nyateƒe me la, dɔlékuiwutike ɖesiaɖe si wua dɔlékui nyui siwo le míaƒe dɔgbo me eye mekpɔa ŋusẽ ɖe C. diff dɔlékuiwo dzi o ate ŋu ahe C. diff dɔlékui kple pseudomembranous colitis si dona tso eme vɛ. Gake wosusu be dɔlékuiwutike aɖewo ate ŋu ahe afɔku gã aɖe vɛ. Wo dometɔ aɖewoe nye:

• Clindamycin ƒe atike
• Cephalosporin ƒe hatsotso si nye atikewo
• Penicillin ƒuƒoƒo ƒe atikewo
• Fluoroquinolones ƒe atikewo
• Aztreonam ƒe ŋkɔ
• Carbapenems ƒe lãwo

Vevietɔ: Esia mefia be dɔlékuiwutike siawo menyo o. Ne ɖɔkta aɖe ŋlɔ wo la, ele be woazã wo le alesi wòhiãe nu. Gake dɔlékuiwutikewo zazã madzemadzee ate ŋu ahe afɔku siawo tɔgbe vɛ.

Ðe susu bubuwo hã lia?

Pseudomembranous colitis ateŋu adzɔ hã ne dɔgbo ƒe dɔdzẽ tso nu bubuwo gbɔ, negbe C. diff. Kpɔɖeŋu ʋɛ aɖewoe nye esi:

• Staphylococcus aureus ƒe dɔléle
• E. coli dɔlékui `(E. coli dɔlékui)`
• Cytomegalovirus ƒe dɔléle
• Dɔdzẽ si wokpɔna le nusuekpɔmɔ̃ me
• Behçet ƒe dɔlélea
• Ischemic colitis (dɔdzẽ si tso ʋu ƒe sisi ɖe dɔgboa me ƒe ɖiɖi gbɔ) .
• Atike siwo tsia kansa nu `(Chemotherapy atikewo)`
• Cocaine zazã
• Vasculitis (ʋukawo ƒe dɔléle) .
• Ga kpekpewo ƒe aɖi

Le nɔnɔme mawo me la, dɔlélea nu sẽna alo sesẽna wu dɔgbo ƒe dɔléle si sɔ. Ɣeaɖewoɣi la, ʋu si sina yia dɔgboa ƒe gli ememetɔ me dzi ɖena kpɔtɔna (ischemia), lãmenugbagbeviwo kuna (necrosis), eye pseudomembranes dona. Azɔ hã, dɔléle siwo nɔ anyi do ŋgɔ abe Inflammatory Bowel Disease (IBD) ene hã ate ŋu ana dɔgboa nate ŋu axɔ nɔnɔme sia bɔbɔe wu.

Amekawoe le afɔku gã me be woaxɔ dɔléle sia?

Anɔ eme be pseudomembranous colitis adze dziwò ne è:

• Ne woxɔ wò ɖe kɔdzi.
• Ne èzã dɔlékuiwutikewo nyitsɔ laa.
• Ne wowɔ dɔ na wò nyitsɔ laa.
• Ne ame aɖe tsi ame tsitsiwo dzikpɔƒe.
• Ne èxɔ ƒe 65 kple edzivɔ.
• Ne dɔléle si dɔlékuiwutikewo ƒe dɔlélenutsiŋutete hena vɛ le ŋuwò.
• Ne wò dɔlélenutsiŋutete gbɔdzɔ.
• Ne C. diff dɔlékui aɖe le ŋuwò xoxo.

Nukawoe nye kuxi siwo ate ŋu ado tso Pseudomembranous Colitis me?

Ne nɔnɔme sia va nu sẽ eye edzi ɖuɖu sesẽ la, kuxi aɖewo siwo me afɔku le ate ŋu ado mo ɖa. Eyata ele vevie be nànya esia hã.

• Tsikuɖiɖi kple elektrikŋusẽ ƒe bu: Le pseudomembranous colitis sesẽ me la, aɖuɖɔtoe ate ŋu adzɔ zi 10-15 gbesiagbe. Esia ate ŋu ana tsi naɖiɖi eye elektrikŋusẽ nabu. Esia ate ŋu ahe nɔnɔme siwo me afɔku le abe ʋu ƒe agbɔsɔsɔ si bɔbɔ, ʋu ƒe sisi, kple ayiku ƒe dɔmawɔmawɔ nyuie ene vɛ.
• Tsi si le dodom: Tsi ate ŋu atso dɔgbo gã la ƒe gli si gblẽ la me ayi ƒodoa me, si ana ƒodoa navuvu. Woyɔa esia be ascites. Proteinwo abe albumin ene hã ate ŋu abu le dɔgbo gã la me. Ne albumin mesɔ gbɔ o la, tsi dona le ʋukawo me, si wɔnɛ be abɔ kple afɔwo vuvu (edema).
• Aɖi megacolon: Dɔgbo ƒe dɔdzẽ sesẽ aɖe si dzi womate ŋu aɖu o si ate ŋu ana dɔgboa navuvu akpa eye wòadzudzɔ dɔwɔwɔ. Le gɔmedzedzea me la, lãmeka siwo le dɔgboa me dzudzɔa ƒoƒo, si xea mɔ na aɖuɖɔtoe. Ne dɔgboa yi edzi le vuvu la, eƒe gliwo ate ŋu agbã, si ana emenuwo nate ŋu age ɖe ƒodoa me. Woyɔa esia be peritonitis. Esia ate ŋu ade ame ƒe agbe afɔku me.
• Dɔgbo ƒe ʋuʋu: Do ate ŋu adzɔ le dɔgbo gã la ƒe gli me aɖi megacolon manɔmee. Esia ate ŋu adzɔ ne abiwo do le dɔgbo gã la me eye woto gli la me, alo ne lãkusiwo ku vevie (necrosis) le dɔgbo gã la ƒe gli ŋu. Ne dɔlékui siwo le dɔgbo gã me do go yi ƒodoa me (peritonitis) la, woate ŋu akaka ɖe ʋukawo me (septicemia).
• Sepsis: Sepsis nye dɔléle si tsoa dɔlékuiwo ƒe ƒuƒoƒo ɖe ʋu me (septicemia). Sepsis nye dɔlékui sesẽ aɖe si ate ŋu awu ame, si kaka ɖe ŋutilã bliboa me. Esia ate ŋu ahe septic shock, ŋutinu geɖe ƒe dɔmawɔmawɔ nyuie, kple ku gɔ̃ hã vɛ.

Kuxi siawo ŋu nya ate ŋu ado vɔvɔ̃ na ame. Gake ɖo ŋku edzi be womedzɔna ɖe amesiame dzi o. Ne wokpɔ dɔlélea kaba eye wodae nyuie la, ate ŋu axe mɔ ɖe nɔnɔme sesẽ siawo nu.

Aleke woawɔ anya dɔléle sia?

Ðɔkta abia nya wò tso wò dzesiwo kple wò lãmesẽ ŋutinya ŋu gbã. Emegbe, woate ŋu aɖe gbe be woawɔ dodokpɔ vovovowo atsɔ adi nusi gbɔ wò dzesiawo tso. Le kpɔɖeŋu me, woate ŋu abia be woado ʋu kpɔ, woado nɔnɔmetatawo kpɔ abe scan ene, kple aɖuɖɔ dodokpɔ. Dodokpɔ siawo dia dɔlékuiwo, dɔdzẽ, kple afɔku bubuwo.

Wò aɖuɖɔ dodokpɔa alé ŋku ɖe C. diff dɔlékui aɖe ŋu koŋ. Ne wokpɔe la, woadze atikewɔwɔ gɔme enumake. Ne kuxi aɖeke mele ŋuwò o eye nèle nu wɔm nyuie ɖe atikewɔwɔ ŋu la, ɖewohĩ susu aɖeke koŋ manɔ anyi si ta nàlé ŋku ɖe wò dɔgbo gã la me be alakpa lãkusiwo le eme o.

Ɣeaɖewoɣi la, nɔnɔmetatawo dodokpɔ (abe CT scan ene) ate ŋu aɖe dzesi siwo fia be pseudomembranous colitis. Ne dɔgboa ƒe gli la lolo (si sɔ kple "asibidɛ ƒe dzesi" alo "accordion dzesi") la, ɖɔkta ate ŋu atso nya me be yeagawɔ dodokpɔ bubuwo.

Eyome, be nàlé ŋku ɖe nu ŋu nyuie la, ele be nàwɔ dodokpɔ aɖe si alé ŋku ɖe dɔgbo gã la me. Woyɔa esia be dɔgbomekpɔkpɔ. Le esia me la, wozãa mɔ̃ si me fotoɖemɔ̃ le tsɔ léa ŋku ɖe dɔgbo gã la me. Ne èkpɔ nusi woyɔna be ‘pseudomembrane’ la, woɖea lãkusi sue aɖe (si nye biopsy) le eme heɖonɛ ɖe nudokpɔƒe be woatsɔ aɖo kpe dɔlélea dzi.

Nukawoe nye atikewɔmɔnuawo?

Atikewɔwɔ nɔ te ɖe nusi gbɔ dɔléle sia tso dzi.

• Ne dɔlékui ƒe dɔléle abe C. diff ene la, ahiã be nàna dɔlékuiwutike tɔxɛ siwo wɔa dɔ nɛ.
• Ne atike bubu si zãm nèle gbɔe nɔnɔme sia tso alo wògagblẽ ɖe edzi la, ahiã be nàdzudzɔ atike ma alo atrɔe.
• Le go aɖewo me la, woate ŋu aŋlɔ atikewo na ame be woatsɔ aɖe dɔgbo gã la ƒe dɔdzẽ dzi akpɔtɔ.

Beléle si akpe ɖe ame aɖewo ŋu koe hiã. Le kpɔɖeŋu me, tsi si wodona ɖe ʋuka me (IV fluids) be wòakpe ɖe tsi ƒe léle ɖe te ŋu, alo IV nunyiame be wòakpe ɖe dɔgboa ŋu wòagbɔ ɖe eme. Ðewohĩ ahiã be woakpɔ kuxiwo gbɔ na ame bubuwo, ɖewohĩ le dɔnɔdzikpɔƒe si wokpɔa dɔnɔwo gbɔ le vevie. Ðewohĩ ahiã be woawɔ dɔ na ame aɖewo siwo ŋu dɔgbo ƒe dɔléle sesẽ ŋutɔ alo kuxiwo le wo ŋu (wowɔ dɔ na wo be woaɖe dɔgboa ƒe akpa si gblẽ la ɖa).

Nukae nye atike vevi siwo wonana nenye be `C. diff`?

Ne nusi gbɔ pseudomembranous colitis tsonae nye C. diff dɔlékui la, ke atike geɖe li woatsɔ adae. Wò ɖɔkta atia esi nyo na wò. Atike siwo wonana na C. diff dɔlékuiwoe nye:

• Metronidazole ƒe atike
• Vancomycin si wozãna tsɔ wɔa dɔe
• Fidaxomicin ƒe atike

Ðe woate ŋu axe mɔ ɖe Pseudomembranous Colitis nua?

Mɔ vevitɔ si dzi woato axe mɔ ɖe dɔléle sia nu enye be woaɖu C. diff dɔlékuiwo ƒe kaka dzi le nuto siwo me afɔku le ŋutɔ (vevietɔ kɔdziwo kple ame tsitsiwo dzikpɔƒewo). Ame siwo le nɔnɔme siawo me la ate ŋu axɔ dɔlélea eye dzesi sesẽwo abe pseudomembranous colitis ene adze wo dzi.

Eyata lãmesẽdɔwɔla siwo le dɔwɔƒe siawo ƒomevi ɖea afɔ tɔxɛwo tsɔ léa C. diff dɔlékui nu:

• Amewo ɖeɖe ɖe aga: Wotsɔa ame siwo ŋu C. diff dɔlékuia le la dana ɖe xɔ si le vovo me, alo wotsɔa xɔ si me ame bubu siwo ŋu dɔlélea le koe le. Wozãa asigɛ siwo wotsɔna ƒua gbe ne woge ɖe xɔa me.
• Asikɔklɔ: Asiklɔ enuenu kple adzalẽ kple tsi dzodzoe nye mɔ nyuitɔ si dzi nàto akpɔ ɖokuiwò ta tso C. diff me. Dɔlékui sia te ŋu nɔa te ɖe asikɔklɔtikewo nu. Ele vevie ŋutɔ be nàklɔ asi hafi awɔ nu ɖe ​​nuɖuɖu ŋu.
• Dɔlékuiwutikewo: Dɔlékuiwutike siwo wozãna edziedzi mate ŋu awu C. diff o. Gake nusiwo wotsɔ chlorine wɔe ate ŋu... Ele vevie be woawu dɔlékuiwo ɖe anyigba siwo katã ŋu dɔlékuia le la ŋu nyuie.

Ðe woate ŋu ada dɔléle sia keŋkeŋua? Nukae nye amesiwo kuna?

Ẽ, woate ŋu ada pseudomembranous colitis keŋkeŋ ne wodae. Zi geɖe la, dzesiawo nu ayi kaba. Ke hã, ame aɖewo ate ŋu ahiã be woawɔ atike na ame geɖe wu eye woazã ɣeyiɣi didi wu ame bubuwo. Ne C. diff dɔlékui aɖe si nɔa anyi ɖaa si dzi ɖuɖu sesẽna le ŋuwò la, ahiã be woawɔ dɔ sue aɖe na wò atsɔ adae. Le go aɖewo me la, ate ŋu ahiã be woawɔ dɔ na ame.

Le ku gome la, dɔnɔ siwo ŋu pseudomembranous colitis le ƒe 2% koe kuna. Gake le amesiwo ŋu wokpɔa dɔnɔwo gbɔ ɣeyiɣi didi eye dɔlélenutsiŋutete gbɔdzɔ gome la, agbɔsɔsɔ sia ate ŋu asɔ gbɔ va ɖo 15%. Ne kuxi si míeyɔ va yi si woyɔna be toxic megacolon dzɔ la, ame ƒe ku ate ŋu adzi ɖe edzi va ɖo 35%. Esia tae atikewɔwɔ kaba le vevie ɖo.

Ɣekaɣie wòle be nàkpɔ ɖɔkta?

Ne dzesi siawo dometɔ aɖe le ŋuwò la, di atikewɔlawo ƒe aɖaŋuɖoɖo enumake:

• Dɔgbo ƒe vevesese sesẽ alo ʋuʋudedi.
• Ne aɖuɖɔtoe le ŋuwò wu zi atɔ̃ gbesiagbe.
• Ne ʋu le aɖuɖɔ me.
• Ne mèɖe aɖuɖɔ o ŋkeke etɔ̃e nye sia.
• Ne mèɖe aɖuɖɔ ŋkeke ɖeka o, alo ne wò aɖuɖɔ ƒe amadede do viviti.
• Ne dzoxɔxɔ si wu Celsius 39 (Fahrenheit 102) le ŋuwò ŋkeke etɔ̃.

Mlɔeba la, nu siwo dzi wòle be woaɖo ŋkui

Dɔlékui siwo hea dɔgbo ƒe dɔléle vɛ bɔ, eye zi geɖe la, womesẽna o. Menye amesiame si xɔ C. diff lae axɔ pseudomembranous colitis o. Gake ne èwɔe la, ate ŋu ado vɔvɔ̃ na ame vie. Nyanya be wò dɔgbo le gbegblẽm tso ememe ate ŋu ado vɔvɔ̃ na ame, eye dzesiwo abe vevesese kple ʋu le dodom ene anɔ eŋu.

Ne dzesi siawo tɔgbe dze le ŋuwò la, ɖewohĩ ahiã be nàkpɔ atikewɔla tɔxɛ aɖe. Gake ɖo ŋku edzi be ne wowɔ atike na wò nyuie la, wò dɔgbo ate ŋu ahaya.Lãmetsiŋusẽ ƒe lãkusiwo, abe míaƒe dɔgbo ƒe lãkusi ene, hayana nyuie ne womegblẽ o. Ne èse le ɖokuiwò me be yeƒe dɔgbo ƒe dzesiwo mele nyonyom ɖe edzi o la, ƒo nu kple ɖɔkta. Ate ŋu akpe ɖe ŋuwò nàke ɖe nusi gbɔ wò dɔlélea tso ŋu, awɔ nusi hiã be nàtɔ te, eye wòana wò dɔgbo nagbɔ ɖe eme si wòhiã. Nu vevitɔe nye be màgatsi dzodzodzoe eye nàdi atikewɔlawo ƒe aɖaŋuɖoɖo kaba o.

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` Pseudomembranous Colitis, C. diff, aɖuɖɔtoe, dɔgbo ƒe vevesese, dɔgbo ƒe dɔléle, dɔlékuiwutikewo