Koj puas tau mob plab lossis mob plab tom qab noj tshuaj tua kab mob ib zaug? Feem ntau nws yuav ploj mus tom qab ib lossis ob hnub. Txawm li cas los xij, qee zaum qhov mob no yuav hnyav dua me ntsis. Hnub no peb yuav tham txog ib qho mob hnyav uas tuaj yeem cuam tshuam nrog kev siv tshuaj tua kab mob. Peb hu qhov no ua Pseudomembranous Colitis. Txawm hais tias lub npe yuav zoo li txawv me ntsis, nws yog ib qho tseem ceeb heev uas yuav tsum paub txog nws.
Hais yooj yim xwb, Pseudomembranous Colitis yog dab tsi?
Qhov no yog ib qho mob o (mob plab hnyuv loj heev) uas tshwm sim hauv peb txoj hnyuv loj (colon), uas txhais tau tias o thiab raug mob. Xav txog tias muaj ib yam dab tsi ua rau lub txheej sab hauv (mucosa) hauv peb txoj hnyuv loj puas tsuaj. Qhov kev puas tsuaj no tuaj yeem tshwm sim los ntawm cov kab mob, cov tshuaj lom uas cov kab mob ntawd tsim tawm, lossis lwm yam kab mob.
Thaum qhov kev puas tsuaj no tshwm sim, cov plaques tuab, tawv tawv yuav tsim rau saum cov chaw raug mob. Ib yam li cov tawv nqaij tawv thaum peb muaj qhov txhab. Tab sis cov no tsis yog cov tawv nqaij tawv tiag. Lawv yog ua los ntawm cov qe ntshav tuag thiab cov qe ntshav dawb. Cov daim nyias nyias daj-dawb no yog cov uas cov kws kho mob hu ua "pseudomembranous colitis." "Pseudo" txhais tau tias "cuav." Qhov ntawd txhais tau tias lawv yog cov daim nyias nyias cuav. Cov mob no yog qhov peb hu ua pseudomembranous colitis.
Cov tsos mob ntawm tus mob no yog dab tsi?
Ib tug neeg uas muaj tus mob no yuav muaj ntau yam tsos mob, tab sis muaj ob peb yam tseem ceeb uas pom tau.
| Cov tsos mob | Kev piav qhia |
|---|---|
| Mob raws plab hnyav (Rain) | Qhov no yog cov tsos mob tseem ceeb. Tej zaum koj yuav tau tso quav li ntawm 10-15 zaug hauv ib hnub. Tej zaum koj yuav pom ntshav lossis kua qaub tawm nrog cov quav. |
| Mob plab | Tej zaum yuav mob plab heev thiab mob. Lub plab kuj tseem yuav mob thaum kov. |
| Ua npaws | Tej zaum yuav muaj kub taub hau hauv lub cev. Qhov no txhais tau tias muaj kab mob kis mus rau hauv lub cev. |
| Xeev siab | Tej zaum koj yuav xav tias koj yuav ntuav. Tej zaum ib txhia neeg yuav ntuav thiab. |
Vim li cas hom kab mob no thiaj tshwm sim? Dab tsi yog qhov ua rau muaj kab mob no?
Qhov ua rau muaj qhov no yog kev kis tus kab mob Clostridium difficile , uas peb hu ua C. diff luv luv. Qhov no yog qhov ua rau ntau dua 90% ntawm cov neeg mob.
Tam sim no tej zaum koj yuav xav paub tias cov kab mob C. diff no ua rau muaj kab mob li cas. Zaj dab neeg mus zoo li no:
Muaj ntau lab tus kab mob, ob qho tib si zoo thiab phem, nyob hauv peb txoj hnyuv. Cov kab mob zoo no ua ntau yam rau peb lub cev. Tam sim no xav txog tias tus kws kho mob muab tshuaj tua kab mob rau koj rau lwm yam kab mob (piv txwv li, mob caj pas). Cov tshuaj tua kab mob no tua cov kab mob hauv peb lub cev. Tab sis thaum lawv ua li ntawd, lawv tsis yog tua cov kab mob phem uas ua rau muaj mob xwb, tab sis kuj tua ntau tus kab mob zoo hauv peb txoj hnyuv.
Tiamsis qhov xav tsis thoob yog tias C. diff tiv taus ntau yam tshuaj tua kab mob. Yog li thaum lwm cov kab mob tuag, C. diff muaj lub sijhawm los nthuav dav sai li nws xav tau, tsis muaj kev sib tw.
Cov kab mob C. diff loj hlob ntau dhau no pib tsim cov tshuaj lom uas ua rau lub txheej ntawm peb txoj hnyuv loj puas tsuaj. Cov tshuaj lom no ua rau cov hlwb plab tuag thiab raug mob, tsim cov pseudomembranes uas peb tau tham txog ua ntej.
Cov tshuaj tua kab mob uas feem ntau ua rau muaj kab mob C. diff
Txawm hais tias cov tshuaj tua kab mob twg los xij tuaj yeem ua rau muaj kev pheej hmoo no, qee hom tshuaj muaj feem ntau dua uas ua rau muaj kev pheej hmoo no. Qee qhov ntawm cov no suav nrog:
- Clindamycin
- Cov Hom Tshuaj Cephalosporins
- Hom Tshuaj Penicillin
- Cov Hom Tshuaj Fluoroquinolones
Puas muaj lwm yam ua rau tsis yog C. diff?
Yog. Txawm hais tias tus kab mob C. diff yog tus ua rau muaj tus kab mob no, tab sis qhov teeb meem no kuj tshwm sim tau vim muaj lwm yam ua rau, tsis tshua muaj.
- Lwm yam kab mob bacterial (piv txwv li *Staphylococcus aureus*, *E. coli*)
- Kev kis mob Cytomegalovirus
- Txo cov ntshav ntws mus rau txoj hnyuv loj (Ischemic colitis)
- Qee cov tshuaj chemotherapy rau mob qog noj ntshav
- Qee cov kab mob autoimmune
Leej twg muaj feem yuav mob no tshaj?
Txawm hais tias leej twg los xij tuaj yeem muaj tus mob no, qee tus neeg muaj kev pheej hmoo siab dua.
- Cov neeg tau txais kev kho mob hauv tsev kho mob: Cov tsev kho mob yog qhov chaw uas cov kab mob zoo li C. diff tuaj yeem kis tau yooj yim.
- Cov neeg uas nyuam qhuav noj tshuaj tua kab mob: Raws li peb tau tham txog ua ntej, qhov no yog qhov tseem ceeb tshaj plaws.
- Cov neeg hnub nyoog tshaj 65 xyoos: Vim tias lub cev tiv thaiv kab mob txo qis thaum laus.
- Cov neeg nyob hauv tsev laus:
- Cov neeg uas lub cev tiv thaiv kab mob tsis muaj zog: (piv txwv li cov neeg muaj tus kab mob HIV, cov neeg mob qog noj ntshav)
- Cov neeg uas muaj cov kab mob autoimmune: (piv txwv li Kab mob plab hnyuv o - IBD)
- Cov neeg uas tau muaj tus kab mob C. diff ua ntej lawm:
Yog qhov no loj heev ces yuav muaj teeb meem dab tsi tshwm sim?
Qhov no yuav zoo li ua rau koj ntshai me ntsis. Tiam sis nco ntsoov, cov teeb meem no feem ntau tsuas yog tshwm sim thaum tus kab mob hnyav zuj zus thiab tsis kho kom zoo. Yog vim li ntawd peb thiaj xav kom koj mus ntsib kws kho mob thaum ntxov.
- Kev qhuav dej thiab electrolyte tsis sib npaug: Thaum koj muaj 10-15 zaus quav ib hnub, koj poob dej thiab electrolytes ntau heev. Yog tias qhov no hnyav zuj zus, nws tuaj yeem ua rau muaj cov mob txaus ntshai xws li ntshav siab thiab lub raum tsis ua haujlwm.
- Toxic Megacolon: Qhov no yog ib qho mob txaus ntshai heev. Qhov tshwm sim yog tias qhov o ntawm txoj hnyuv loj zuj zus ua rau txoj hnyuv tsis ua haujlwm zoo, muaj roj thiab quav daig, thiab txoj hnyuv loj zuj zus ua rau nws tawg.
- Kev raug mob hnyav ua rau lub plab hnyuv tawg: Kev raug mob hnyav ua rau lub plab hnyuv tawg. Yog tias qhov no tshwm sim, cov kab mob hauv plab hnyuv tuaj yeem nkag mus rau hauv lub plab thiab ua rau muaj kev kis kab mob uas txaus ntshai rau lub neej (peritonitis, sepsis).
- Sepsis: Ib qho mob uas ua rau tuag taus uas tus kab mob kis mus thoob plaws lub cev thiab cov kab mob hauv lub cev pib ua haujlwm tsis zoo.
Tsis txhob ntshai tej yam no. Tej yam no tshwm sim tsawg tsawg. Qhov tseem ceeb tshaj plaws yog nrhiav kev pab kho mob sai li sai tau thaum muaj cov tsos mob tshwm sim.
Tus kws kho mob yuav kuaj mob no li cas kom meej?
Thaum koj mus ntsib kws kho mob, nws yuav nug koj txog koj cov tsos mob, cov tshuaj uas koj tau noj tsis ntev los no (tshwj xeeb yog cov tshuaj tua kab mob), thiab tom qab ntawd yuav ua qee qhov kev kuaj mob kom paub meej tias koj tau kuaj mob.
1. Kev kuaj quav: Qhov no yog qhov kev kuaj tseem ceeb tshaj plaws. Ib qho qauv ntawm koj cov quav raug coj mus kuaj seb puas muaj cov kab mob C. diff lossis cov tshuaj lom uas cov kab mob tsim tawm.
2.Kev kuaj ntshav: Cov no pab kuaj seb puas muaj kab mob thiab cov qe ntshav dawb ntau ntxiv.
3. Kev kuaj mob plab hnyuv loj: Qhov no suav nrog kev ntxig ib lub raj nyias nyias nrog lub koob yees duab los ntawm lub qhov quav los kuaj sab hauv ntawm txoj hnyuv loj. Qhov no tso cai rau peb pom nrog ob lub qhov muag seb puas muaj cov qog nqaij hlav uas peb tau tham txog. Yog tias tsim nyog, ib daim nqaij me me (biopsy) tuaj yeem raug coj mus kuaj.
Cov kev kho mob rau qhov no yog dab tsi?
Kev kho mob nyob ntawm seb qhov ua rau mob thiab qhov hnyav ntawm tus kab mob.
- Kev Kho Mob Qhov Ua Rau Mob: Yog tias tus kab mob C. diff yog tus ua rau mob, koj tus kws kho mob yuav sau tshuaj tua kab mob tshwj xeeb uas tuaj yeem tua cov kab mob. Metronidazole, Vancomycin, thiab Fidaxomicin yog qee cov tshuaj no.
- Kev Saib Xyuas Txhawb Nqa: Qhov no yuav suav nrog kev muab cov kua dej IV kom tiv thaiv kev qhuav dej thiab muab cov khoom noj khoom haus rau hauv cov hlab ntsha kom cov hnyuv tau so.
- Kev Phais Mob: Hauv cov mob hnyav heev, xws li cov teeb meem xws li mob toxic megacolon, kev phais tshem tawm qhov puas tsuaj ntawm txoj hnyuv loj (colectomy). Txawm li cas los xij, qhov no tsis tshua muaj.
Kab mob no kho tau tag nrho. Yog kho kom zoo, feem ntau cov neeg yuav zoo sai.
Peb yuav tsum ua li cas thiaj li dim tau qhov xwm txheej no?
Kev tiv thaiv qhov no yog ib qho tseem ceeb heev, tshwj xeeb tshaj yog nyob rau hauv cov chaw xws li tsev kho mob thiab cov tsev laus.
- Ntxuav koj txhais tes ntau zaus: C. diff tiv taus cov tshuaj ntxuav tes uas muaj cawv, yog li ntxuav koj txhais tes kom huv si nrog xab npum thiab dej yog qhov kev tiv thaiv zoo tshaj plaws.
- Kev Cais Tawm: Hauv cov tsev kho mob, cov neeg mob uas muaj tus kab mob C. diff raug kho hauv ib chav sib cais.
- Kev Ntxuav Cov Nto: C. diff tuaj yeem nyob tau ntev rau ntawm cov nto. Nws yog ib qho tseem ceeb uas yuav tsum ntxuav cov nto tsis tu ncua nrog cov tshuaj tua kab mob uas muaj chlorine.
Thaum twg peb yuav tsum mus ntsib kws kho mob sai li sai tau?
Yog koj muaj ib qho ntawm cov tsos mob hauv qab no, mus ntsib kws kho mob tam sim ntawd lossis mus rau chav kho mob ceev (ETU) ntawm tsev kho mob.
| Cov cim ceeb toom uas yuav tsum tau saib xyuas | |
|---|---|
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Txawm hais tias nws yog ib qho uas feem ntau yuav mob plab tom qab noj tshuaj tua kab mob, nws tsis yog ib txwm yooj yim li ntawd. Qee zaum nws tuaj yeem yog qhov pib ntawm tus mob hnyav xws li Pseudomembranous Colitis. Yog vim li ntawd nws thiaj li tseem ceeb heev uas yuav tsum mloog koj lub cev. Yog tias koj muaj kev tsis ntseeg txog koj cov tsos mob, tsis txhob yig tham nrog koj tus kws kho mob. Yog tias koj kho mob zoo, koj tuaj yeem rov zoo los ntawm tus mob no.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Tsis txhob xav tias raws plab thiab mob plab tom qab noj tshuaj tua kab mob tseem ceeb heev.
- Kab mob Pseudomembranous Colitis yog tshwm sim los ntawm cov kab mob hu ua C. diff. Nws yog tshwm sim los ntawm kev puas tsuaj ntawm cov kab mob zoo hauv cov hnyuv vim yog cov tshuaj tua kab mob.
- Yog koj muaj cov tsos mob xws li raws plab hnyav, kub taub hau, lossis mob plab hnyav, mus ntsib koj tus kws kho mob tam sim ntawd yam tsis muaj kev ncua.
- Muaj cov kev kho mob zoo heev rau tus kab mob no. Yog li ntawd, tsis tas yuav ntshai. Qhov tseem ceeb tshaj plaws yog kuaj mob thaum ntxov thiab pib kho.
- Ntxuav koj txhais tes kom huv si nrog xab npum yog txoj hauv kev zoo tshaj plaws los tiv thaiv koj tus kheej ntawm cov kab mob xws li C. diff.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus