Kodi munayamba mwavutikapo ndi m'mimba mutamwa mankhwala opha tizilombo? Tiyeni tiphunzire za C. diff (Clostridioides difficile)!

Kodi mwayamba kutsekula m'mimba kwambiri posachedwapa mutamwa mankhwala opha tizilombo toyambitsa matenda? Kapena mwakhala mukumva kupweteka m'mimba komanso kutsegula m'mimba kwa masiku ambiri? Zitha kukhala chifukwa cha matenda a bakiteriya omwe sitinamve zambiri, koma akhoza kukhala oopsa kwambiri. Lero, tiyeni tikambirane za C. diff, chifukwa chake imachitika, komanso momwe tingadzitetezere.

Kodi C. diff (Clostridioides difficile) ndi chiyani?

Mwachidule, C. diff ndi dzina lalifupi lomwe limaperekedwa ku mtundu wa mabakiteriya. Dzina lake lonse ndi *Clostridioides difficile*. Mabakiteriyawa amatha kufalikira m'matumbo athu akuluakulu (m'matumbo). Akatero, amayambitsa kutsegula m'mimba ndi zizindikiro zina zambiri zosasangalatsa.

Ndizachilendo kupeza matenda a bakiteriya m'matumbo mwanu, ndipo ambiri mwa iwo si oopsa. Koma matenda a C. diff awa ndi oopsa pang'ono, ndipo amatha kuwononga m'matumbo mwanu. Izi zili choncho chifukwa mabakiteriya a C. diff amatulutsa poizoni m'matumbo mwanu. Ma poizoni amenewa amawononga maselo omwe ali m'matumbo mwanu, zomwe zimapangitsa kuti atupane. M'mawu azachipatala, timatcha matenda a colitis . Kaya mukupeza zizindikiro komanso kuopsa kwake kumadalira kuchuluka kwa kuwonongeka komwe poizoniyo wachita m'matumbo mwanu. Nthawi zina, vutoli likhoza kukhala pachiwopsezo.

Kodi zizindikiro za matenda a C. diff ndi ziti?

Chizindikiro chachikulu komanso choyamba cha matendawa ndi kutuluka m'mimba ngati madzi . Ngati matendawa si aakulu, mungakhale ndi kutuluka m'mimba katatu patsiku, limodzi ndi kupweteka pang'ono m'mimba.

Matenda akamakula, kutsegula m'mimba kumakulanso. Mungakhale ndi matumbo khumi kapena khumi ndi asanu patsiku. Muthanso kuona magazi m'chimbudzi chanu. Izi ndi zizindikiro zina zomwe zingawonekere vuto likakula kwambiri.

Poyamba, zizindikirozi zingawoneke ngati poizoni wa chakudya kapena chimfine cha m'mimba. Ngati mukumwa maantibayotiki, mungaganize molakwika kuti kusokonezeka kwa m'mimba kumeneku ndi zotsatira zabwinobwino za mankhwalawo.

Kodi ndowe zimakhala bwanji mu matenda a C. diff?

Mu matenda otsegula m'mimba a C. diff, ndowe nthawi zambiri zimakhala ngati phala komanso zokhuthala, osati zamadzimadzi okhaokha. Nthawi zina zimakhala zobiriwira. Nthawi zina, magazi, ntchofu, kapena mafinya amatha kuoneka.

Anthu ambiri amanena kuti matenda otsegula m'mimba a C. diff ali ndi fungo lapadera . Amanena kuti ndi fungo lamphamvu komanso lokoma kwambiri kuposa ndowe wamba. Izi zitha kukhala chifukwa chakuti mabakiteriya a C. diff amawonjezera kuchuluka kwa asidi m'ndowe mwathu.

Nchifukwa chiyani timapeza C. diff?

Taganizirani za matumbo athu ngati munda wokongola wa maluwa. M'munda uno, muli maluwa abwino ndi udzu winawake. M'matumbo mwa munthu amene ali ndi chitetezo chamthupi chathanzi, muli mabakiteriya ambiri "abwino" (monga maluwa) ndipo mabakiteriya "oipa" (monga udzu) ndi omwe amalamulira. C. diff ndi mabakiteriya omwe nthawi zambiri amakhala m'matumbo mwathu pang'ono.

Ngati kulinganiza kumeneku kwasokonekera, zomwe zikutanthauza kuti mabakiteriya abwino ndi ochepa, mabakiteriya oipa monga C. diff ali ndi mwayi wofalikira ngati udzu ndi kutenga malo.

Kodi C. diff imafalikira bwanji?

Mabakiteriya a C. diff ndi obisika kwambiri. Akatuluka m'thupi, amapanga chipolopolo cholimba kwambiri chotchedwa spore. Ma spores awa ali ngati mbewu zazing'ono za mabakiteriya. Akhoza kukhala m'manja mwathu komanso pazinthu zomwe timakhudza (zogwirira zitseko, matebulo, zimbudzi). Ngati tikhudza malo omwe ali ndi spores awa, tikhoza kudwala, kaya ndi kudya chakudya ndi dzanja lomwelo kapena kuyika manja athu mkamwa mwathu.

Tizilombo toyambitsa matenda timeneti ndi tovuta kwambiri kupha. Sitilimbana ndi kutentha, ma acid, ndi maantibayotiki ambiri komanso mankhwala ophera tizilombo toyambitsa matenda. Titha kukhalanso ndi moyo pa malo kwa miyezi ingapo. Ichi ndichifukwa chake matendawa amafalikira mofulumira kwambiri, makamaka m'malo monga zipatala.

Ndani ali pachiwopsezo chachikulu chotenga matenda a C. diff?

Anthu ena ali ndi mwayi waukulu wopeza matendawa.

• Anthu opitirira zaka 65: Chiwopsezo chimakhala chachikulu chifukwa chitetezo cha mthupi chimachepa ndi ukalamba, amamwa mankhwala ambiri a matenda ena, ndipo amakhala m'zipatala kapena m'nyumba zosungira okalamba.
• Makanda aang'ono: Chifukwa chitetezo chawo cha mthupi sichinakule mokwanira.
• Anthu m'zipatala: Zipatala ndi malo omwe ma spores a C. diff amatha kufalikira mosavuta. Amatha kufalikira mosavuta kudzera m'zimbudzi za anthu onse.
• Anthu omwe ali ndi chitetezo chamthupi chofooka: Anthu omwe ali ndi matenda monga khansa, HIV, matenda a impso, ndi matenda a shuga ali ndi chitetezo chamthupi chofooka. Anthu omwe akumwa mankhwala oletsa chitetezo chamthupi nawonso ali pachiwopsezo chachikulu.
• Anthu omwe ali ndi matenda a m'mimba: Anthu omwe ali ndi matenda monga matenda a kutupa m'matumbo (IBD) , monga matenda a Crohn ndi matenda a zilonda zam'mimba, amakhala pachiwopsezo chachikulu chotenga matenda chifukwa chitetezo cha m'matumbo chimakhala chofooka.

Koma kumbukirani, ngakhale munthu wopanda chilichonse mwa zinthuzi akhoza kukhala ndi matenda a C. diff.

Kodi mavuto omwe angakhalepo chifukwa cha C. diff ndi ati?

Nthawi zambiri, matenda a C. diff si oopsa kwambiri. Koma nthawi zina, makamaka ngati sanachiritsidwe, mavuto aakulu amatha kuchitika.

• Matenda obwerezabwereza: Ngakhale atalandira chithandizo, pafupifupi 20% ya anthu adzadwalanso matendawa mkati mwa milungu iwiri kapena isanu ndi itatu.
• Kutaya madzi m'thupi: Kutsegula m'mimba kwambiri kumapangitsa kuti thupi litaye madzi ambiri ndi ma electrolyte. Ngati izi zikukula kwambiri, zingayambitse kuthamanga kwa magazi komanso kulephera kwa impso.
• Matenda a m'matumbo otchedwa pseudomembranous colitis:Imeneyi ndi matenda oopsa (colitis). Mkati mwa matumbo mumayamba kutupa ndi kupindika ngati nembanemba.
• Megacolon yoopsa: Iyi ndi vuto losowa koma loopsa kwambiri. M'matumbo mwa munthu m'modzi mumatupa kwambiri moti simugwira ntchito mokwanira. Izi zingayambitse sepsis, vuto lomwe mabakiteriya amafalikira m'thupi lonse.

Pa milandu yoopsa ngati iyi, kungakhale kofunikira kuchitidwa opaleshoni kuti achotse matumbo omwe ali ndi kachilomboka.

Dokotala, kodi mumazindikira bwanji matendawa? Kodi chithandizo chake ndi chiyani?

Ngati dokotala wanu akukayikira kuti muli ndi matenda a C. diff kutengera zizindikiro zanu, adzakufunsani kuti mupereke chitsanzo cha ndowe. Chidzatumizidwa ku labu kuti akayesedwe ngati pali poizoni wa C. diff.

Ngati matendawa atsimikizika, kuyezetsa magazi ndi mwina kusanthula mkati mwa matumbo kungachitike kuti adziwe kuopsa kwa matendawa.

Njira zochizira

Chithandizo chimadalira kuopsa kwa matendawa.

• Kuletsa maantibayotiki: Ngati mukupeza C. diff mukumwa maantibayotiki chifukwa cha vuto lina, chinthu choyamba chomwe dokotala wanu angachite ndikusiya kumwa mankhwalawo. Kwa anthu ena, ndicho chokha chomwe ayenera kuchita. Mabakiteriya abwino m'matumbo mwanu adzakulanso ndipo matendawa adzatha okha.
• C. maantibayotiki osiyanasiyana: Ngati zimenezo sizikugwira ntchito, dokotala wanu angakulembereni maantibayotiki enaake omwe angaphe mabakiteriya a C. diff. Mwachitsanzo , (Metronidazole) , (Vancomycin) , kapena (Fidaxomicin) .
• Kugonekedwa m'chipatala: Ngati matendawa ndi oopsa, mungafunike kugonekedwa m'chipatala, komwe mungapatsidwe mankhwala amchere (IV fluids) ndi maantibayotiki kudzera m'mitsempha.

Kodi mungachite chiyani ndi matenda obwerezabwereza?

Anthu ena amabwereranso kuchipatala atalandira chithandizo. Pazochitika zotere, njira zomwe angatsatire ndi izi:

• Bwerezani chithandizo cha maantibayotiki: Mankhwala ena opha tizilombo toyambitsa matenda kapena mankhwala a nthawi yayitali angaperekedwe.
• Kusamutsa Mabakiteriya a Fecal Microbiota (FMT): Dzinali lingamveke lachilendo pang'ono, koma ndi mankhwala othandiza kwambiri pa matenda a C. diff omwe amabwereranso. Mwachidule, limaphatikizapo kupatula mabakiteriya 'abwino' kuchokera ku ndowe kuchokera kwa munthu wathanzi ndikuwapatsa jakisoni m'matumbo a wodwalayo. Izi zimabwezeretsa bwino mabakiteriya abwino omwe atayika m'matumbo.

Kodi tiyenera kuchita chiyani kuti tipewe kufalikira kwa C. diff?

Popeza matendawa ndi opatsirana kwambiri, tiyenera kusamala kwambiri. Makamaka ngati wina m'banjamo ali ndi matendawa, onetsetsani kuti mwachita izi.

• Kudzipatula: Ndi bwino kuti munthu amene ali ndi kachilomboka akhale m'chipinda china ngati n'kotheka. Ndi bwinonso ngati angagwiritse ntchito chimbudzi china. Ngati mugwiritsa ntchito chimbudzi cha anthu onse, nthawi zonse pukutani chimbudzicho ndi chotsukira chokhala ndi bleach mukatha kugwiritsa ntchito.
• Kuyeretsa malo: Tsukani malo omwe amakhudzidwa kawirikawiri (zogwirira zitseko, maswichi a magetsi) ndi yankho lokhala ndi bleach.
• Kugwiritsa ntchito maantibayotiki moyenera: Musamwe maantibayotiki omwe dokotala sanakupatseni. Imwani mankhwala onse monga momwe mwalangizidwira.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati muli ndi zizindikiro izi, pitani kwa dokotala nthawi yomweyo.

• Ngati mukuyamba kutsegula m'mimba mutayamba kumwa mankhwala opha tizilombo.
• Ngati kutsegula m'mimba kuli koopsa (kupitirira nthawi 10 patsiku).
• Ngati muwona magazi mu ndowe zanu.
• Ngati muli ndi ululu waukulu m'mimba komanso malungo.
• Ngati mukusanza mpaka kufika poti simungathe kudya kapena kumwa.

Ngati mukukumana ndi zizindikiro izi, pitani ku Dipatimenti Yothandiza Anthu Odwala Mwadzidzidzi (ETU) ya chipatala nthawi yomweyo:

• Zizindikiro za kusowa madzi m'thupi (pakamwa pouma, maso olowa m'madzi, mkodzo wochepa kwambiri, kutopa kwambiri).
• Kupweteka m'mimba kwambiri komanso kosapiririka.
• Kusokonezeka kwa kukumbukira.

Matenda a C. diff si matenda oti munthu angowatenga mopepuka. Koma musachite mantha. Ngati mukaonana ndi dokotala nthawi yoyenera ndikupeza chithandizo, akhoza kuchiritsidwa kwathunthu.