Kodi m'mimba mwanu mukumva ngati kuti mwasanduka mwala? Tiyeni tiphunzire za vuto losowa ili (Ogilvie Syndrome)

Kodi munayamba mwamvapo ngati chinachake chatsekeredwa m'mimba mwanu, mimba yanu ikukulirakulira, ndipo munkamva ngati chiphulika? Zinali ngati matumbo anu atsekeredwa kwathunthu. Nthawi zambiri, izi zimachitika pamene china chake chatsekeredwa m'matumbo mwanu. Komabe, pali vuto lachilendo komanso losowa pomwe matumbo anu amasiya kugwira ntchito mwadzidzidzi popanda chilichonse chotsekeredwa mkati. Lero, tikambirana za vuto lomwe anthu ambiri sanamvepo. M'mawu azachipatala, timatcha Ogilvie Syndrome kapena Acute Colonic Pseudo-obstruction (ACPO) .

Mwachidule, kodi Ogilvie Syndrome ndi chiyani?

Tangoganizirani, pali magalimoto ambiri, koma palibe ngozi kapena zopinga pamsewu. Magalimoto akungoyima. Ogilvie Syndrome ndi chinthu chonga chimenecho. Kuyenda kwa chakudya ndi zinyalala mkati mwa matumbo anu kumayima mwadzidzidzi. Zikumveka ngati chinachake chatsekedwa m'matumbo anu, koma kwenikweni palibe choletsa chakuthupi. Vuto lili mu dongosolo la mitsempha lomwe limalamulira minofu m'matumbo anu. Chifukwa sichigwira ntchito bwino, kuyenda kwa matumbo (omwe timatcha "peristalsis"`) kumayima, ndipo zomwe zili mkati zimayima pamalo amodzi. Izi zimapangitsa kuti matumbo aang'ono ayambe kukula pang'onopang'ono, kapena kutupa.

Mawu akuti ``pseudo-obstruction'' m'dzina lake amatanthauza ``false obstruction.'' Izi zikutanthauza kuti zimasonyeza zizindikiro ngati kuti pali choletsa, ngakhale kuti palibe choletsa.

Kodi izi zikusiyana bwanji ndi mavuto ena a m'mimba?

Pali matenda osiyanasiyana omwe amalepheretsa matumbo kugwira ntchito bwino. Tiyeni tiwone momwe Ogilvie Syndrome imasiyanirana ndi matendawo.

• Poyerekeza ndi matenda ena a `Intestinal Pseudo-obstruction`: Ogilvie Syndrome ndi vuto la `acute`. Ndiko kuti, limabwera mwadzidzidzi, ndipo ndi la kanthawi kochepa . Ndipo limakhudza matumbo akulu okha . Komabe, anthu ena amatha kukhala ndi matenda a `chronic` `pseudo-obstruction`. Nthawi zambiri amayamba chifukwa cha matenda ena osatha kapena vuto lobadwa nalo.
• Kusiyana ndi `Paralytic Ileus`: Mwina munamvapo mawu akuti `Paralytic Ileus`. Amagwiritsidwa ntchito pofotokoza vuto lomwe matumbo amasiya kugwira ntchito kwakanthawi, makamaka pambuyo pa opaleshoni ya m'mimba. Ndi lofala kwambiri. Limakhudza matumbo ang'onoang'ono ndi akuluakulu omwe amasiya kugwira ntchito kwakanthawi kenako nkuchira okha mkati mwa masiku ochepa. Komabe, Ogilvie Syndrome ndi vuto lovuta komanso losowa . Limakhudza kwambiri matumbo akuluakulu , makamaka cecum.

Ndani amene ali pachiwopsezo chachikulu chotenga matendawa?

Ngakhale kuti imatha kufalikira mwa aliyense, imapezeka kwambiri mwa anthu okalamba azaka zopitilira 60 omwe ali ndi mavuto ena azaumoyo.Vutoli limanenedwa mwa wodwala m'modzi mwa odwala 1,000 omwe ali m'chipatala.

Mwachidule, izi zitha kuchitika nthawi iliyonse thupi likakhala ndi nkhawa kwambiri. Taganizirani za opaleshoni yayikulu, ngozi yayikulu, matenda a mtima, kapena matenda oopsa. Zinthuzi zimakhudza momwe mitsempha yathu imagwirira ntchito. Mitsempha iyi ndi yomwe imauza minofu m'matumbo kuti "isunthe." Chifukwa chake pakakhala kusalinganika pamenepo, matumbo amasiya kugwira ntchito ndipo Ogilvie Syndrome imatha kuchitika.

Kodi zizindikiro za Ogilvie Syndrome ndi ziti?

Mpweya, madzi, ndi chakudya chosagayidwa zikatsekeredwa m'matumbo mwanu, mutha kuwona zizindikiro ngati izi. Izi zingayambe mwadzidzidzi ndipo pang'onopang'ono zimawonjezeka.

Chifukwa chiyani izi zimachitika? Tiyeni tiwone bwino zifukwa zake.

Ngakhale kuti chifukwa chenicheni cha izi sichikudziwika bwino 100%, asayansi amakhulupirira kuti izi zimachitika chifukwa cha kulephera kugwira ntchito bwino kwa dongosolo lathu la mitsempha lodziyimira pawokha . Taganizirani izi, zinthu zomwe zimachitika zokha m'thupi lathu, monga kugunda kwa mtima, kupuma, ndi kugaya chakudya, zimayendetsedwa ndi dongosolo la mitsempha ili, lomwe limagwira ntchito ngati "auto-pilot." Chifukwa chake, chifukwa cha kupsinjika kwambiri m'thupi, dongosolo la "auto-pilot" ili likhoza kukhala losakhazikika, ndipo zizindikiro zomwe zimalamulira matumbo zimatha kusokonekera.

Zifukwa zazikulu zomwe zimayambitsa vutoli zitha kugawidwa m'magulu angapo.

Kodi izi zingakhale zovuta kwambiri? Kodi mavuto ake ndi otani?

Inde, ngati izi sizipezeka ndi kuchiritsidwa bwino, zingayambitse mavuto aakulu komanso oopsa . Tangoganizirani, chimachitika ndi chiyani ngati mupitiliza kupumira mpweya mu baluni? Umaphulika. Matumbo ali chimodzimodzi.

M'mimba mwake mwabwinobwino wa m'matumbo akuluakulu ndi pafupifupi masentimita 8. Komabe, mu Ogilvie Syndrome, ngati ikukula kuposa masentimita 12, chiopsezo cha zovuta chimakhala chachikulu kwambiri.

Mavuto akuluakulu omwe angachitike ndi awa:

• Ischemia: Kutambasula kwambiri makoma a matumbo kumapangitsa kuti mitsempha yofewa ya magazi yomwe imapatsa magazi ikhale yopapatiza, zomwe zimachepetsa magazi . Izi zimayambitsa kutupa kwa matumbo (ischemic colitis), komwe, ngati sikuchiritsidwa, kungayambitse kufa kwa minofu (necrosis).
• Kubowoka: Minofu ikafa, khoma la matumbo limafooka ndipo dzenje laling'ono limatha kupangika . Izi ndi zoopsa kwambiri chifukwa majeremusi ndi zinyalala zochokera m'matumbo zimatha kutuluka m'mimba, zomwe zimayambitsa matenda oopsa (peritonitis).
• Sepsis: Matenda omwe afalikira m'mimba satha. Amatha kulowa m'magazi ndikufalikira m'thupi lonse.Uwu ndi matenda omwe amaika moyo pachiswe omwe amafunika chithandizo chamankhwala chadzidzidzi. Angayambitsenso kulephera kwa ziwalo, chimodzi ndi chimodzi.

Kodi mungadziwe bwanji matendawa molondola?

Madokotala amakhudzidwa kwambiri ndi zinthu ziwiri akamazindikira matendawa.

1. Choyamba, timayang'ana ngati pali vuto la m'mimba.

2. Ngati palibe choletsa chotere, zimatsimikiziridwa ngati chomwe chimayambitsa zizindikirozi ndi Ogilvie Syndrome kapena china chake.

Mayeso osiyanasiyana akuchitidwa pa izi.

• Kujambula X-ray ndi CT scan: Kujambula X-ray kapena CT scan ya m'mimba kumatha kuwonetsa bwino matumbo akuluakulu, omwe ali otupa komanso odzaza ndi mpweya. Nthawi zina, madzi apadera ('chopangira chosiyana') amaperekedwa kuti amwe kapena ngati jakisoni kuti apeze zithunzi zomveka bwino.
• Gastrografin Enema: Iyi ndi mayeso apadera kwambiri. Chifukwa ndi mayeso komanso nthawi zina chithandizo. Apa, madzi osungunuka m'madzi otchedwa `gastrografin` amalowetsedwa m'matumbo kudzera mu rectum, ndipo momwe amayendera m'matumbo amawonedwa ndi kanema X-ray `(fluoroscopy)`. Izi zitha kudziwa molondola ngati pali chotchinga m'matumbo kapena ayi. Komanso, madzi a `gastrografin` awa ali ndi mphamvu zotulutsa madzi m'thupi. Chifukwa chake, nthawi zina mphamvu yake imathandiza kuyambitsanso ntchito ya m'matumbo yomwe yasiya kugwira ntchito.

Kodi mankhwala ochizira izi ndi otani?

Chithandizo chimadalira momwe m'mimba mwanu mulili wotupa komanso ngati muli pachiwopsezo cha mavuto. Nthawi iliyonse ikatheka, madokotala amayesa kuchiza ndi mankhwala osavuta othandizira (`mankhwala osasintha`) m'malo mochita opaleshoni.

Chithandizo cha Conservative

Poyamba, chithandizochi chimachitika poyang'anira bwino mkhalidwe wa wodwalayo.

• Kuchiza matenda omwe amayambitsa matendawa: Ngati pali vuto linalake, monga matenda opatsirana kapena matenda a mtima, ndiye kuti limachiritsidwa kaye.
• Kusiya mankhwala: Mankhwala omwe akuganiziridwa kuti amayambitsa Ogilvie Syndrome amasiya kwakanthawi.
• Kupumitsa matumbo: Kusiya kwathunthu chakudya cham'kamwa ndi madzi.
• Mchere wa m'mitsempha: Madzi ndi mchere wofunikira m'thupi umaperekedwa kudzera mu mtsempha (madzi a m'mitsempha).
• Kuyenda ndi kusintha malo: Ngati n'kotheka, limbikitsani wodwalayo kuti ayende pang'ono ndikusintha malo ake pabedi. Izi zingathandize kuti m'mimba muyambe kuyenda bwino.
• Kulowetsa mpweya m'mimba: Chubu (`Nasogastric chubu`) chimalowetsedwa m'mimba kudzera m'mphuno kuti chichotse mpweya wochuluka ndi madzi. Chubu (`Rectal chubu`) chimalowetsedwanso kudzera m'matako kuti mpweya utuluke.

Pa nthawi ya chithandizochi, madokotala nthawi zonse amachita X-ray ndi mayeso a magazi kuti aone momwe matumbo alili komanso mavuto aliwonse omwe angakhalepo.

Nanga bwanji ngati chithandizo chothandizira sichikuyenda bwino?

Ngati vutoli silikuyenda bwino patatha maola pafupifupi 72, kapena ngati matumbo apitirira masentimita 12, madokotala apitiliza ndi gawo lotsatira.

• Kuchotsa Kupanikizika kwa Colonoscopic: Mu izi, chubu chokhala ndi kamera yolumikizidwa (`colonoscope`) chimayikidwa kudzera mu anus ndipo mpweya womwe wasonkhana m'matumbo umakokedwa kudzera mu chubu. Izi zimachepetsa nthawi yomweyo kuthamanga kwa magazi m'matumbo. Komabe, popeza iyi ndi njira yosasangalatsa ndipo nthawi zina pamakhala chiopsezo chochepa cha kubowoka kwa m'matumbo, imachitika mosamala kwambiri.
• Jakisoni wa Neostigmine: Uwu ndi mankhwala amphamvu kwambiri olimbikitsa minofu. Nthawi zambiri amagwiritsidwa ntchito kuthandiza minofu kuchira pambuyo pochita opaleshoni. Mankhwalawa akaperekedwa ngati jakisoni wa mtsempha (IV) kwa anthu omwe ali ndi Ogilvie Syndrome, minofu ya m'mimba imayambanso kugwira ntchito, ndipo zotsatira zabwino zapezeka. Komabe, chifukwa mankhwalawa angayambitse kugunda kwa mtima pang'onopang'ono, amaperekedwa pokhapokha ngati dokotala ali mu chipinda chosamalira odwala kwambiri (ICU) .
• Opaleshoni (Colectomy / Colostomy): Ngati, ngakhale kuti pali njira zonsezi, matumbo akupitiriza kutupa, kapena ngati pali vuto lalikulu monga kubowoka, opaleshoni ikhoza kukhala njira yomaliza. Pankhaniyi, gawo lowonongeka la matumbo limadulidwa ndikuchotsedwa (Colectomy). Nthawi zina, pamafunika kupangidwa dzenje la kanthawi kapena lokhazikika m'mimba kuti chopondacho chilowe. Timachitcha kuti Colostomy.

Kodi vutoli likhoza kupha munthu?

Popanda mavuto, chiopsezo cha imfa kwa munthu amene ali ndi Ogilvie Syndrome chokha ndi pafupifupi 15%. Komabe, chiwerengerochi chikuphatikizaponso zotsatira za matenda ena omwe wodwalayo ali nawo.

Komabe, ngati vuto lalikulu monga kuboola m'mimba lichitika, chiwerengero cha imfa chimafika pa 40%. Izi zikusonyeza momwe vutoli lingakhalire loopsa.

Chofunika kwambiri ndi kusamala zizindikiro zikangoyamba kuonekera, kuzindikira matendawa mwachangu, ndikuyamba kulandira chithandizo. Ngati mutatero, mutha kupewa mavuto akuluakulu ndikuchira mwachangu ndi mankhwala osavuta.