Kodi munayamba mwamva kupweteka m'mimba mutamwa mankhwala opha tizilombo? Tiyeni tiphunzire za Pseudomembranous Colitis!

Kodi munayamba mwakhalapo ndi vuto la m'mimba kapena kachilombo ka m'mimba mutamwa mankhwala opha tizilombo toyambitsa matenda? Nthawi zambiri zimatha patatha tsiku limodzi kapena awiri. Komabe, nthawi zina vutoli limakhala lalikulu pang'ono. Lero tikambirana za vuto limodzi lalikulu lomwe lingagwirizane ndi kugwiritsa ntchito mankhwala opha tizilombo. Tikutcha kuti Pseudomembranous Colitis. Ngakhale dzinali lingamveke lachilendo pang'ono, ndikofunikira kudziwa za izi.

Mwachidule, kodi Pseudomembranous Colitis ndi chiyani?

Uku ndi kutupa kwakukulu (matenda oopsa a m'matumbo) komwe kumachitika m'matumbo athu akuluakulu (matumbo), zomwe zikutanthauza kutupa ndi kuvulala. Tangoganizani kuti chinachake chimawononga mkati mwa matumbo athu akuluakulu (mucosa). Kuwonongeka kumeneku kungayambitsidwe ndi bakiteriya, poizoni wopangidwa ndi bakiteriyayo, kapena matenda ena.

Kuwonongeka kumeneku kukachitika, ma plaque okhuthala komanso okhuthala amapangika pamalo ovulala. Monga momwe thunthu limapangikira pakhungu lathu tikakhala ndi bala. Koma izi si thunthu lenileni. Zimapangidwa ndi maselo akufa ndi maselo oyera amagazi. Ma membrane oyera achikasu ndi omwe madokotala amatcha "pseudomembranes." "Pseudo" amatanthauza "zabodza." Izi zikutanthauza kuti ndi membrane zabodza. Vutoli ndi lomwe timatcha pseudomembranous colitis.

Kodi zizindikiro za vutoli ndi ziti?

Munthu amene ali ndi vutoli akhoza kukhala ndi zizindikiro zosiyanasiyana, koma pali zinthu zingapo zazikulu zomwe zingaonekere.

N’chifukwa chiyani matenda amtunduwu amapezeka? Kodi chifukwa chachikulu n’chiyani?

Chifukwa chachikulu komanso chofala kwambiri cha izi ndi matenda a bakiteriya wotchedwa Clostridium difficile , omwe mwachidule timawatcha kuti C. diff . Ichi ndi chomwe chimayambitsa milandu yoposa 90%.

Tsopano mwina mukudabwa kuti mabakiteriya a C. diff angayambitse bwanji matenda otere. Nkhaniyi ikunena motere:

Mabakiteriya mamiliyoni ambiri, abwino ndi oipa, amakhala m'matumbo mwathu. Mabakiteriya abwinowa amachita zambiri m'thupi mwathu. Tsopano taganizirani kuti dokotala akukupatsani maantibayotiki a matenda ena (monga matenda a pakhosi). Maantibayotiki amenewa amapha mabakiteriya m'thupi mwathu. Koma akachita zimenezo, osati mabakiteriya oipa okha omwe amayambitsa matendawa, komanso mabakiteriya ambiri abwino m'matumbo mwathu amawonongeka.

Kuchulukana kwa mabakiteriya a C. diff kumayamba kupanga poizoni yemwe amawononga mkati mwa matumbo athu akuluakulu. Ma poizoni amenewa amachititsa maselo a m'matumbo kufa ndi kuvulala, zomwe zimapangitsa kuti ma pseudomembranes omwe tidakambirana kale ayambe.

Maantibayotiki omwe nthawi zambiri amayambitsa matenda a C. diff

Ngakhale kuti maantibayotiki aliwonse angayambitse vutoli, mitundu ina imakhala ndi chiopsezo chachikulu chotere. Zina mwa izi ndi izi:

• Clindamycin
• Mitundu ya Cephalosporins
• Mitundu ya Penicillin
• Mitundu ya Fluoroquinolones

Kodi pali zifukwa zina kupatula C. diff?

Inde. Ngakhale kuti matenda a C. diff ndiye chifukwa chachikulu, vutoli likhozanso kuchitika chifukwa cha zifukwa zina, zomwe sizichitika kawirikawiri.

• Matenda ena a bakiteriya (monga *Staphylococcus aureus*, *E. coli*)
• Matenda a Cytomegalovirus
• Kuchepa kwa magazi kupita ku matumbo (Ischemic colitis)
• Mankhwala ena a chemotherapy a khansa
• Matenda ena a autoimmune

Ndani amene ali pachiwopsezo chachikulu chotenga matendawa?

Ngakhale kuti aliyense akhoza kukhala ndi vutoli, anthu ena ali pachiwopsezo chachikulu.

• Anthu omwe akulandira chithandizo m'zipatala: Zipatala ndi malo omwe majeremusi monga C. diff amatha kufalikira mosavuta.
• Anthu omwe angomwa mankhwala opha majeremusi posachedwapa: Monga tanenera kale, ichi ndiye chinthu chachikulu chomwe chimayambitsa vutoli.
• Anthu azaka zoposa 65: Chifukwa chitetezo cha mthupi chimachepa ndi ukalamba.
• Anthu omwe ali m'nyumba zosungira okalamba:
• Anthu omwe ali ndi chitetezo chamthupi chofooka: (monga anthu omwe ali ndi kachilombo ka HIV, odwala khansa)
• Anthu omwe ali ndi matenda a autoimmune: (monga Matenda a Inflammatory Bowel Disease - IBD)
• Anthu omwe kale anali ndi matenda a C. diff:

Kodi ndi mavuto otani omwe angabwere ngati izi zitakhala zazikulu?

Izi zingakuchititseni mantha pang'ono. Koma kumbukirani kuti mavutowa nthawi zambiri amapezeka pokhapokha ngati matendawa afika poipa kwambiri ndipo chithandizo choyenera sichiperekedwa. Ndicho chifukwa chake tikukulimbikitsani kuti mukaone dokotala msanga.

• Kusowa madzi m'thupi komanso kusalinganika kwa ma electrolyte: Mukayamba matumbo anu ka 10-15 patsiku, mumataya madzi ndi ma electrolyte ambiri. Ngati izi zikukula kwambiri, zingayambitse matenda oopsa monga kutsika kwa magazi ndi kulephera kwa impso.
• Megacolon yoopsa: Imeneyi ndi vuto loopsa kwambiri. Chomwe chimachitika n'chakuti kutupa kwa m'matumbo kumakhala koopsa kwambiri moti m'matumbo mumakhala osagwira ntchito bwino, mpweya ndi ndowe zimatsekeka, ndipo m'matumbo mumakhala waukulu kwambiri moti ukhoza kuphulika.
• Kuboola kwa m'mimba: Kuvulala kwambiri kungayambitse dzenje pakhoma la m'mimba. Ngati izi zitachitika, mabakiteriya ochokera m'matumbo amatha kulowa m'mimba ndikuyambitsa matenda omwe angawononge moyo (peritonitis, sepsis).
• Sepsis: Matenda omwe amaika moyo pachiswe pomwe matenda amafalikira m'thupi lonse ndipo ziwalo za thupi zimayamba kulephera kugwira ntchito.

Kodi dokotala amazindikira bwanji matendawa molondola?

Mukapita kukaonana ndi dokotala, adzakufunsani za zizindikiro zanu, mankhwala aliwonse omwe mwamwa posachedwapa (makamaka maantibayotiki), ndipo angachite mayeso ena kuti atsimikizire matendawa.

1. Kuyesa chopondapo: Iyi ndi mayeso ofunikira kwambiri. Chitsanzo cha chopondapo chanu chimatengedwa ndikuyesedwa kuti chione ngati pali mabakiteriya a C. diff kapena poizoni wopangidwa ndi mabakiteriya.

2.Kuyezetsa magazi: Izi zimathandiza kufufuza ngati pali matenda komanso kuchuluka kwa maselo oyera m'magazi.

3. Colonoscopy: Izi zimaphatikizapo kulowetsa chubu chopyapyala chokhala ndi kamera kudzera mu anus kuti tiwone mkati mwa matumbo akulu. Izi zimatithandiza kuwona ndi maso onse awiri ngati pali ma pseudomembranes omwe tidakambirana. Ngati pakufunika, chidutswa chaching'ono cha minofu (biopsy) chingatengedwe kuti chikaunikidwe.

Kodi mankhwala ochizira izi ndi otani?

Chithandizo chimadalira chifukwa ndi kuopsa kwa matendawa.

• Kuchiza chomwe chimayambitsa matendawa: Ngati matenda a C. diff ndi omwe amayambitsa matendawa, dokotala wanu adzakupatsani mankhwala enaake opha mabakiteriya. Metronidazole, Vancomycin, ndi Fidaxomicin ndi ena mwa mankhwala amenewa.
• Chithandizo Chothandizira: Izi zingaphatikizepo kupereka madzi m'mitsempha kuti apewe kutaya madzi m'thupi komanso kupereka zakudya zopatsa thanzi m'mitsempha kuti matumbo apumule.
• Opaleshoni: Pa milandu yoopsa kwambiri, monga mavuto monga megacolon ya poizoni, kuchotsa gawo lowonongeka la m'matumbo (colectomy) kungakhale kofunikira opaleshoni. Komabe, izi zimachitika kawirikawiri.

Kodi tiyenera kuchita chiyani kuti tipulumuke mu mkhalidwe uwu?

Kupewa izi n'kofunika kwambiri, makamaka m'malo monga zipatala ndi malo osungira okalamba.

• Sambani m'manja nthawi zambiri: C. diff imagonjetsedwa ndi mankhwala ophera tizilombo toyambitsa matenda m'manja okhala ndi mowa, kotero kusamba m'manja bwino ndi sopo ndi madzi ndiye chitetezo chabwino kwambiri.
• Kudzipatula: M'zipatala, odwala omwe ali ndi matenda a C. diff amachiritsidwa m'chipinda china.
• Kuyeretsa malo: C. diff imatha kukhala pamalopo kwa nthawi yayitali. Ndikofunikira kuyeretsa malo nthawi zonse ndi mankhwala ophera tizilombo toyambitsa matenda okhala ndi chlorine.

Kodi tiyenera kupita kwa dokotala nthawi iti mwamsanga?

Ngati muli ndi zizindikiro zotsatirazi, pitani kwa dokotala nthawi yomweyo kapena pitani ku Dipatimenti Yothandiza Padzidzidzi (ETU) ya chipatala.

Ngakhale kuti nthawi zambiri munthu amavutika m'mimba akamamwa mankhwala opha majeremusi, nthawi zina zimakhala zosavuta. Nthawi zina zimatha kukhala chiyambi cha matenda aakulu monga Pseudomembranous Colitis. Ndicho chifukwa chake ndikofunikira kwambiri kumvetsera thupi lanu. Ngati muli ndi kukayikira kulikonse za zizindikiro zanu, musazengereze kulankhula ndi dokotala wanu. Ndi chithandizo choyenera, mutha kuchira kwathunthu ku vutoli.