Kodi m'mimba mwanu mwatupa chonchi? Tiyeni tiphunzire za Pseudomembranous Colitis!

Kodi mumakhala ndi ululu waukulu m'mimba komanso kutsegula m'mimba kangapo patsiku? Mwina mumamvanso nseru pamodzi ndi kutentha thupi? Makamaka, kodi zizindikirozi zinayamba mutamwa mankhwala opha maantibayotiki posachedwapa chifukwa cha matenda enaake? Ngati ndi choncho, ichi ndi chinthu chofunikira kwa inu. Lero tikambirana za matenda otchedwa 'Pseudomembranous Colitis'. Musadandaule, ngati mwadziwitsidwa bwino za izi, mutha kupeza chithandizo ndikuchira mwachangu.

Kodi Pseudomembranous Colitis ndi chiyani?

Mwachidule, 'Pseudomembranous Colitis' ndi matenda otupa kwambiri omwe amapezeka m'matumbo athu akuluakulu, kapena m'matumbo. Pachifukwa ichi, pazifukwa zina (zingakhale mabakiteriya, poizoni, kapena matenda ena), khoma lamkati la matumbo anu akuluakulu, kapena nembanemba ya mucous ('mucosa'), limawonongeka. Kuwonongeka kumeneku kumapangitsa kuti ma plaque oyera achikasu, okhuthala, komanso okhuthala apangidwe m'malo owonongeka. Madokotala amatcha izi 'pseudomembrane'.

Kodi 'ma pseudomembrane' ndi chiyani?

Ma pseudomembrane ndi omwe amapangidwa pamene maselo omwe ali mu membrane wa matumbo akulu, monga membrane wa matumbo akulu, amafa. Taganizirani izi motere: pakachitika kuvulala, chitetezo chathu cha mthupi chimatumiza maselo oyera amagazi pamalopo. Mofananamo, panonso, zidutswa za maselo akufa zimasakanikirana ndi maselo oyera amagazi (makamaka ma neutrophils) kuti apange ma pseudomembrane. Awa ndi pafupifupi masentimita awiri m'lifupi, oyera ngati chikasu, komanso okweza pang'ono pamwamba.

Kodi zizindikiro za vutoli ndi ziti?

Munthu amene ali ndi pseudomembranous colitis angakumane ndi zizindikiro monga:

• Kupweteka kwambiri m'mimba.
• Kutsegula m'mimba. Izi zitha kuchitika kangapo patsiku, nthawi zina ngati madzi.
• Malungo.
• Kusanza.
• Nthawi zina, mungaone magazi kapena mafinya akutuluka m'chimbudzi chanu, koma izi sizichitika kwa aliyense.

Kodi n’chiyani chimayambitsa matenda a Pseudomembranous Colitis?

Chifukwa chachikulu komanso chofala kwambiri cha izi ndi matenda a bakiteriya `C. diff` (Clostridioides difficile). Ma poizoni opangidwa ndi bakiteriyawa amawononga mkati mwa matumbo akulu. Pafupifupi 10% ya matenda a `C. diff` amatha kupita ku vuto lalikulu lotchedwa `pseudomembranous colitis. Ndipotu, 90% ya milandu iyi imayamba chifukwa cha bakiteriya `C. diff`. Komabe, matenda ena otupa m'matumbo angayambitsenso kuwonongeka kwamtunduwu.

Kodi mabakiteriya a C. difficile amakhudza bwanji izi?

Bakiteriya ya C. difficile imapanga poizoni amene amawononga maselo omwe ali m'matumbo athu akuluakulu. Matendawa amatha kufalikira mofulumira komanso moopsa kuposa momwe mungaganizire.

Nthawi zambiri, mumadwala matenda a C. diff chifukwa muli ndi matenda ena.Mukatha kugwiritsa ntchito maantibayotiki. Taganizirani izi, mukamwa maantibayotiki, mabakiteriya ena "abwino" m'matumbo mwathu omwe amatithandiza kufa. Komabe, maantibayotiki ambiri sangaphe mabakiteriya a 'C. diff' awa. Chifukwa chake, mabakiteriya abwinowo akatha, mabakiteriya a 'C. diff' amakhala ndi mwayi wokulira ndikufalikira popanda kuthetsedwa, zomwe zimayambitsa mavutowa popanda mpikisano uliwonse.

Ndi maantibayotiki ati omwe amagwira ntchito bwino kwambiri pa vutoli?

Ndipotu, mankhwala aliwonse opha mabakiteriya abwino m'matumbo mwathu ndipo osakhudza mabakiteriya a C. diff angayambitse matenda a C. diff ndipo zotsatira zake zimakhala pseudomembranous colitis. Komabe, maantibayotiki ena amaganiziridwa kuti ndi oopsa kwambiri. Ena mwa iwo ndi awa:

• Clindamycin
• Mankhwala a gulu la Cephalosporin
• Mankhwala a gulu la penicillin
• Fluoroquinolones
• Aztreonam
• Carbapenems

Chofunika: Izi sizikutanthauza kuti maantibayotiki awa ndi oipa. Ngati dokotala wakupatsani mankhwala, ayenera kugwiritsidwa ntchito ngati pakufunika kutero. Komabe, kugwiritsa ntchito maantibayotiki mosafunikira kungayambitse zoopsa ngati izi.

Kodi pali zifukwa zina?

Matenda a m'matumbo otchedwa Pseudomembranous colitis amathanso kuchitika pamene kutupa kwa m'matumbo kumachitika chifukwa cha zifukwa zina, kupatula C. diff. Nazi zitsanzo zingapo:

• Matenda a Staphylococcus aureus
• Matenda a E. coli `(matenda a E. coli)`
• Matenda a Cytomegalovirus
• Matenda a m'matumbo a microscopic
• Matenda a Behçet
• Ischemic colitis (kutupa komwe kumachitika chifukwa cha kuchepa kwa magazi kupita ku matumbo)
• Mankhwala oletsa khansa `(mankhwala a Chemotherapy)`
• Kugwiritsa ntchito cocaine
• Vasculitis (kutupa kwa mitsempha yamagazi)
• Kupha poizoni ndi zitsulo zolemera

Zikatero, matendawa amakhala ovuta kwambiri kapena ovuta kuposa matenda a m'matumbo wamba. Nthawi zina, magazi amapita ku khoma lamkati la m'matumbo amachepa (ischemia), kufa kwa minofu (necrosis) kumachitika, ndipo ma pseudomembranes amakula. Komanso, matenda omwe analipo kale monga Inflammatory Bowel Disease (IBD) angapangitsenso kuti m'matumbo mukhale ovuta kudwala matendawa.

Ndani ali pachiwopsezo chachikulu chotenga matendawa?

Muli ndi mwayi waukulu wopeza matenda a pseudomembranous colitis ngati:

• Ngati muli m'chipatala.
• Ngati mwagwiritsa ntchito maantibayotiki posachedwapa.
• Ngati mwangochitidwa opaleshoni posachedwapa.
• Ngati wina amakhala m'nyumba yosungira okalamba.
• Ngati muli ndi zaka zoposa 65.
• Ngati muli ndi matenda a autoimmune.
• Ngati chitetezo chanu cha mthupi chili chofooka.
• Ngati munali kale ndi matenda a C. diff.

Kodi ndi mavuto otani omwe angayambitse Pseudomembranous Colitis?

Ngati vutoli lakula kwambiri ndipo limakhala lovuta kulithetsa, mavuto ena oopsa angachitike. Choncho ndikofunikira kudziwa izi.

• Kusowa madzi m'thupi komanso kutayika kwa ma electrolyte: Mu matenda oopsa a pseudomembranous colitis, kutsegula m'mimba kumatha kuchitika mpaka nthawi 10-15 patsiku. Izi zingayambitse kutaya madzi m'thupi komanso kutayika kwa ma electrolyte. Izi zingayambitse matenda oopsa monga kuchepa kwa magazi, kuthamanga kwa magazi, komanso kulephera kwa impso.
• Kutuluka kwa madzimadzi: Madzimadzi amatha kutuluka kuchokera pakhoma lowonongeka la matumbo akuluakulu kupita m'mimba, zomwe zimapangitsa kuti mimba itukuke. Izi zimatchedwa ascites. Mapuloteni monga albumin amathanso kutayika kuchokera m'matumbo akuluakulu. Albumin ikachepa, madzimadzi amatuluka m'mitsempha yamagazi, zomwe zimapangitsa kuti miyendo itukuke (edema).
• Megacolon yoopsa: Kutupa kwakukulu komanso kosalamulirika kwa m'matumbo komwe kungayambitse m'matumbo kutupa kwambiri ndikusiya kugwira ntchito. Poyamba, minofu ya m'matumbo imasiya kugwira ntchito, ndikutseka njira yolowera m'matumbo. Pamene m'matumbo mukupitirira kutupa, makoma ake amatha kusweka, zomwe zimapangitsa kuti zomwe zili mkati mwake zituluke m'mimba. Izi zimatchedwa peritonitis. Izi zitha kukhala zoopsa pamoyo.
• Kuboola kwa m'mimba: Bowo pakhoma la matumbo akulu lingachitike popanda megacolon yoopsa. Izi zitha kuchitika ngati zilonda zikutuluka m'matumbo akulu ndikudutsa pakhoma, kapena ngati pali kufa kwakukulu kwa minofu (necrosis) pakhoma la matumbo akulu. Mabakiteriya m'matumbo akulu akatuluka m'mimba (peritonitis), amatha kufalikira m'magazi (septicemia).
• Sepsis: Sepsis ndi matenda omwe amayamba chifukwa cha kuchulukana kwa mabakiteriya m'magazi (septicemia). Sepsis ndi matenda oopsa komanso oopsa omwe amafalikira m'thupi lonse. Izi zingayambitse kugwedezeka kwa septic, kulephera kwa ziwalo zambiri, komanso imfa.

Mavuto amenewa akhoza kukhala oopsa kumva. Koma kumbukirani kuti si aliyense amene amakumana nawo. Kuzindikira matendawa msanga komanso kulandira chithandizo choyenera kungapewe mavuto aakuluwa.

Kodi mungazindikire bwanji matendawa?

Dokotala adzakufunsani kaye za zizindikiro zanu ndi mbiri yanu ya thanzi. Kenako, angakufunseni mayeso osiyanasiyana kuti apeze chomwe chimayambitsa zizindikiro zanu. Mwachitsanzo, angakufunseni mayeso a magazi, mayeso ojambulira zithunzi monga ma scan, ndi mayeso a ndowe. Mayesowa amafufuza matenda, kutupa, ndi zinthu zina zoopsa.

Kuyezetsa ndowe yanu kudzayang'ana makamaka ngati muli ndi matenda a C. diff. Ngati apezeka, chithandizo chidzayamba nthawi yomweyo. Ngati mulibe mavuto ndipo mukuyankha bwino chithandizo, sipangakhale chifukwa chenicheni choyang'ana m'matumbo anu akuluakulu kuti mupeze ma pseudomembranes.

Nthawi zina, mayeso ojambulira zithunzi (monga CT scan) angasonyeze zizindikiro za matenda a pseudomembranous colitis. Ngati khoma la m'matumbo lakhuthala (mofanana ndi "chizindikiro cha chala chachikulu" kapena "chizindikiro cha accordion"), dokotala angasankhe kuchita mayeso ena.

Kenako, kuti muyang'ane mozama, muyenera kuchita mayeso omwe amayang'ana mkati mwa matumbo akuluakulu. Amatchedwa colonoscopy. Pa izi, chubu chokhala ndi kamera chimagwiritsidwa ntchito kuyang'ana mkati mwa matumbo akuluakulu. Ngati muwona chomwe chimatchedwa 'pseudomembrane', chidutswa chaching'ono cha minofu (biopsy) chimatengedwa kuchokera pamenepo ndikutumizidwa ku labotale kuti akatsimikizire matendawa.

Kodi mankhwala ake ndi otani?

Chithandizo chimadalira chifukwa cha matendawa.

• Ngati ndi matenda a bakiteriya monga C. diff, muyenera kupereka mankhwala enaake opha tizilombo omwe amagwira ntchito bwino.
• Ngati vutoli layamba kapena lakula chifukwa cha mankhwala ena omwe mukumwa, mankhwala amenewo angafunike kuimitsidwa kapena kusinthidwa.
• Nthawi zina, mankhwala angapatsidwe kuti achepetse kutupa m'matumbo akulu.

Anthu ena amangofunika chithandizo chothandizira. Mwachitsanzo, madzi a m'mitsempha (madzi a m'mitsempha) kuti athandize kusunga madzi m'thupi, kapena zakudya za m'mitsempha kuti athandize m'mimba kupumula. Ena angafunike kuthandizidwa chifukwa cha mavuto, mwina m'chipinda chosamalira odwala kwambiri. Anthu ena omwe ali ndi matenda a m'mimba oopsa kwambiri kapena mavuto ena angafunike kuchitidwa opaleshoni yochotsa mbali yowonongeka ya m'mimba.

Kodi mankhwala akuluakulu operekedwa ndi ati ngati ayambitsidwa ndi `C. diff`?

Ngati chomwe chimayambitsa matenda a C. diff ndi matenda a C. diff, pali mankhwala angapo omwe angagwiritsidwe ntchito pochiza matendawa. Dokotala wanu adzasankha omwe ali abwino kwa inu. Mankhwala omwe amaperekedwa a matenda a C. diff ndi awa:

• Metronidazole
• Vancomycin
• Fidaxomicin

Kodi Pseudomembranous Colitis ingapewedwe?

Njira yofunika kwambiri yopewera matendawa ndikuletsa kufalikira kwa mabakiteriya a C. diff m'madera omwe ali pachiwopsezo chachikulu (makamaka zipatala ndi malo osungira okalamba). Anthu omwe ali m'malo amenewa amakhala ndi mwayi waukulu wotenga kachilomboka ndikuyamba kukhala ndi zizindikiro zoopsa monga pseudomembranous colitis.

Choncho, ogwira ntchito zachipatala m'mabungwe amtunduwu amachita zinthu zapadera kuti athetse matenda a C. diff:

• Kudzipatula: Anthu omwe ali ndi kachilombo ka C. diff amaikidwa m'chipinda china, kapena m'chipinda chomwe anthu ena omwe ali ndi kachilomboka amagawana. Magolovesi otayidwa amagwiritsidwa ntchito polowa m'chipindamo.
• Kusamba m'manja: Kusamba m'manja pafupipafupi ndi sopo ndi madzi ofunda ndiyo njira yabwino kwambiri yodzitetezera ku C. diff. Bakiteriya iyi imagonjetsedwa ndi mankhwala oyeretsera m'manja. Ndikofunikira kwambiri kusamba m'manja musanagwiritse ntchito chakudya.
• Kupha tizilombo toyambitsa matenda: Mankhwala ophera tizilombo toyambitsa matenda wamba sangaphe C. diff. Komabe, mankhwala okhala ndi chlorine amatha. Ndikofunikira kupha tizilombo toyambitsa matenda pamalo onse omwe munthu wodwala wakumana nawo.

Kodi matendawa angachiritsidwe kwathunthu? Kodi chiwerengero cha anthu omwe amafa ndi chotani?

Inde, matenda a pseudomembranous colitis amatha kuchiritsidwa kwathunthu ndi chithandizo. Nthawi zambiri, zizindikiro zimatha msanga. Komabe, anthu ena angafunike chithandizo chochulukirapo komanso nthawi yayitali kuposa ena. Ngati muli ndi matenda a C. diff omwe amapitilira komanso ovuta kuwalamulira, mungafunike opaleshoni yaying'ono kuti muwachiritse. Nthawi zina, opaleshoni ingafunike.

Ponena za imfa, 2% yokha ya odwala omwe ali ndi matenda a pseudomembranous colitis amafa. Komabe, mwa anthu omwe ali ndi chithandizo cha nthawi yayitali komanso chitetezo chamthupi chofooka, kuchuluka kumeneku kumatha kufika pa 15%. Ngati vuto lomwe latchulidwa kale lotchedwa megacolon yoopsa litachitika, kuchuluka kwa imfa kumatha kukwera kufika pa 35%. Ndicho chifukwa chake chithandizo chachangu n'chofunikira.

Kodi muyenera kupita kwa dokotala liti?

Ngati muli ndi zizindikiro izi, funsani upangiri wa dokotala nthawi yomweyo:

• Kupweteka kwambiri m'mimba kapena kudzimbidwa.
• Ngati muli ndi vuto lotsegula m'mimba nthawi zoposa zisanu patsiku.
• Ngati pali magazi mu ndowe.
• Ngati simunachite chimbudzi kwa masiku atatu.
• Ngati simunakodze kwa tsiku limodzi, kapena ngati mkodzo wanu uli wakuda.
• Ngati muli ndi kutentha kwa madigiri opitilira 39 Celsius (madigiri 102 Fahrenheit) kwa masiku atatu.

Pomaliza, zinthu zoti muzikumbukira

Matenda a bakiteriya omwe amayambitsa matenda a m'matumbo ndi ofala, ndipo nthawi zambiri si oopsa. Si aliyense amene ali ndi matenda a C. diff amene adzadwala matenda a m'matumbo otchedwa pseudomembranous colitis. Komabe, ngati mutatero, zingakhale zoopsa pang'ono. Kudziwa kuti m'matumbo mwanu mukuwonongeka kuchokera mkati kungakhale koopsa, komwe kumabweretsa zizindikiro monga kupweteka ndi kutuluka magazi.

Ngati mukumva zizindikiro ngati izi, mungafunike thandizo lapadera lachipatala. Koma kumbukirani kuti ndi chithandizo choyenera, m'mimba mwanu mutha kuchira.Ma nembanemba a m'matumbo, monga mkati mwa m'matumbo mwathu, amachira bwino ngati sanawonongeke. Ngati mukuona kuti zizindikiro za matenda a m'matumbo sizikuchepa, lankhulani ndi dokotala. Iye angakuthandizeni kupeza chomwe chayambitsa vuto lanu, kuchita zomwe zikufunika kuti muthetse vutoli, ndikupatsa m'matumbo mwanu chakudya chokwanira chomwe mukufuna. Chofunika kwambiri ndichakuti musachite mantha ndikupempha upangiri wa dokotala mwachangu.

` Pseudomembranous Colitis, C. diff, kutsegula m'mimba, kupweteka m'mimba, colitis, maantibayotiki