Tangoganizani kuti mwapita kuchimbudzi ndipo mwatuluka opanda kanthu. Koma patangopita mphindi zochepa, mukumvanso chisoni chachikulu, ngati kuti mukufunika kuchita chimbudzi kachiwiri. Kaya muyese bwanji, palibe chomwe chimatuluka. Kodi inunso mukuvutika ndi vutoli? Ichi ndi chomwe timachitcha kuti Tenesmus mu zamankhwala. Izi si vuto lokha, koma chizindikiro chakuti pali vuto m'thupi lanu.
Kodi tenesmus kwenikweni ndi chiyani?
Mwachidule, tenesmus ndi chilakolako chofuna kuchita chimbudzi nthawi zonse, ngakhale mutatulutsa matumbo anu kapena chikhodzodzo. Mutha kumva kupweteka m'mimba, kupweteka m'mimba, kulemera, kapena ngakhale chilakolako chofuna kuchita chimbudzi mwadzidzidzi.
Mkhalidwewu ukhoza kuchitika m'njira ziwiri zazikulu:
1. Rectal Tenesmus: Izi zikugwirizana ndi kusamba m'mimba. Zimatanthauza kuti ngakhale mutayamba kusamba m'mimba, mumakhalabe ndi malingaliro akuti muyenera kusamba m'mimba.
2. Vesical Tenesmus: Izi zikugwirizana ndi kukodza. Zimatanthauza kuti ngakhale mutakodza, chikhodzodzo chimamvabe chodzaza ndipo chikumva ngati mukuyenera kukodzanso.
Chofunika kwambiri ndichakuti tenesmus si vuto lachibadwa. Ndi chizindikiro cha vuto lina lachipatala lomwe limayambitsa vutoli. Chifukwa chake, sikoyenera kunyalanyaza.
Kodi ndi zifukwa ziti zomwe zimayambitsa rectal tenesmus?
Pali magulu awiri akuluakulu a zifukwa za tenesmus zokhudzana ndi ndowe. Izi ndi kutupa ndi kudzimbidwa. Tiyeni tiwone izi padera.
| Gulu la zifukwa | Kufotokozera ndi zitsanzo |
|---|---|
| Kutupa | Vutoli limatha kuchitika pamene gawo la m'mimba mwanu (m'mimba mwa rectum ndi m'matako) latupa ndipo layamba kufooka. Izi zingakupangitseni kumva kukhuta mukamatuluka chopondapo, komanso zingalimbikitse mitsempha yomwe imatumiza uthenga ku ubongo wanu wokuuzani kuti mupitirize kuchita chimbudzi. Zifukwa zazikulu:
|
| Kudzimbidwa | Ngati ndowe zolimba zatsekeredwa m'matumbo chifukwa cha kudzimbidwa, nthawi zonse zimalimbitsa makoma a matumbo. Izi zimapangitsa kuti munthu azimva ngati akufunika kutulutsa madzi m'matumbo, ngakhale kuti matumbo ake sali opanda kanthu. Zifukwa za kudzimbidwa:
|
Kodi ndi zinthu ziti zomwe zimayambitsa matenda a urinary tenesmus (vesical tenesmus)?
Chifukwa chomwecho chomwe chimakupangitsani kuti mufunenso kukodza mukamaliza kukodza ndi chowonadi. Vutoli lingayambike chifukwa cha mkodzo womwe umatsala mu chikhodzodzo kapena kutupa kapena matenda m'njira ya mkodzo.
| Gulu la zifukwa | Kufotokozera ndi zitsanzo |
|---|---|
| Mkodzo wotsalira mu chikhodzodzo | Ngati chikhodzodzo sichingathe kuchotsedwa kwathunthu pazifukwa zina, mkodzo wotsalawo umalimbikitsa minofu ya chikhodzodzo ndipo umayambitsa kumva ngati ukufunika kupitiriza kukodza. Zifukwa:
|
| Kutupa/matenda a mkodzo | Pamene mkodzo wa mkodzo uyamba kutupa komanso kukhala wofewa, mitsempha imatha kudzutsidwa, zomwe zimayambitsa izi. Zifukwa:
|
Kodi pali kugwirizana pakati pa kupsinjika maganizo ndi vutoli?
Inde, pali kugwirizana. Tenesmus siimayamba chifukwa cha kupsinjika maganizo kapena nkhawa. Komabe, ngati muli kale ndi vuto lomwe limayambitsa vutoli, kupsinjika maganizo kungapangitse kuti vutoli liwonjezeke. Kumbukirani, pamene tikupsinjika maganizo, dongosolo lathu la mitsempha limasintha, zomwe zimapangitsa kuti zikhale zovuta kulamulira minofu yathu. Izi zitha kuwonjezera minofu yomwe imachitika mu Tenesmus mosadzifunira. Komanso, kukhala ndi vutoli nthawi zonse kungakhale kovuta kwambiri.
Kodi tenesmus imachiritsidwa bwanji?
Ngati muli ndi zizindikiro izi, chinthu choyamba chomwe muyenera kuchita ndikuonana ndi dokotala . Dokotalayo adzakuyesani ndikuyesera kupeza chomwe chikuyambitsa zizindikiro zanu. Akhoza kuchita mayeso otsatirawa:
- Kuyezetsa kwa digito kwa rectal: Kuyezetsa pamanja kwa rectum.
- Anoscopy/Flexible Sigmoidoscopy: Kufufuza rectum ndi m'mimba pogwiritsa ntchito chubu chokhala ndi kamera.
- Colonoscopy: Kufufuza m'matumbo onse.
Chifukwa chikapezeka, chithandizo chimatsimikiziridwa kutengera chifukwacho.
- Kuchiza vuto lomwe limayambitsa matendawa: Mankhwala opha tizilombo toyambitsa matenda angaperekedwe pa matenda, ndipo mankhwala oletsa kudzimbidwa kwambiri angaperekedwe. Matenda ena angafunike opaleshoni.
- Kuchiza kutupa: Mankhwala monga corticosteroids angaperekedwe kuti achepetse kutupa.
- Chithandizo cha zizindikiro za rectum: Mankhwala ochepetsa ululu ndi kutupa angaperekedwe ngati ma suppositories oikidwa mu rectum.
- Chithandizo cholunjika ku minofu: Mankhwala omwe amaletsa kupweteka kwa minofu kosafunikira (anticholinergics) kapena (antispasmodics) angaperekedwe.
- Kuthana ndi zizindikiro za khansa: Kuchiza matenda a tenesmus omwe amayamba chifukwa cha khansa n'kovuta. Nthawi zina mankhwala ochepetsa ululu kapena opaleshoni angafunike.
Kodi muyenera kupita kwa dokotala nthawi yomweyo liti?
Nthawi zonse lankhulani ndi dokotala wanu za vutoli. Komabe, ngati muli ndi zizindikiro zoopsa izi, musaiwale kufunafuna upangiri wa dokotala nthawi yomweyo .
Ngati muli ndi zizindikiro izi: kutentha thupi , nseru ndi kusanza , kupweteka kwambiri , kapena magazi mu ndowe/mkodzo wanu , funsani upangiri wa dokotala nthawi yomweyo. Ngati kuli kofunikira, pitani ku Dipatimenti Yodzidzimutsa (ETU) ya chipatala chapafupi.
Kukhala ndi vuto lamtunduwu kungakhale kovuta kwambiri. Musachite manyazi kulankhula ndi dokotala za vutoli. Musavutike chete. Tenesmus ndi chizindikiro cha vuto lomwe likufunika kuchiritsidwa. Ngakhale vuto lomwe limayambitsa vutoli ndi losatha komanso losachiritsika (monga IBD), ndi chithandizo choyenera, mutha kuwongolera zizindikiro zosasangalatsazi ndikukhala moyo wabwinobwino.
Uthenga Wopita Nawo Kunyumba
- Tenesmus si matenda, koma chizindikiro cha vuto lina loyambitsa.
- Kusasangalala kumeneku kungachitike ndi kutsuka m'mimba (kutulutsa m'mimba) kapena kukodza (vesical).
- Ndikofunikira kupeza chomwe chimayambitsa matendawa ndikuchichiza. Choncho musanyalanyaze zizindikiro izi.
- Ngati muli ndi zizindikiro monga malungo, kupweteka kwambiri, kapena magazi mu ndowe/mkodzo wanu, pitani kwa dokotala nthawi yomweyo.
👩🏽⚕️ Mafunso ena (Mafunso Ofunsidwa Kawirikawiri)
💬 Kodi makapisozi a Disopyramide / Norpace ndi mankhwala amphamvu kwambiri pa matenda?
Iyi si mankhwala wamba! Iyi ndi mankhwala amphamvu (Class 1A Antiarrhythmic) omwe amagwiritsidwa ntchito poletsa Ventricular Arrhythmias / V-Tach / PVCs zomwe zimawopseza moyo, zomwe ndi kayendedwe kadzidzidzi, kosalamulirika, kosazolowereka/kofulumira m'zipinda zapansi pa mtima (Ventricles), zomwe zimapangitsa wodwalayo kugwa ndi kufa, ndikubwezeretsa mtima kukhala wabwinobwino!
💬 Mtima wanu ukakhala kuti ukugunda mopanda nzeru, kodi piritsi ili (Disopyramide) limathandiza bwanji kuchepetsa kugunda kwa mtima wanu?
Kuti mtima ugwire ntchito yamagetsi ndikugunda mwachangu, tinthu ta 'sodium' tiyenera kulowa m'maselo! Piritsi ili likalowa mumtima, limatseka njira zonse za sodium (Moderate Sodium channel blocker). Kuphatikiza apo, limawonjezera ndikuchedwetsa nthawi yomwe maselo amagetsi amtima amalipiritsa ndikubwezeretsanso (Repolarization / Potassium blockade)! Ndi machitidwe onsewa, zizindikiro zonse zamagetsi zimadulidwa ndipo mtima umachepa.
💬 Kodi machenjezo otani okhudza mankhwala oletsa choleretic ndi 'machenjezo a bokosi lakuda' omwe anthu omwe akumwa mankhwalawa (Norpace) ayenera kudziwa ndi ati?
Vuto lalikulu ndi izi ndikuti zimaumitsa madzi otuluka m'thupi lonse (Severe Anticholinergic effect)! Chifukwa chake, lilime/pakamwa pamakhala pouma komanso pamakhala povuta kugwiritsa ntchito, mkodzo umakakamira m'chikhodzodzo (Kusunga mkodzo), maso amakhala osawoneka bwino ndipo kudzimbidwa kwambiri kumachitika. Choopsa china chachikulu ndichakuti chimafooketsa kwambiri 'Negative inotropic effect' ya mtima! Chifukwa chake ngati munthu amene ali ndi vuto la mtima (Heart Failure) amwa izi, mtima ukhoza kuyima ndikufa (Proarrhythmic effect).
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