Ese amara yawe yahagaritse gukora mu buryo butunguranye? Reka twitondere iyi ndwara iteje akaga (Ogilvie Syndrome)!

Ese wigeze wumva ubyibushye cyane kandi ukumva igifu gifunze? Ni nk'aho hari ikintu cyafatiwe mu nda yawe, ariko si ko biri. Iyo ni yo ndwara idasanzwe kandi ishobora guteza akaga tugiye kuvugaho uyu munsi. Yitwa Ogilvie Syndrome. Reka turebe icyo ari cyo, impamvu ibaho, uko wayimenya, n'uko wayivura.

Indwara ya Ogilvie ni iki?

Muri make, Ogilvie Syndrome ni igihe amara yawe ahagarika gukora mu buryo butunguranye nta mpamvu igaragara. Abaganga banayita ACPO (acute colonic pseudo-obstruction) . "Pseudo-obstruction" bivuze ko amara yawe akora nk'aho yafunzwe n'ikintu runaka, ariko mu by'ukuri , nta kintu na kimwe kiba cyafunzwe ku buryo bufatika . Ikibazo kiri mu buryo bugenzura ingendo z'amara. Ni ukuvuga ko ahagarika gusunika ibiryo n'ibinyobwa imbere mu mara. Hanyuma, ibintu nk'ibiribwa n'umwuka byirundanya mu mara, bigatuma inkuta z'amara ziyongera, cyangwa zibyimba. Tekereza nk'umuvuduko w'imodoka, aho imodoka zihagarara kugenda n'umuhanda ugafungwa.

Ni gute indwara ya Ogilvie itandukaniye n'izindi ndwara z'amara ziterwa n'ingufu?

Indwara ya Ogilvy ni indwara ikabije . Ibi bivuze ko ihita ibaho mu buryo butunguranye kandi ikaba iy'igihe gito. Igira ingaruka ku mara gusa . "Guhagarika amara" ni ijambo rusange. Rivuga imikorere mibi iyo ari yo yose ibaho nta mbogamizi mu mara. Hari abantu bagira imikorere idakira y'amara, rimwe na rimwe bitewe n'indi ndwara y'igihe kirekire cyangwa indwara bavukanye.

Ni irihe tandukaniro riri hagati ya Ogilvie Syndrome na Paralytic Ileus?

Ileus y'ubumuga nayo ni indwara ifata amara cyane. Ariko, ikunze kwibasira amara mato n'amanini. Iyi ndwara ikunze kugaragara cyane nyuma yo kubagwa mu nda . Ibi bibaho iyo amara atangiye gukora buhoro nyuma yo kubagwa. Akenshi ihita yiyahura ubwayo mu minsi mike.

Ariko, indwara ya Ogilvy yibasira cyane cyane amara yawe, ndetse akenshi n'igice cy'amara yawe cyitwa cecum , aho itangirira. Ntabwo ikunze kugaragara nk'indwara ya paralytic ileus, kandi ishobora kugorana gato.

Ni nde ushobora kurwara indwara ya Ogilvie Syndrome cyane?

Nubwo ibi bishobora kubaho kuri buri wese, bikunze kugaragara ku bantu bakuze ndetse n'abafite ibindi bibazo by'ubuzima birenze kimwe.Tekereza ku muntu wabazwe cyane, wagize impanuka, ufite indwara y'umutima, cyangwa wanduye indwara zikomeye. Ibi bintu bishobora gutera indwara ya Ogilvy. Nanone, imikorere mibi ya electrolyte , indwara z'imitsi , no gufata imiti myinshi icyarimwe ni ibintu bishobora gutera ibyago. Ibi byose bigira ingaruka ku mitsi yacu. Iyo mitsi ni yo ibwira imitsi yo mu mara yacu manini gusunika ibiryo imbere.

Ibi ni ibisanzwe gute?

Bivugwa ko indwara ya Ogilvy igaragara ku muntu umwe mu 1000 bakirwa mu bitaro. Impuzandengo y'imyaka y'abayirwaye ni hafi imyaka 60.

Ni ibihe bimenyetso bya Ogilvie Syndrome?

Iyo ibiryo n'umwuka bitaragera mu mara bitangiye kwirundanya mu mara manini, ushobora guhura n'ibintu nk'ibi:

• Kubyimba inda: Kumva igifu kibyimba kandi kikarushaho kwiyongera.
• Ububabare bwo mu nda: Ububabare bukomeye bwo mu nda bushobora kubaho.
• Kubura ubushake bwo kurya: Kubura ubushake ubwo aribwo bwose bwo kurya.
• Kugira isesemi no kuruka: Kumva urwaye no kuruka.
• Kubyimba no kuzura umwuka: Kumva ufite ibyo kurya byinshi mu nda.
• Kurya impatwe cyangwa impiswi: Hari abantu bashobora kugira impatwe, abandi bakarwara impiswi.

Tekereza Marume Nimal, afite imyaka 65, arwaye diyabete, n'indwara y'umutima. Yakorewe operasiyo yo gusimbuza ikibuno. Nyuma y'iminsi ibiri cyangwa itatu, igifu cye cyahise cyuzura, atangira guhumeka nabi. Igihe yagikoragaho, cyari gikomeye nk'ibuye. Yavuze ko nta bushake bwo kurya yari afite, ndetse akagira n'iseseme. Ni bwo abaganga bamusuzumye bamenye ko ari indwara ya Ogilvy.

Ni iki gitera indwara ya Ogilvie?

Impamvu nyayo ntirasobanuka neza. Ariko abahanga mu bya siyansi bemeza ko biterwa n'imikorere mibi mu mitsi yacu. Iyi mitsi ikora ku mubiri ni igice cy'umubiri wacu kigenzura imitsi tutazi. Igenzura kandi imigendere y'umuraba (peristalsis) isunika ibiryo mu mara yacu. Kubera ko iyi ari indwara ikomeye, iterwa n'umuvuduko udasanzwe ku mitsi ikora ku mubiri. Ariko, hari n'ibindi bintu by'ubuzima bishobora kuyitera.

Hari indwara nyinshi zikomeye zishobora gutera indwara ya Ogilvy:

• Indwara y'umutima
• Kunanirwa k'umutima (kunanirwa kw'imitsi y'umutima bitewe n'indwara z'umutima)
• Gukomereka mu buryo bw'ihungabana
• Indwara zikomeye (urugero: umusonga cyangwa sepsis)
• Kubagwa inda mu buryo bugaragara
• Kubagwa umutima mu buryo bufunguye
• Kubagwa kw'amagufwa (urugero nko gusimbuza ikibuno)
• Kubyara kwa muganga / Kubagwa kwa C-bection

Ibintu by’ubuzima bisanzwe bishobora gutera indwara ya Ogilvy:

• Kunanirwa kw'impyiko
• Kunanirwa guhumeka
• Indwara z'imitsi
• Indwara z'umutima n'imitsi
• Kanseri
• Indwara za metabolike
• Ubusumbane bwa electrolyte
• Imyaka igeze mu zabukuru
• Kugira intege nke z'umubiri
• Gufata imiti myinshi icyarimwe

Imiti imwe n'imwe ifitanye isano na Ogilvy syndrome:

• Imiti igabanya ubukana bw'indwara zo mu mutwe
• Amphetamine
• Corticosteroids
• Opioid (imiti igabanya ububabare)
• Imiti igabanya ubudahangarwa bw'umubiri
• Anesthesia yo mu mugongo

Ni izihe ngorane zishobora guterwa na Ogilvie Syndrome?

Akenshi, indwara ya Ogilvy irakira ubwayo cyangwa ifashijwe n'ubufasha. Ariko, hari igihe iba ikenewe kugira icyo ikora . Iyo itaramenyekana igihe kirekire, ishobora gutera ingorane zikomeye iyo indwara irushijeho gukomera. Ubushakashatsi bwerekana ko ingorane zishobora kubaho iyo amara manini yagutse (arenga santimetero 12). Ubugari busanzwe bw'amara ni santimetero 8.

Uko amara agenda arushaho kwaguka, ni ko ibyago biba byinshi. Ingaruka zishobora kubaho:

• Ischema: Gukanda cyane ku nkuta z'amara bishobora gutuma amaraso ahagarara . Ibi bishobora gutera ububyimbirwe bukomeye, bwitwa ischemic colitis . Iyo bitavuwe, gupfa kw'imitsi (necrosis) bishobora kubaho. Tekereza nko gukanda umuyoboro w'amazi cyane ku buryo amazi ahagarara gutemba.
• Gutobora: Uduce tw’imitsi ishobora gucika cyangwa gucika byoroshye . Iyo igifu kibonye imyobo, uburozi na bagiteri bishobora gukwirakwira mu nda, bigatera indwara ikomeye yitwa peritonitis .
• Sepsis: Peritonitis ishobora gukwirakwira mu maraso byoroshye (septicemia) . Ibi ni ibintu byihutirwa! Sepsis ni igihe ubwandu bukwirakwira mu mubiri wose kandiIndwara yitwa septic shock ishobora kubaho, ishobora gutuma ingingo nyinshi zinanirwa gukora neza.

Izi ngorane zirakomeye cyane, niyo mpamvu ari ngombwa gushaka inama kwa muganga ukimara kubona ibimenyetso bya Ogilvy syndrome.

Indwara ya Ogilvie ipimwa ite?

Isuzuma rishingiye kuri ibi bintu:

• Ibipimo bya radiyo byemeza ko amara maremare yagutse kandi ko nta mara afunganye.
• Ibizamini byihariye kugira ngo harebwe izindi ndwara zishobora gutera indwara yawe.

Ni ubuhe bwoko bw'ibizamini bya radiyo bishobora gusuzuma ibi?

Kugira ngo abaganga barebe neza imbere mu mara yawe, bakoresha uburyo bwitwa internal contrast agent hamwe na radiology. Ubu buryo bwo gutandukanya ibintu butwikiriwe imbere mu mara yawe kandi bugaragara neza ku mashusho ya X-ray. Ubu buryo bwo gutandukanya ibintu bushobora guhabwa ngo unywe, nk'imashini yo gupima, cyangwa nk'amazi ashyirwa mu mitsi (IV). Uburyo bwo gupima CT scan na contrast fluoroscopy ni bwo buryo bubiri bukoreshwa kuri ibi.

Hari ikizamini cyitwa gastrografin enema , rimwe na rimwe gishobora gukoreshwa nk'ubuvuzi. Ibi bikubiyemo gushyiramo umuti ushonga mu mara unyuze mu nda yawe, hanyuma ugafata X-rays za fluoroscopic. (Fluoroscopy ni nk'ishusho ya X-ray ishobora kureba uko umuti ugenda.) Nk'ingaruka mbi, gastrografin ishobora no gukora nk'umuti woroshya amara, igafasha amara yawe kongera kwimuka.

Indwara ya Ogilvie ivurwa ite?

Ubuvuzi buterwa n'uburyo amara yawe yagutse ndetse niba ufite ibyago byo kugira ingorane. Igihe cyose bishoboka, abaganga bagerageza kuyavura bakurikije uburyo bwo kuyavura kandi bakayikurikiranira hafi . Ibyo bivuze gufasha umubiri gukira wonyine nta ngaruka nyinshi. Ariko iyo bibaye ngombwa, bakoresha imiti cyangwa uburyo bwo kugabanya imbaraga z'amara no kugabanya ibyago byo kugira ingorane. Iyo habayeho ingorane, bakeneye ubuvuzi bwihutirwa.

Uburyo bwo kuvura indwara zishingiye ku mitekerereze bushobora kuba burimo:

• Kuvura indwara zishingiye ku ngingo zitera iyi ndwara.
• Guhagarika imiti bishobora gutera iyi ndwara.
• Kuruhuka mu mara: Kugabanya umuvuduko w'amaraso binyuze mu kutarya mu kanwa.
• Ibinyobwa biva mu mitsi (ibinyobwa biva mu mitsi):Kubungabunga amazi no gukosora ihindagurika ry’amashanyarazi binyuze mu gushyira ibintu nk'umunyu mu mitsi.
• Shishikariza kwituma mu nda ugendagenda cyangwa uhindura imiterere.
• Umuyoboro wa Nasogastric: Gukuramo umwuka n'amazi menshi mu nda.
• Umuyoboro w'inyuma: Catheter ishyirwa mu nda y'inyuma kugira ngo ikuremo umwuka n'amazi hakoreshejwe imbaraga z'isi.
• Gukurikirana ikibazo binyuze mu gupima no gupima amaraso buri gihe.

Ibi bikunze kugaragara mu minsi ibiri cyangwa itatu (hafi amasaha 72). Ariko, iyo amara yamaze kwaguka birenga santimetero 12, cyangwa niba nta terambere ryabayeho nyuma y’ubu buryo bwo kuvura, muganga ashobora gufata icyemezo cyo kugabanya umuvuduko ku mara.

Ibikorwa birimo:

• Gukuraho colonoscopy: Colonoscopy ni uburyo bwo gusuzuma no kuvura. Bukubiyemo gushyira kamera nto ku mpera y'umuyoboro muremure witwa colonoscope mu mara manini unyuze mu kibuno. Intego ya colonoscopy ni ugukura umwuka urenze mu mara manini unyuze mu muyoboro hanyuma ugatanga enema unyuze mu muyoboro. Ubu buryo bushobora kugabanya kuziba kw'impimbano mu gihe imiti yananiwe cyangwa idafite umutekano kuri wewe. Ariko, abaganga babukoresha bitonze kuko bigoye gukora kandi bufite ibyago bike byo kugira ingorane. Hari igihe colonoscopy ishobora gutera umwobo mu mara (gutobora amara).
• Urushinge rwa Neostigmine: Uyu muti utangwa binyuze mu muyoboro wa IV. Ni umuti utera imitsi imbaraga. Akenshi ukoreshwa mu gufasha imitsi kuruhuka nyuma yo gusinziriza. Byagaragaye ko bigira akamaro mu "gukangura" imitsi yo mu mara no kongera gutangira peristalsis ku bantu barwaye Ogilvy syndrome. Ariko, kubera ko ari umuti ukomeye cyane , utangwa gusa ukurikiranwe neza mu cyumba cy’indembe (ICU) . Abaganga bazakurikirana umutima wawe kugira ngo barebe ko umuvuduko w’umutima wawe udatinda cyane mu gihe urimo guhabwa neostigmine.
• Gukubaga inda nini / Colostomy: Niba inda nini ikomeza kwaguka nubwo hari ubwo buryo bwo kuyivura, cyangwa niba habayeho ingorane nko gutobora cyangwa gucikamo ibice, ushobora gukenera kubagwa kugira ngo ukureho igice cy'inda nini cyangiritse . Ubu ni uburyo bwa nyuma . Iyo ubaye ikubanyi, ushobora kubagwa inda nini by'agateganyo cyangwa burundu.Bishobora kandi kuba ngombwa kubikora. Ni ukuvuga gushyiraho umwenge utandukanye wo kunyuramo umwijima. Hari igihe, colostomy ishobora gusubizwa inyuma nyuma yo kubagwa.

Ese indwara ya Ogilvie ishobora kwica?

Yego, ingorane zishobora kwica . Iyo habayeho ingorane nko gutobora cyangwa ischemia, igipimo cy'impfu gishobora kugera kuri 40%. Ariko, izi ngorane ziba munsi ya 15% by'abantu. Iyo hatabayeho ingorane, igipimo cy'impfu za Ogilvy syndrome kiri hafi ya 15%. Iyi mibare ishobora kuba idahagarariye Ogilvy syndrome yonyine. Kubera ko abantu benshi barwara Ogilvy syndrome bafite izindi ndwara zigira ingaruka ku rupfu rwabo.

Guhagarika acute colonic pseudo-obstruction ni ikintu gitunguranye gishobora kuzana ingorane nshya ku bantu basanzwe bahanganye n'izindi ndwara. Nta muntu witeze Ogilvy syndrome, ariko buri wese agomba kumenya ibimenyetso . Kumenya hakiri kare ni ingenzi mu kwirinda ingorane zikomeye za Ogilvy syndrome. Iyo nta ngorane zibayeho, birashoboka ko umuntu akira iyo avuwe mu buryo burambye.

Ibintu by'ingenzi tugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Rero, Ogilvie Syndrome ni indwara ishobora kuba ikomeye kurusha uko ubitekereza. Ariko nta kintu na kimwe cyo guhangayikishwa nacyo, kandi kumenya neza bishobora gukumira ibibazo byinshi.

• Isuzuma: Niba ugize ibimenyetso nko kubyimba mu buryo butunguranye, kubabara mu gifu cyane, kubura ubushake bwo kurya, kugira isesemi, cyangwa kuruka, menya neza ko wagiye kwa muganga, cyane cyane niba ugeze mu zabukuru, ufite izindi ndwara, cyangwa uherutse kubagwa.
• Impamvu: Ibi bishobora guterwa n'indi ndwara, kubagwa, cyangwa imiti. Rero ni ngombwa kubwira muganga wawe amateka yawe yose y'ubuzima.
• Ingorane: Iyo idavuwe vuba, amaraso agabanuka ajya mu mara ashobora gutuma ingingo zipfa, amara akoroha, ndetse n'indwara zikomeye. Ibi bishobora gushyira ubuzima mu kaga.
• Uburyo bwo kuvura: Indwara nyinshi zikemuka hakoreshejwe ubuvuzi bw’inyongera, ariko rimwe na rimwe hashobora kuba ngombwa ko ufata imiti igabanya umuvuduko w’amaraso, imiti cyangwa se kubagwa kugira ngo ugabanye umuvuduko w’amaraso.
• Kumenya ibimenyetso hakiri kare birakiza ubuzima: Ntukirengagize ibi bimenyetso kubera impamvu iyo ari yo yose. Icy'ingenzi ni ukubimenya hakiri kare no gutangira kuvurwa.

Niba wowe cyangwa undi muntu uzi afite kimwe muri ibi bimenyetso, ntutindiganye gushaka inama kwa muganga. Komeza ugire ubuzima bwiza!

Indwara ya Ogilvie , kubyimba kw'igifu mu buryo bw'agahinda gakomeye, kugabanya umura, kudakora neza kw'amara, kubyimba inda, kubabara mu gifu, kugabanya umura mu buryo bw'agahinda gakomeye