Dumbu rako rinonzwa sekunge riri kuchinja kuita dombo here? Ngatidzidzei nezvechirwere ichi chisingawanzoitiki (Ogilvie Syndrome)

Wakambonzwa here sekuti chimwe chinhu chakabatwa mudumbu mako, dumbu rako richikura, uye wainzwa sekuti chaizoputika? Zvaiita sekuti ura hwako hwakavharwa zvachose. Kazhinji, izvozvo zvinoitika kana chimwe chinhu chakavharwa muura hwako. Zvisinei, pane chirwere chinoshamisa uye chisingawanzoitiki apo ura hwako hunomira kushanda pasina chinhu chakabatwa mukati. Nhasi, tichataura nezvechirwere icho vanhu vazhinji vasati vambonzwa nezvacho. Mukurapa, tinodana ichi kuti Ogilvie Syndrome kana kuti Acute Colonic Pseudo-obstruction (ACPO) .

Zvichitaurwa zviri nyore, chii chinonzi Ogilvie Syndrome?

Fungidzira, kune motokari dzakawanda, asi hapana tsaona kana zvipingamupinyi mumugwagwa. Mota dziri kungomira. Ogilvie Syndrome chinhu chakadaro. Kufamba kwechikafu nemarara mukati memudumbu mako kunomira kamwe kamwe. Zvinonzwa sekunge pane chinhu chakabatwa mudumbu mako, asi hapana kuvharika kwemuviri. Dambudziko riri mutsinga dzinodzora tsandanyama dziri mudumbu mako. Nekuti hazvishande nemazvo, kufamba kwedumbu (tinodaidza kuti ``peristalsis``) kunomira, uye zviri mukati zvinomira panzvimbo imwe chete. Izvi zvinoita kuti dumbu riwedzere zvishoma nezvishoma, kana kuzvimba.

Izwi rekuti "pseudo-obstruction" muzita raro rinoreva "false obstruction." Izvi zvinoreva kuti rinoratidza zviratidzo sekunge pane dambudzo, kunyangwe pasina dambudzo.

Izvi zvakasiyana sei nezvimwe zvinetso zvemudumbu?

Kune zvirwere zvakasiyana-siyana zvinokanganisa mashandiro emudumbu. Saka ngationei kuti Ogilvie Syndrome yakasiyana sei nazvo.

• Zvichienzaniswa nezvimwe zvirwere zve "Intestinal Pseudo-obstruction": Ogilvie Syndrome chirwere che "acute". Kureva kuti, chinouya kamwe kamwe, uye ndechenguva pfupi . Uye chinongobata ura hukuru chete . Zvisinei, vamwe vanhu vanogona kuva nemamiriro ezvinhu e "chronic" `pseudo-obstruction'. Anowanzo kukonzerwa nechimwe chirwere chisingaperi kana chirwere chekuzvarwa nacho.
• Musiyano ne `Paralytic Ileus`: Ungave wakambonzwa izwi rekuti `Paralytic Ileus`. Rinoshandiswa kutsanangura mamiriro ezvinhu apo ura hunomira kushanda kwenguva yakati, kunyanya mushure mekuvhiyiwa kwedumbu. Izvi zvinowanzoitika. Zvinobatanidza ura hudiki nehukuru hunomira kushanda kwenguva pfupi uye hwozopora hwega mukati memazuva mashoma. Zvisinei, Ogilvie Syndrome chirwere chakaoma uye chisingawanzoitiki . Chinonyanya kukanganisa ura hukuru , kunyanya cecum.

Ndiani ari panjodzi huru yekuva nechirwere ichi?

Kunyangwe ichigona kuitika kune chero munhu, inonyanya kuitika kune vakwegura vane makore anopfuura makumi matanhatu vane mamwe matambudziko ehutano.Dambudziko iri rinoonekwa mumurwere mumwe chete pavarwere chiuru vanosvika 1,000 vari muchipatara.

Zvichitaurwa zviri nyore, izvi zvinogona kuitika chero nguva muviri paunenge uri pasi pekushushikana kwakanyanya. Funga nezvekuvhiyiwa kukuru, tsaona yakakura, kurwara nemoyo, kana hutachiona hwakanyanya. Zvinhu izvi zvinokanganisa mashandiro etsinga dzedu. Tsinga iyi ndiyo inoudza tsandanyama dziri muura kuti "dzifambe." Saka kana paine kusawirirana ipapo, ura hunomira kushanda uye Ogilvie Syndrome inogona kuitika.

Ndezvipi zviratidzo zveOgilvie Syndrome?

Kana mweya, mvura, uye chikafu chisina kumedzwa zvikavharirwa muura hwako, unogona kuona zviratidzo zvakaita seizvi. Izvi zvinogona kutanga kamwe kamwe uye zvishoma nezvishoma zvichiwedzera.

Sei izvi zvichiitika? Ngatinyatsoongorora zvikonzero zvacho.

Kunyangwe chikonzero chaicho cheizvi chisati chanyatsojeka, masayendisiti anotenda kuti zvinokonzerwa nekusashanda zvakanaka kwehurongwa hwedu hwetsinga dzinozvitonga . Funga nezvazvo, zvinhu zvinoitika zvoga mumuviri wedu, zvakaita sekurova kwemoyo, kufema, uye kugaya, zvinodzorwa nehurongwa uhwu hwetsinga, hunoshanda se "auto-pilot." Saka, nekuda kwekunetseka kwakanyanya pamuviri, hurongwa uhwu hwe "auto-pilot" hunogona kusashanda zvakanaka, uye zviratidzo zvinodzora kufamba kwedumbu zvinogona kukanganiswa.

Zvikonzero zvikuru zvinokonzera izvi zvinogona kukamurwa kuita zvikamu zvakasiyana-siyana.

Izvi zvingave zvakakomba here? Ndezvipi zvinetso zviri kuitika?

Ehe, kana izvi zvikasaongororwa uye zvikarapwa nemazvo, zvinogona kukonzera matambudziko akakomba uye anotoisa hupenyu pangozi . Fungidzira, chii chinoitika kana ukaramba uchifemera mweya mubharumu? Unoputika. Matumbu akafanana.

Upamhi hweura hwemukati hunosvika masendimita masere. Zvisinei, muOgilvie Syndrome, kana ikawedzera kupfuura masendimita gumi nemaviri, njodzi yekusangana nematambudziko yakakura zvikuru.

Matambudziko makuru anogona kuitika ndeaya:

• Ischemia: Kutambanudzwa kwakanyanya kwemadziro emudumbu kunoita kuti tsinga dzeropa dzakapfava dzinopa ropa dziome, zvichiita kuti ropa ridzikire . Izvi zvinokonzera kuzvimba kwemudumbu (ischemic colitis), izvo, kana zvikasarapwa, zvinogona kukonzera kufa kwenyama (necrosis).
• Kuboorwa: Kana nyama yafa, madziro eura anoshaya simba uye buri diki rinogona kuumbwa . Izvi zvine njodzi nekuti utachiona nezvinhu zvakaraswa kubva muura zvinogona kudonhera mudumbu, zvichikonzera hutachiona hwakakomba (peritonitis).
• Sepsis: Utachiona hwakapararira mudumbu hahugumiri ipapo. Hunogona kupinda muropa hukapararira mumuviri wese.Ichi chirwere chinoisa upenyu panjodzi chinoda kurapwa nekukurumidza. Chinogona kutokonzera kutadza kushanda kwenhengo dzemuviri, chimwe nechimwe.

Nzira yekuziva chirwere ichi nemazvo sei?

Vanachiremba vanonyanya kunetseka nezvinhu zviviri pavanoongorora chirwere ichi.

1. Kutanga, tinoongorora kana paine kuvharika kwemuviri muura.

2. Kana pasina chipingamupinyi chakadaro, zvinoonekwa kana chikonzero chezviratidzo izvi chiri Ogilvie Syndrome kana chimwewo chinhu.

Miedzo yakasiyana-siyana iri kuitwa pakuita izvi.

• X-rays neCT scans: X-ray yemudumbu kana CT scan inogona kuratidza zviri pachena ura hukuru, hwakazvimba uye hwakazara nemhepo. Dzimwe nguva, mvura yakakosha ('contrast agent') inopihwa kuti inwe kana kuti ibayiwe jekiseni kuti mifananidzo inyatsojeka.
• Gastrografin Enema: Iyi bvunzo yakakosha zvikuru. Nekuti bvunzo uye dzimwe nguva kurapwa. Pano, mvura inonyungudika mumvura inonzi `gastrografin` inopinzwa muura kuburikidza nerectum, uye kufamba kwayo muura kunotariswa nevhidhiyo X-ray `(fluoroscopy)`. Izvi zvinogona kuona nemazvo kana paine kuvharika muura kana kwete. Zvakare, mvura iyi ye`gastrografin` ine hunhu hwekusvuta. Saka, dzimwe nguva kushanda kwayo kunobatsira kutangazve basa remudumbu ramira.

Ndezvipi zvinorapwa izvi?

Kurapwa kunoenderana nekuti ura hwako hwakazvimba zvakadii uye kana uri panjodzi yekusangana nematambudziko. Kana zvichibvira, vanachiremba vanoedza kurapa nekurapwa kuri nyore ('kurapa kunochengetedza') pane kushandisa zvinhu zvakaita sekuvhiyiwa.

Kurapa Kwekuchengetedza

Pakutanga, kurapwa uku kunoitwa vachinyatsoongorora mamiriro emurwere.

• Kurapa zvirwere zviri pasi pechirwere: Kana paine chirwere chiri pasi pechirwere, chakadai sehutachiona kana chirwere chemwoyo, chinotanga charapwa.
• Kurega kushandisa mishonga: Mishonga inofungidzirwa kuti ndiyo inokonzera Ogilvie Syndrome inomiswa kwenguva pfupi.
• Kuzorodza ura: Kurega zvachose kudya nekumwa.
• Munyu wemutsinga: Huwandu hwemvura nemunyu zvinodiwa mumuviri zvinopihwa kuburikidza netsinga (IV fluids).
• Kufamba nekuchinja nzvimbo: Kana zvichibvira, kurudzira murwere kuti afambe-fambe zvishoma uye achinje nzvimbo pamubhedha. Izvi zvinogona kukurudzira kufamba kwetsvina.
• Kupinza: Chubhu (`Nasogastric tube`) inopinzwa nemhino mudumbu kubvisa mweya wakawandisa nemvura. Chubhu (`Rectal tube`) inopinzwawo nepamusana pehuro kuti mweya ubude.

Munguva yekurapwa uku, vanachiremba vanogara vachiita X-rays uye bvunzo dzeropa kuti vaone mamiriro eura pamwe nematambudziko ese aripo.

Ko kana kurapwa kunotsigira kukasabudirira?

Kana mamiriro acho akasavandudzika mushure memaawa angangoita makumi manomwe nemaviri, kana kuti ura hwakakura kupfuura masendimita gumi nemaviri, vanachiremba vanoenderera mberi nedanho rinotevera.

• Kubviswa kweColonoscopic Decompression: Muizvi, chubhu ine kamera yakabatana ('colonoscope') inopinzwa kuburikidza neanus uye mweya wakaungana muura unodhonzwa kuburikidza nechubhu. Izvi zvinoderedza kumanikidzwa muura. Zvisinei, sezvo iyi iri nzira isingafadzi uye dzimwe nguva paine njodzi diki yekuboorwa kweura, inoitwa nekungwarira kukuru.
• Jekiseni reNeostigmine: Iri ijekiseni rine simba guru rekusimbisa tsandanyama. Rinowanzo shandiswa kubatsira tsandanyama kupora mushure mekunzwa kurwadza. Kana mushonga uyu ukapinzwa mutsinga (IV) kuvanhu vane Ogilvie Syndrome, tsandanyama dzemudumbu dzinotanga kushanda zvakare, uye mhedzisiro yakanaka yakawanikwa. Zvisinei, nekuti mushonga uyu unogona kukonzera kurova kwemoyo kunonoka, unongopihwa chete pasi pekutarisirwa kwachiremba ari muchikamu chevarwere vakanyanya (ICU) .
• Kuvhiyiwa (Colectomy / Colostomy): Kana, pasinei nekurapwa uku kwese, ura hukaramba huchizvimba, kana kana paine dambudziko rakakura rakadai sekuboorwa, kuvhiyiwa kungave ndiyo nzira yekupedzisira. Panyaya iyi, chikamu chakakuvara cheura chinochekwa chobviswa (Colectomy). Dzimwe nguva, panofanira kuitwa buri rechinguvana kana renguva dzose mudumbu kuti tsvina ipfuure nepairi. Tinoti izvi iColostomy.

Dambudziko iri rinogona kuisa upenyu panjodzi here?

Pasina matambudziko, njodzi yekufa kwemunhu ane Ogilvie Syndrome chete inenge 15%. Zvisinei, chikamu ichi chinosanganisirawo migumisiro yezvimwe zvirwere zvine murwere.

Zvisinei, kana paine dambudziko guru rakadai sekuboorwa kwemudumbu, huwandu hwerufu hunosvika 40%. Izvi zvinoratidza kuti dambudziko iri rinogona kunge rakakomba sei.

Chinhu chinonyanya kukosha ndechekuteerera zviratidzo nekukurumidza pazvinoonekwa, kuongorora chirwere nekukurumidza, uye kutanga kurapwa. Kana ukadaro, unogona kudzivirira matambudziko akakomba uye kupora nekukurumidza nekurapwa kuri nyore.