Utumbu hwako hwakazvimba seizvi here? Ngatidzidzei nezvePseudomembranous Colitis!

Une kurwadziwa kwakanyanya mudumbu uye manyoka kakawanda pazuva here? Pamwe unonzwawo kuda kurutsa pamwe chete nefivha? Zvikuru sei, zviratidzo izvi zvakaonekwa here mushure mekunge watora mishonga inorwisa mabhakitiriya nekuda kwechimwe chirwere? Kana zvakadaro, ichi chinhu chingave chakakosha kwauri. Nhasi tichataura nezvechirwere chinonzi 'Pseudomembranous Colitis'. Usazvidya moyo, kana ukaziviswa zvakanaka nezveizvi, unogona kurapwa wopora nekukurumidza.

Chii chinonzi Pseudomembranous Colitis?

Zvichitaurwa zviri nyore, 'Pseudomembranous Colitis' chirwere chakakomba chekuzvimba chinoitika muura hwedu hukuru, kana muura. Muizvi, nekuda kwechimwe chikonzero (chinogona kunge chiri mabhakitiriya, chepfu, kana chimwe chirwere), madziro emukati meura hwako hukuru, kana mucous membrane ('mucosa'), anokuvara. Kukuvara uku kunokonzera ma plaque eyero-chena, gobvu, uye akakora kuti aumbe munzvimbo dzakakuvara. Vanachiremba vanodana aya kuti 'pseudomembrane'.

Chii chinonzi 'pseudomembranes'?

Ma "pseudomembranes" ndiwo maumbirwo emasero ari muura hukuru, akadai se "liner" yeura hukuru, paanofa. Funga nezvazvo nenzira iyi: kana paine kukuvara, masoja edu ekudzivirira muviri anotumira masero machena eropa panzvimbo yacho. Saizvozvowo, pano zvakare, zvidimbu zvemasero akafa zvinosangana nemasero machena eropa (kunyanya ma "neutrophils") kuti zvigadzire ma "pseudomembranes". Aya ane upamhi hwemasendimita maviri, machena-yero, uye akasimudzwa zvishoma pamusoro.

Ndezvipi zviratidzo zvechirwere ichi?

Munhu ane pseudomembranous colitis anogona kuona zviratidzo zvakaita se:

• Kurwadziwa kwakanyanya mudumbu.
• Manyoka. Izvi zvinogona kuitika kakawanda pazuva, dzimwe nguva semvura.
• Kupindwa nechando.
• Kusvotwa.
• Dzimwe nguva, unogona kuona ropa kana hurwa zvichibuda mutsvina yako, asi izvi hazviitiki kune wese munhu.

Chii chinokonzera Pseudomembranous Colitis?

Chikonzero chikuru uye chinonyanya kukonzera izvi hutachiona hwebhakitiriya rinonzi `C. diff` (Clostridioides difficile). Chepfu dzinogadzirwa nebhakitiriya iri dzinokanganisa jira reura guru. Inenge 10% yehutachiona hwe`C. diff` inogona kukura kusvika pachirwere chakakomba chinonzi `pseudomembranous colitis.` Kutaura zvazviri, 90% yezviitiko izvi zvinokonzerwa nebhakitiriya rinonzi `C. diff`. Zvisinei, mamwe matambudziko ekuzvimba kwedumbu anogonawo kukonzera rudzi urwu rwekukuvara.

Mabhakitiriya eC. difficile anokanganisa sei izvi?

Bakiteria inonzi C. difficile inoburitsa chepfu inoparadza masero ari muura hwedu hukuru. Utachiona uhwu hunogona kupararira nekukurumidza uye zvakanyanya kupfuura zvaungafunga.

Kazhinji, unowana chirwere cheC. diff nekuti une chimwe chirwere.Mushure mekushandisa mishonga inorwisa mabhakitiriya. Funga nezvazvo, kana ukatora mishonga inorwisa mabhakitiriya, mamwe mabhakitiriya "akanaka" ari mudumbu mako anotibatsira kufa. Zvisinei, mishonga inorwisa mabhakitiriya mazhinji haagone kuuraya iyi bacteria ye 'C. diff'. Saka, kana mabhakitiriya akanaka iwayo apera, bhakitiriya ye 'C. diff' ine mukana wekukura nekupararira isingadzoreki, zvichikonzera matambudziko aya pasina makwikwi.

Ndeapi maantibiotic anonyanya kushanda kana munhu arwara nechirwere ichi?

Kutaura zvazviri, chero mushonga unouraya mabhakitiriya akanaka mudumbu medu uye usingakanganisi mabhakitiriya eC. diff unogona kukonzera hutachiona hweC. diff uye chirwere chepseudomembranous colitis chinozobuda. Zvisinei, mamwe maantibiotic anofungidzirwa kuti ane njodzi huru. Mamwe acho ndeaya:

• Clindamycin
• Mishonga yerudzi rweCephalosporin
• boka remishonga yepenicillin
• Fluoroquinolones
• Aztreonam
• Carbapenems

Zvakakosha: Izvi hazvirevi kuti mishonga iyi inorwisa mabhakitiriya yakaipa. Kana chiremba akainyorera, inofanira kushandiswa sezvinodiwa. Zvisinei, kushandisa mishonga inorwisa mabhakitiriya zvisina kufanira kunogona kukonzera njodzi dzakadai.

Pane zvimwe zvikonzero here?

Pseudomembranous colitis inogonawo kuitika kana kuzvimba kweura kunokonzerwa nezvimwe zvikonzero, kunze kweC. diff. Heano mimwe mienzaniso:

• Utachiona hweStaphylococcus aureus
• Utachiona hweE. coli `(Utachiona hweE. coli)`
• Utachiona hweCytomegalovirus
• Microscopic colitis
• Chirwere chaBehçet
• Ischemic colitis (kuzvimba kunokonzerwa nekushomeka kweropa rinoenda muura)
• Mishonga yekurapa kenza `(Mishonga yeChemotherapy)`
• Kushandisa cocaine
• Vasculitis (kuzvimba kwetsinga dzeropa)
• Chepfu yesimbi yakawandisa

Muzviitiko zvakadaro, chirwere ichi chakanyanya kuoma kana kuti chakaoma kupfuura chirwere checolitis chakajairika. Dzimwe nguva, kuyerera kweropa kumadziro emukati meura kunodzikira (ischemia), kufa kwenyama (necrosis) kunoitika, uye ma pseudomembranes anokura. Zvakare, zvirwere zvakagara zviripo zvakaita seInflammatory Bowel Disease (IBD) zvinogonawo kuita kuti ura huve nyore kubatwa nechirwere ichi.

Ndiani ari panjodzi huru yekuva nechirwere ichi?

Une mukana mukuru wekuwana pseudomembranous colitis kana:

• Kana uri muchipatara.
• Kana wakashandisa mishonga inorwisa mabhakitiriya nguva pfupi yadarika.
• Kana wakambovhiyiwa nguva pfupi yadarika.
• Kana mumwe munhu akagara mudzimba dzevakwegura.
• Kana une makore anopfuura makumi matanhatu nemashanu ekuberekwa.
• Kana uine chirwere che autoimmune.
• Kana masoja emuviri wako asina simba.
• Kana wakambova nechirwere cheC. diff.

Ndezvipi zvinetso zvinogona kuitika zvePseudomembranous Colitis?

Kana chirwere ichi chikanyanya kuoma uye chikaoma kudzora, mamwe matambudziko ane njodzi anogona kuitika. Saka zvakakosha kuziva izvi zvakare.

• Kushaya mvura mumuviri uye kurasikirwa nemaelectrolyte: Muchirwere chepseudomembranous colitis chakanyanya, manyoka anogona kuitika kusvika ka10-15 pazuva. Izvi zvinogona kukonzera kushaya mvura mumuviri uye kurasikirwa nemaelectrolyte. Izvi zvinogona kukonzera zvirwere zvine njodzi zvakaita sekushaya ropa, BP yakaderera, uye kutadza kushanda kweitsvo.
• Kubuda kwemvura: Mvura inogona kubuda kubva pamadziro akakuvara eura hukuru ichienda mudumbu, zvichiita kuti dumbu rizvimbe. Izvi zvinonzi ascites. Mapuroteni akadai sealbumin anogonawo kurasika kubva muura hukuru. Kana albumin yaderera, mvura inobuda mutsinga dzeropa, zvichikonzera kuzvimba mumakumbo (edema).
• Megacolon ine chepfu: Kuzvimba kwakanyanya kusingadzoreki kweura kunogona kukonzera kuti ura rizvimbe zvakanyanya uye rimire kushanda. Pakutanga, tsandanyama dziri muura dzinomira kugwinha, zvichivhara kufamba kwetsvina. Sezvo ura rinoramba richizvimba, madziro aro anogona kuputika, zvichiita kuti zviri mukati zvidonhe mudumbu. Izvi zvinonzi peritonitis. Izvi zvinogona kuisa upenyu panjodzi.
• Kuboorwa kwedumbu: Buri riri mumadziro eura guru rinogona kuitika pasina megacolon ine chepfu. Izvi zvinogona kuitika kana maronda akabuda muura guru ndokupfuura nepamadziro, kana kana paine kufa kukuru kwenyama (necrosis) mumadziro eura guru. Kana mabhakitiriya ari muura guru akadonhera mudumbu (peritonitis), anogona kupararira muropa (septicemia).
• Sepsis: Sepsis chirwere chinokonzerwa nekuungana kwemabhakitiriya muropa (septicemia). Sepsis chirwere chakakomba, chinouraya chinopararira mumuviri wese. Izvi zvinogona kukonzera septic shock, kutadza kushanda kwenhengo dzakawanda, uye kunyange kufa.

Matambudziko aya anogona kutyisa kunzwa nezvawo. Asi yeuka kuti haasi munhu wese. Kuongororwa nekukurumidza uye kurapwa kwakakodzera kunogona kudzivirira matambudziko aya akakomba.

Nzira yekuziva sei chirwere ichi?

Chiremba achatanga nekukubvunza nezvezviratidzo zvako uye nhoroondo yehutano hwako. Zvadaro, vanogona kuraira bvunzo dzakasiyana-siyana kuti vaone chikonzero chezviratidzo zvako. Semuenzaniso, vanogona kuraira kuongororwa kweropa, bvunzo dzemifananidzo dzakadai sekuskena, uye bvunzo dzetsvina. bvunzo idzi dzinotsvaga hutachiona, kuzvimba, nezvimwe zvinhu zvine njodzi.

Kuongororwa kwetsvina yako kuchanyatsoongorora hutachiona hweC. diff. Kana hukawanikwa, kurapwa kunotanga nekukasika. Kana usina matambudziko uye uri kupindura zvakanaka kurapwa, pangave pasina chikonzero chaicho chekutarisa muura hwako hukuru kuti uwane ma pseudomembranes.

Dzimwe nguva, bvunzo dzemifananidzo (dzakadai seCT scan) dzinogona kuratidza zviratidzo zve pseudomembranous colitis. Kana madziro emudumbu akakora (zvakafanana ne "thumbprint sign" kana "accordion sign"), chiremba anogona kusarudza kuita dzimwe bvunzo.

Tevere, kuti utarise zvakadzama, unofanirwa kuita bvunzo inotarisa mukati meura hukuru. Inonzi colonoscopy. Muizvi, chubhu ine kamera inoshandiswa kutarisa mukati meura hukuru. Kana ukaona chinonzi 'pseudomembrane', chidimbu chidiki chenyama (biopsy) chinotorwa kubva mairi chotumirwa kurabhoritari kuti chisimbiswe chirwere chacho.

Ndezvipi zviri kurapwa?

Kurapwa kunoenderana nechikonzero chechirwere ichi.

• Kana chiri chirwere chebhakitiriya chakaita seC. diff, unofanira kupa mishonga chaiyo inorwisa mabhakitiriya inoshanda.
• Kana chirwere ichi chikakonzerwa kana kuti chikanyanya kuipa nekuda kwemumwe mushonga wauri kutora, mushonga iwoyo ungangoda kumira kana kuchinjwa.
• Mune zvimwe zviitiko, mishonga inogona kunyorerwa kuderedza kuzvimba muura hukuru.

Vamwe vanhu vanongoda rubatsiro rwekutsigira. Semuenzaniso, mvura inopinzwa mutsinga (IV fluids) kuti ibatsire kuchengetedza mvura, kana kudya kunovaka muviri (IV nutrition) kuti ura huzorore. Vamwe vangangoda kurapwa nekuda kwezvinetso, zvichida mukamuri rinochengeterwa varwere vakawanda. Vamwe vanhu vane colitis yakanyanya kana matambudziko vangangoda kuvhiyiwa kubvisa chikamu chakakuvara cheura hudiki.

Ndeipi mishonga mikuru inopihwa kana ichikonzerwa ne `C. diff`?

Kana chikonzero che pseudomembranous colitis chiri chirwere cheC. diff, kune mishonga yakati wandei iripo yekurapa. Chiremba wako achasarudza yakakunakira. Mishonga inopiwa yechirwere cheC. diff ndeiyi:

• Metronidazole
• Vancomycin
• Fidaxomicin

Pseudomembranous Colitis inogona kudzivirirwa here?

Nzira inonyanya kukosha yekudzivirira chirwere ichi ndeyekudzora kupararira kwebhakitiriya reC. diff munharaunda dzine njodzi huru (kunyanya zvipatara nedzimba dzevakwegura). Vanhu vari munzvimbo idzi vane mukana wekutapukirwa uye vanotanga zviratidzo zvakakomba zvakaita sepseudomembranous colitis.

Nokudaro, vashandi vehutano vari mumhando idzi dzezvipatara vanotora matanho akakosha ekudzivirira hutachiona hweC. diff:

• Kuzviparadzanisa: Vanhu vane hutachiona hweC. diff vanoiswa mukamuri rakasiyana, kana mukamuri rinogovaniswa nevamwe vanhu vane hutachiona chete. Magorovhosi anoraswa anoshandiswa kana vachipinda mukamuri.
• Kugeza maoko: Kugeza maoko ako nguva nenguva nesipo nemvura inodziya ndiyo nzira yakanakisisa yekuzvidzivirira kubva kuC. diff. Utachiona uhwu hahuna mushonga wekuchenesa maoko. Zvakakosha zvikuru kugeza maoko ako usati wabata chikafu.
• Kuuraya utachiona: Mishonga yekuuraya utachiona yenguva dzose haigone kuuraya C. diff. Zvisinei, mishonga ine chlorine inogona. Zvakakosha kuuraya utachiona zvakakwana panzvimbo dzese dzakabatwa nemunhu ane hutachiona.

Chirwere ichi chinogona kurapwa zvachose here? Chiyero cherufu chakawanda sei?

Ehe, chirwere chepseudomembranous colitis chinogona kurapwa zvachose nekurapwa. Kazhinji, zviratidzo zvinopera nekukurumidza. Zvisinei, vamwe vanhu vangada kurapwa kwakawanda uye kwenguva yakareba kupfuura vamwe. Kana uine chirwere cheC. diff chinogara chiripo, chinonetsa kudzora, ungangoda kuvhiyiwa kudiki kuti chirapwe. Mune zvimwe zviitiko, kuvhiyiwa kunogona kudiwa.

Panyaya yekufa, 2% chete yevarwere vane pseudomembranous colitis vanofa. Zvisinei, kune vanhu vane kutarisirwa kwenguva refu uye masoja emuviri asina simba, chiyero ichi chinogona kusvika pa15%. Kana dambudziko rataurwa kare rinonzi megacolon rine chepfu rikaitika, huwandu hwekufa hunogona kukwira kusvika pa35%. Ndosaka kurapwa nekukurumidza kuchikosha.

Unofanira kuona chiremba rini?

Kana uine chimwe chezviratidzo izvi, tsvaga rubatsiro rwechiremba nekukasika:

• Kurwadziwa kwakanyanya mudumbu kana kuzvimba.
• Kana uine manyoka kanopfuura kashanu pazuva.
• Kana paine ropa mutsvina.
• Kana usina kubuda tsvina kwemazuva matatu.
• Kana usina kuita weti kwezuva rimwe chete, kana kuti weti yako ine ruvara rwakasviba.
• Kana uine fivha inodarika 39 degrees Celsius (102 degrees Fahrenheit) kwemazuva matatu.

Pakupedzisira, zvinhu zvekurangarira

Utachiona hwemabhakitiriya hunokonzera colitis hunowanzoitika, uye kazhinji hahuna kuipa. Havasi vese vanobatwa neC. diff vanozobatwa nepseudomembranous colitis. Zvisinei, kana ukadaro, zvinogona kutyisa zvishoma. Kuziva kuti ura hwako huri kukuvara kubva mukati kunogona kutyisa, nezviratidzo zvakaita sekurwadziwa uye kubuda ropa.

Kana ukaona zviratidzo zvakaita seizvi, ungangoda rubatsiro rwakakosha rwechiremba. Asi yeuka, kana ukarapwa zvakanaka, ura hwako hwemukati hunogona kupora.Matumbu, sezvakaita jira remuura wedu, anopora zvakanaka kana asina kukuvara. Kana uchinzwa sekuti zviratidzo zvechirwere checolitis hazvisi kupera, taura nachiremba. Iye anogona kukubatsira kuwana chikonzero chechirwere chako, kuita zvinodiwa kuti chimiswe, uye kupa dumbu rako zvese zvarinoda. Chinhu chakakosha kusatya uye kutsvaga mazano echiremba nekukurumidza.

` Pseudomembranous Colitis, C. diff, manyoka, kurwadziwa kwemudumbu, colitis, mishonga inorwisa mabhakitiriya