Mudumbu mako mune chepfu yakanyanya here? (Toxic Megacolon) Ngatidzidzei nezvazvo.

Wakambova nekurwadziwa kwakanyanya mudumbu, kuzvimba, uye kunzwa kusagadzikana nguva dzose mumuviri wako here? Dzimwe nguva izvi zvinogona kuva kutanga kwedambudziko guru. Nhasi tichataura nezvechirwere chakakomba zvishoma, asi chinogona kurapwa kana chikaonekwa nekukurumidza. Izvozvo zvinonzi `(Toxic Megacolon)`. Zita racho rinonzwika serinotyisa zvishoma, handiti? Asi ngatinzwisise izvi zviri nyore.

Chii chinonzi `(Toxic Megacolon)`? Zvichitaurwa zviri nyore...

Zvichitaurwa zviri nyore, `(Toxic Megacolon)` chirwere chakakomba, chekukurumidzira chinoitika muura hwako hukuru (chinozivikanwawo se`(Colon)`). Chinokonzerwa nekuzvimba kwakanyanya, kureva kuzvimba kana kukuvara (`(Colitis)`) kweura hukuru.

Funga nezvazvo nenzira iyi: ura hwedu hukuru hwakaita sechubhu inochinjika. Hune membrane yakatetepa mukati. Kazhinji, paunobatwa necolitis, inokanganisa membrane iyi. Asi kana kuzvimba kwacho kukakura zvakanyanya , kunogona kupararira kusvika kuzvikamu zvakadzika zveura, kureva tsandanyama dziri mumadziro eura.

Chii chinoitika kana izvi zvikaitika? Tsandanyama dziri mumadziro eura dzinomira kushanda zvakanaka. Tsandanyama idzi ndidzo dzinosundira chikafu nemhepo muura. Padzinomira kushanda, chikafu nemhepo zvinobatwa mukati meura. Ipapo madziro eura anoshaya simba, anotambanuka, uye anokura. Anoputira sebharumu. Chinhu chine njodzi zvikuru ndechekuti marara anoungana nenzira iyi anoumba chepfu uye anodonhedza nemadziro iwayo asina simba achipinda muropa. Ipapo muviri wese unotanga kucheneswa. Tinodaidza izvi kuti megacolon ine chepfu kana kuti ``Toxic Megacolon``.

Ndeupi musiyano uripo pakati pe `(Toxic Megacolon)` nedzimwe mhando dze `(Megacolon)`?

Zvino ungave uchifunga kuti, "Hapana zvimwe zvirwere zvinokonzera kuti ura huzvimbe here?" Ehe, zviripo. Dzimwe nguva ura hunogona kuzvimba nekuda kwezvipingamupinyi (`(Zvipingamupinyi)`), kana dzimwe nguva pasina zvipingamupinyi (`(Pseudo-obstructions)`). Izvi zvinonziwo `(Megacolon)`.

Zvisinei, hunyanzvi hwe `(Toxic Megacolon)` ndehwekuti, sezvambotaurwa, chepfu iyi inopararira mumuviri wese (`(Systemic Toxicity)`) . Izvi hazviwanzoitika mune mamwe marudzi e `(Megacolon)`. Kunyanya, iyi chepfu inowanzoonekwa ne `(Colitis)` inoitika nekuzvimba kweura (`(Colitis)`, kureva kuti, nekuda kwehutachiona hwakasiyana-siyana kana mamiriro e `(Inflammatory)`. Ndipo panotanga zviratidzo zvakaita sekudzikira kweropa, kurova kwemoyo nekukurumidza, uye kuvhiringidzika.

Ndezvipi zvinetso zvakakomba zvinogona kuitika nekuda kwe `(Toxic Megacolon)`?

Izvi zvinoonekwa sedambudziko rehutano , sezvo zvinogona kukonzera matambudziko akawanda akakomba anogona kuisa hupenyu panjodzi.

• Kuboorwa/kutsemuka kwedumbu : Zvandiri kutaura ndezvekuti madziro eura anoshaya simba uye anotambanudzwa. Kana izvozvo zvikaitika, anogona kuputika kana kuputika zviri nyore.
• Kubuda ropa kwakanyanya mudumbu uye kurasikirwa neropa : Matumbu anogona kukuvara uye kubuda ropa rakawanda.
• Utachiona hwemuviri uye sepsis: Kana chepfu inobva muura ikapinda muropa, hutachiona hunogona kupararira mumuviri wese, zvichikonzera chirwere chine njodzi chinonzi sepsis.
• Dambudziko remudumbu: Kuwedzera kwekumanikidzwa mukati medumbu kunogona kukanganisa dzimwe nhengo dzemuviri.

Zvakakosha: Kana uine zviratidzo zvakaita seizvi, chinhu chakanakisa chekuita kutsvaga rubatsiro rwechiremba nekukurumidza.

Toxic Megacolon inogona sei kukonzera rufu?

Iyi inyaya yakakomba. Sezvambotaurwa, madziro eura, ayo asina simba uye akatambanudzwa, anogona kubvaruka nyore nyore uye kubhoboka. Kana kubhoboka kwakadaro kukaitika, kubuda ropa kwakanyanya kunogona kuitika mukati medumbu, uye zvinhu zvakaita setsvina zvinogona kudonhera mudumbu, zvichikonzera hutachiona mukati medumbu (peritonitis). Utachiona uhwu hunogona kuungana nekukurumidza muropa uye hunokonzera chepfu mumuviri wese, zvichikonzera chirwere chinonzi toxic shock. Uyewo, kana kumanikidzwa mukati medumbu kukawedzera zvakanyanya, kuyerera kweropa kune dzimwe nhengo dzinokosha (dzakadai seitsvo nemapapu) kunogona kukanganiswa, uye dzinogona kushaya okisijeni uye dzotadza kushanda. Ichi ndicho chikonzero chikuru cherufu.

Ndezvipi zviratidzo zve `(Toxic Megacolon)`?

Mumamiriro ezvinhu aya, zviratidzo zvakasiyana-siyana zvinogona kuoneka. Zvimwe zvacho zvinogona kunzwa sekurwadziwa kwemudumbu kwakajairika. Asi kana uine zviratidzo zvinopfuura chimwe chete, kana kuti zvakanyanya, unofanira kunetseka.

• Manyoka (anowanzova neropa) : Kufamba-famba kwetsvina nguva dzose, uye kana zvichiperekedzwa neropa, chiratidzo chine njodzi.
• Kurwadziwa kwemudumbu nekupfava : Kurwadziwa kunoita sekunge dumbu rako riri kudzvanywa, uye kunorwadza kunyangwe paunoribata.
• Dumbu rakazvimba : Dumbu racho rakakura, sekunge razara nemhepo.
• Kuzvimba kwechifuva uye kurwadziwa negasi (`(Gasi negasi)`) : Dumbu rakazara negasi, zvichikonzera kurwadziwa.
• Kusvotwa nekurutsa : Kunzwa kuda kurutsa mudumbu, kunzwa sekunge ucharutsa.
• Dzungu (`(Dzungu)`)
• Kushaya mvura mumuviri : Kurasikirwa nemvura mumuviri. Zviratidzo zvinosanganisira kuoma kwemuromo uye kudzikira kweweti.
• Kurova kwemoyo nekukurumidza : Kuwedzera kwekurova kwemoyo.
• Fivha (`(Fivha)`)
• Kuderera kweropa (`(Kuderera kweropa)`) : Kuderera kweropa.
• Kuvhiringidzika kwepfungwa : Kusakwanisa kunzwisisa zviri kuitika, kunzwa kuvhiringidzika.
• Kuneta/kusagadzikana : Kunzwa kushaya simba.

Chii chinonyanya kukonzera `(Toxic Megacolon)`?

Kutaura zvazviri, chero rudzi rwechirwere checolitis chakakomba chinogona kukonzera megacolon ine chepfu. Zvisinei, kazhinji kacho chinokonzerwa nechirwere chinonzi inflammatory bowel disease (IBD).Chirwere chemudumbu chinonzi Inflammatory Bowel Disease (IBD) izwi rinowanzo shandiswa kureva mhando dzakasiyana dzechirwere chemudumbu chisingarapiki, zvichireva kuti chinogara kwenguva yakareba uye chinonetsa kurapa. Semuenzaniso, Ulcerative Colitis neCrohn's Disease zvinowira muchikamu ichi. Kana zvirwere izvi zvikasadzorwa zvakanaka nekudya nemishonga, zvinogona kukanganisa zvikamu zvakadzika zvemudumbu, zvichikonzera Toxic Megacolon.

Ndezvipi zvimwe zvinokonzera Toxic Megacolon?

`(Toxic Megacolon)` idambudziko re`(Colitis)` rakaipisisa. Saka panogona kuva nezvikonzero zvakawanda zve`(Colitis)` iyi. Kureva kuti, `(Toxic Megacolon)` inogona kukonzerwa nemhando dzakasiyana dze`(Colitis)`. Ngationei kuti ndedzipi:

• Ulcerative Colitis : Iyi ndiyo mhando yeIBD inonyanya kuwanikwa uye ndiyo inonyanya kukonzera Toxic Megacolon. Toxic Megacolon inowanzoitika mumakore mashoma ekutanga mushure mekuonekwa kwechirwere ichi.
• Chirwere cheCrohn : Ichi chimwe rudzi rweIBD. Chinonyanya kukanganisa ura hudiki, asi chinogonawo kukanganisa ura hukuru. Vanhu vane chirwere cheCrohn vari panjodzi yekubatwa neToxic Megacolon pakutanga kwechirwere.
• Ischemic Colitis : Kana ura husina kupiwa ropa zvakanaka (Intestinal Ischemic Syndrome), izvi zvinogona kukonzera Ischemic Colitis. Izvi zvakaoma kurapa, uye zvinogona kukura kuita Toxic Megacolon.
• Kurapwa nemwaranzi : Kurapwa nemwaranzi yezvirwere zvakaita sekenza kunogona kukonzera colitis kwenguva pfupi semhedzisiro. Zvisinei, mune vamwe vanhu, inogona kuramba iripo kwenguva yakareba uye kukonzera matambudziko.
• Chirwere cheColitis : Chirwere chebhakitiriya, chinopararira, kana hutachiona chinogona kukonzera chirwere checolitis. Mamwe marudzi ehutachiona anowanzo bata vamwe vanhu. Kunyangwe chepfu yekudya kana furuwenza yemudumbu zvinogona kukonzera chirwere checolitis chakakomba kune vamwe vanhu. Vanhu vane masoja emuviri asina simba ndivo vari panjodzi huru yezvirwere zvakaita se cytomegalovirus.
• Pseudomembranous Colitis : Iyi imhando yechirwere checolitis chinotapukira chinokonzerwa nebhakitiriya rinonzi Clostridium difficile (C. diff). Chinowanzonziwo chinhu chinokonzera njodzi ye megacolon ine chepfu. Chinowanzoitika kuvanhu vanotora mishonga inorwisa mabhakitiriya kuti vawane chimwe chirwere. Izvi zvinodaro nekuti kana mabhakitiriya akanaka ari mudumbu akaurayiwa nemishonga inorwisa mabhakitiriya, mabhakitiriya eC. diff anotanga kukura asingadzoreki. Utachiona hweC. diff uhwu hunogona kukura nekukurumidza.

Ndezvipi zvinhu zvinokonzera njodzi yekukudziridza `(Toxic Megacolon)`?

Vamwe vanhu vane mukana mukuru wekuva nechirwere ichi. Ndivanaani?

• Vanhu vane `(IBD)'.
• Vanhu vane zvirwere zve autoimmune (kureva zvirwere umo masoja emuviri anorwisa masero emuviri)
• Vanhu vane `(HIV/AIDS)`.
• Vanhu vakamboisirwa nhengo dzemuviri kana kuti vari kutora mishonga inodzvinyirira immune system.
• Vanhu vane chirwere cheshuga.
• Vanhu vane chirwere cheitsvo.
• Vanhu vane chirwere chemapapu chisingaperi (Chronic Obstructive Pulmonary Disease - COPD).
• Vanhu vane matambudziko emwoyo (`(Congestive Heart Failure)`).

Uyewo, mimwe mishonga yaunotora inogona kuita kuti dambudziko iri re "Toxic Megacolon" riwedzere kuipa:

• Mhando dzemishonga inoderedza marwadzo (`(Opioids)`)
• Mishonga isiri yesteroidal inorwisa kuzvimba (NSAIDs - semuenzaniso Ibuprofen, Diclofenac)
• Mimwe mishonga yekuderedza kushungurudzika (`(Mishonga yekuderedza kushungurudzika)`)
• Mishonga yeAnticholinergics
• Mishonga inorwisa manyoka (shandisa izvi nokungwarira, sezvo zvichigona kuita kuti dambudziko riwedzere nekuvharira kubuda kwetsvina)
• Kugadzirira ura (mushonga unopiwa kuchenesa dumbu usati waongororwa colonoscopy) (Izvi zvinogona kuva nengozi kune munhu atova nechirwere checolitis)

Toxic Megacolon inoonekwa sei ?

Chiremba achakubvunza nezvezviratidzo zvako, chero zvirwere zvawakamborwara nazvo, uye chero mishonga yaunotora. Ruzivo urwu rwakakosha nekuti zvimwe zvirwere kana mishonga inogona kuwedzera njodzi yekubatwa neToxic Megacolon. Mimwe mishonga, yakaita sesteroids, inogonawo kudzvinyirira zviratidzo zveToxic Megacolon. Chiremba achabva akuongorora muviri wako.

Panguva yekuongororwa kwemuviri, chiremba wako achaongorora dumbu rakazvimba, kupfava, uye kusagadzikana. Vanogona zvakare kushandisa stethoscope kuteerera mafambiro edumbu asina kusimba. Zviratidzo zvako zvakakosha (kurova kwemoyo, tembiricha, uye BP) zvichaongororwa zviratidzo zvechepfu, zvakaita sefivha, BP yakaderera, uye kurova kwemoyo nekukurumidza.

Pamusoro pezvo, kuongororwa ropa uye kuongororwa kwemudumbu (semuenzaniso, X-ray, abdominal ultrasound, kana CT scan) zvinogona kudiwa kuti zviongororwe kuti chirwere chacho chakura sei. Kuongororwa uku kunotarisa kuti ura hwakakura sei uye kana paine zvimwe zvinetso. Kuongororwa kweropa kunogona kutarisa huwandu hwemasero machena eropa nemasero matsvuku eropa, uye kunogona kuona kana paine kuzvimba kwakanyanya.

Kune nzira dzakasiyana siyana dzinoshandiswa kuongorora `(Toxic Megacolon)`:

• Humbowo hunoratidza kuti ura hwemukati hwakakura kupfuura masendimita matanhatu.
• Kuva nehunhu hutatu hunotevera:
• Fivha inopfuura 100.4 Fahrenheit (38 Celsius).
• Kurova kwemoyo kunodarika kurova kwe120 paminiti.
• Kuwedzera kwehuwandu hwemasero machena eropa.
• Anemia (kuderera kwehuwandu hwemasero matsvuku eropa).
• Kuva nehumwe hwehunhu hunotevera:
• Kushaya mvura mumuviri (`(Kushaya mvura mumuviri)`).
• Kusawirirana kwema electrolyte/fluid.
• Kuchinja kwehunhu hwepfungwa.
• Kuderera kweropa (`(Kuderera kweropa)`).

Uyezve, chiremba angada kuyedza ropa rako kana tsvina kuti aone kana paine hutachiona hwakananga.

Ndeipi mishonga yekurapa `(Toxic Megacolon)`?

Dambudziko iri rinoda mazuva mashoma ekurapwa muchipatara. Chinangwa chekutanga kurapwa ndechekugadzirisa mamiriro ako uye kuderedza kuoma kwechirwere checolitis. Kana uine chirwere chakadai se sepsis, ungangoda kurapwa muchikamu chevarwere vanorwara zvakanyanya (ICU). Semuenzaniso, kufefetera kwemagetsi kwezvinetso zvekufema kana dialysis yekutadza kushanda kweitsvo.

Zvikasadaro, aya ndiwo marapirwo ekutanga anowanzoitwa e `(Toxic Megacolon)`:

• Mvura yemutsinga : Rapai kupera mvura mumuviri uye gadzirisai ma electrolytes.
• Mishonga inorwisa mabhakitiriya : Rapa hutachiona kana huripo kana kudzivirira hutachiona kuti husaitike.
• `(Corticosteroids)` : Rudzi rwemushonga unopiwa kuderedza kuzvimba (kuzvimba).
• Kurara : Kudya kwemukati / Kudyisa mwana nechubhu.

Kana mishonga yecorticosteroid ikasagadzirisa dambudziko racho, chiremba anogona kushandisa imwe mhando yemushonga, senge immune modulator. Izvi zvinogona kubatsira kuderedza kupindira kwakanyanya kwemuviri wemuviri, izvo zvinogona kukonzera kuzvimba kwakanyanya uye kuwedzera kwemasero machena eropa munyama.

Kuvhiya

Varwere vanosvika 50% chete ndivo vanogona kurapwa nemishonga. Vamwe vangada kuvhiyiwa, kunyanya kana paine matambudziko anotyisidzira hupenyu. Pakurapa munhu ne megacolon ine chepfu, vanachiremba vanowanzo bvunza vanachiremba vekutanga kuti vabatsire kuita sarudzo. Dzimwe nguva, chiremba anogona kusarudza kuti zvakachengeteka kubvisa chikamu chakakuvara cheura (colectomy) kudzivirira mamwe matambudziko kana njodzi.

Kana uchivhiyiwa colectomy, kazhinji unofanirawo kuvhiyiwa ostomy. Ostomy inzvimbo inogadzirwa mudumbu mako kuti tsvina ipinde nepairi. Iyi ndiyo nzvimbo inovhiyiwa tsvina kana ura hwako husiri kushanda zvakanaka. Zvichienderana nerudzi rwe colectomy yaunayo, ungangoda kuvhiyiwa ostomy kwenguva pfupi kana zvachose. Ingava yenguva pfupi kana refu, kugadzirisa ostomy kunogona kuva shanduko huru uye kunonetsa, kunyanya kana paine emergency. Asi uchawana rutsigiro rwaunoda kuti upfuure nayo.

Megacolon ine Chepfu Inogona Kurapwa Here?

Ehe, kana ukakurumidza kutsvaga kurapwa, mikana yako yekupona yakanyanya. Vanhu vanosvika 93% vanorapwa `(Toxic Megacolon)` vanopora zvizere. Zvisinei, kana matambudziko akadai sekuboorwa kwemudumbu, mwero wekupona unosvika 75%. Matambudziko mazhinji anoitika kana `(Toxic Megacolon)` ikasarapwa kwenguva yakareba. Saka, zvakakosha kuti unzwisise kukomba kwechirwere chako uye uite chimwe chinhu nekukurumidza.

Megacolon ine chepfu chirwere chepfungwa chinogona kuitika kamwe kamwe uye usingatarisiri. Uri panjodzi huru kana uchangobva kuonekwa uine chirwere chemudumbu (IBD) chisina kudzorwa zvakanaka. Zvisinei, chinogonawo kuitika panguva yehutachiona hwakakomba kana imwe colitis yakanyanya. Ziva chero shanduko kana kuwedzera kwezviratidzo zvako zvemazuva ese.

Kana uine chirwere checolitis chakakomba uye ukatanga kunzwa kusanzwa zvakanaka kana kuti uine chepfu, tsvaga rubatsiro rwechiremba nekukasika. Kurapwa nekukurumidza ndiyo nzira yakanakisisa yekudzivirira matambudziko anotyisidzira hupenyu. Zvinogonawo kukubatsira kudzivirira kuvhiyiwa. Kunyangwe uchifanira kuvhiyiwa nekuvhiyiwa kwechimbichimbi uye kubviswa kwechibereko, yeuka kuti uchawana rubatsiro rwese rwaunoda kuti ugadzirire shanduko.

Chinhu chinonyanya kukosha (Mharidzo Yekuenda Kumba)

Megacolon ine chepfu chirwere chakakomba, chekukurumidzira chinoitika muura hukuru. Chinokonzerwa nechirwere checolitis chakakomba (kuzvimba/kukuvara kweura). Kana uine zviratidzo zvakaita sekuzvimba, kurwadziwa kwakanyanya mudumbu, manyoka ane ropa, fivha, uye kurova kwemoyo nekukurumidza, usazviregeredza. Iyi idambudziko rehutano. Kana ukawana kurapwa muchipatara nekukurumidza, unogona kupora zvizere. Saka, kana uine zviratidzo izvi, enda kuna chiremba nekukasika. Kana ukamirira kwenguva yakareba, matambudziko anowedzera uye mukana wako wekufa unowedzera. Chengetedza hutano hwako.

` Chepfu Megacolon, Colitis, Kuzvimba kweura, Kurwadziwa kwedumbu, Manyoka, Kuvhiyiwa, Emergency