Ingaba isisu sakho sivakala ngathi sijika sibe lilitye? Masifunde ngesi sifo singaqhelekanga (i-Ogilvie Syndrome)

Ngaba wakha waziva ngathi kukho into ebambeke esiswini sakho, isisu sakho siya sikhula, kwaye uziva ngathi siza kuqhuma? Kwakungathi amathumbu akho avalekile ngokupheleleyo. Ngokwesiqhelo, oko kwenzeka xa into ivaleke emathunjini akho. Nangona kunjalo, kukho imeko engaqhelekanga nengaqhelekanga apho amathumbu akho ayeka ukusebenza ngequbuliso ngaphandle kokuba nantoni na ivaleleke ngaphakathi. Namhlanje, siza kuthetha ngemeko abantu abaninzi abangazange bayive. Ngokwezonyango, sibiza le Ogilvie Syndrome okanye Acute Colonic Pseudo-obstruction (ACPO) .

Ngamafutshane, yintoni i-Ogilvie Syndrome?

Khawuthelekelele, kukho izithuthi ezininzi, kodwa akukho ngozi okanye imiqobo endleleni. Izithuthi zimi nje. I-Ogilvie Syndrome yinto efana naleyo. Ukuhamba kokutya kunye nenkunkuma ngaphakathi kwikholoni yakho kuyema ngequbuliso. Kuvakala ngathi kukho into ebambekileyo kwikholoni yakho, kodwa eneneni akukho nto iphazamisayo emzimbeni. Ingxaki ikwinkqubo yemithambo-luvo elawula izihlunu kwikholoni yakho. Ngenxa yokuba ayisebenzi kakuhle, ukuhamba kwekholoni (esikubiza ngokuba yi-"peristalsis"`) kuyema, kwaye umxholo ongaphakathi ubambeke kwindawo enye. Oku kubangela ukuba ikholoni ikhule kancinci kancinci, okanye ivuvuke.

Igama elithi ``pseudo-obstruction'' egameni lalo lithetha ``false obstruction.'' Oku kuthetha ukuba iveza iimpawu ngokungathi kukho obstruction, nangona kungekho obstruction.

Oku kwahluke njani kwezinye iingxaki zamathumbu?

Kukho iimeko ezahlukeneyo eziphazamisa ukusebenza kwamathumbu. Ngoko ke makhe sibone indlela i-Ogilvie Syndrome eyahluke ngayo kuzo.

• Xa kuthelekiswa nezinye iimeko ze-'Intestinal Pseudo-obstruction': I-Ogilvie Syndrome yimeko 'ebukhali'. Oko kukuthi, ifika ngequbuliso, kwaye yeyokwexeshana . Kwaye ichaphazela kuphela amathumbu amakhulu . Nangona kunjalo, abanye abantu banokuba neemeko 'ezingapheliyo' ze-'pseudo-obstruction'. Zihlala zibangelwa sisifo esithile esingapheliyo okanye imeko yokuzalwa.
• Umahluko kwi-'Paralytic Ileus': Usenokuba ukhe weva igama elithi 'Paralytic Ileus'. Lisetyenziswa ukuchaza imeko apho amathumbu ayeka ukusebenza okwethutyana, ingakumbi emva kotyando lwesisu. Liqhelekile kakhulu. Libandakanya amathumbu amancinci namakhulu ayeke ukusebenza okwethutyana aze aziphilise ngokwawo kwiintsuku ezimbalwa. Nangona kunjalo, i-Ogilvie Syndrome yimeko enzima kakhulu nengaqhelekanga . Ichaphazela kakhulu amathumbu amakhulu , ngakumbi i-cecum.

Ngubani osengozini enkulu yokuhlaselwa yile meko?

Nangona inokuvela nakubani na, ixhaphake kakhulu kubantu abadala abangaphezu kweminyaka engama-60 ubudala abanezinye iingxaki zempilo.Le meko ixelwa malunga nesinye kwi-1,000 izigulane ezilele esibhedlele.

Ngamafutshane, oku kunokwenzeka nanini na xa umzimba uphantsi koxinzelelo olukhulu. Cinga ngotyando olukhulu, ingozi enkulu, ukuhlaselwa yintliziyo, okanye usulelo olunzima. Ezi zinto zichaphazela ukusebenza kwenkqubo yethu yemithambo-luvo. Le nkqubo yemithambo-luvo yiyo exelela izihlunu emathunjini ukuba "zishukume." Ngoko ke xa kukho ukungalingani apho, amathumbu ayayeka ukusebenza kwaye i-Ogilvie Syndrome inokwenzeka.

Zithini iimpawu ze-Ogilvie Syndrome?

Xa umoya, ulwelo, kunye nokutya okungatyiwayo kubambeke emathunjini akho, unokufumana iimpawu ezifana nezi. Ezi zisenokuqala ngequbuliso kwaye zikhule kancinci kancinci.

Kutheni oku kusenzeka? Makhe sijonge nzulu izizathu.

Nangona unobangela ochanekileyo woku ungekacaci ngokupheleleyo, izazinzulu zikholelwa ukuba kubangelwa kukungasebenzi kakuhle kwenkqubo yethu yemithambo-luvo ezimeleyo . Cinga ngako, izinto ezenzeka ngokuzenzekelayo emzimbeni wethu, ezinje ngokubetha kwentliziyo, ukuphefumla, kunye nokugaya ukutya, zilawulwa yile nkqubo yemithambo-luvo, esebenza njenge "auto-pilot." Ngoko ke, ngenxa yoxinzelelo olukhulu emzimbeni, le nkqubo "auto-pilot" inokungasebenzi kakuhle, kwaye iimpawu ezilawula ukuhamba kwamathumbu zinokuphazanyiswa.

Izizathu eziphambili ezibangela le meko zinokwahlulwahlulwa zibe ziindidi ezahlukeneyo.

Ngaba oku kungaba yinto enzulu? Zithini iingxaki?

Ewe, ukuba oku akuchongwa kwaye akunyangwa ngokufanelekileyo, kunokukhokelela kwiingxaki ezinzulu kakhulu nezisongela ubomi . Khawucinge nje, kwenzeka ntoni ukuba uqhubeka uvuthela umoya kwibhaluni? Iyaqhuma. Amathumbu ayafana.

Ububanzi obuqhelekileyo bekholoni bumalunga neesentimitha ezisi-8. Nangona kunjalo, kwi-Ogilvie Syndrome, ukuba iba nkulu kuneesentimitha ezili-12, umngcipheko weengxaki uphezulu kakhulu.

Iingxaki eziphambili ezinokwenzeka zezi:

• I-Ischemia: Ukolula kakhulu iindonga zamathumbu kubangela ukuba imithambo yegazi ethambileyo ehambisa igazi kubo ixinaniswe, nto leyo enciphisa ukunikezelwa kwegazi . Oku kubangela ukudumba kwamathumbu (ischemic colitis), okuthi, ukuba akunyangwa, kukhokelela ekufeni kwezicubu (necrosis).
• Ukugqobhoka: Xa izicubu zisifa, udonga lwamathumbu luyabuthathaka kwaye umngxuma omncinci unokwenziwa . Oku kuyingozi kakhulu kuba iintsholongwane kunye nemveliso engcolileyo evela emathunjini inokuvuza ingene kwisisu, nto leyo ebangela usulelo olukhulu (i-peritonitis).
• I-Sepsis: Usulelo oluye lwasasazeka lwaya esiswini alupheleli apho. Lungangena egazini luze lusasazeke emzimbeni wonke.Le yimeko esongela ubomi efuna unyango olungxamisekileyo. Inokubangela nokuba amalungu omzimba angasebenzi kakuhle, ngalinye ngalinye.

Indlela yokuxilonga ngokuchanekileyo esi sifo?

Oogqirha baxhalabele kakhulu izinto ezimbini xa bexilonga esi sifo.

1. Okokuqala, sijonga ukuba kukho na ukuphazamiseka okubonakalayo emathunjini.

2. Ukuba akukho ngxaki enjalo, kugqitywa ukuba ngaba imbangela yezi mpawu yi-Ogilvie Syndrome okanye yinto enye.

Kuqhutywa iimvavanyo ezahlukeneyo malunga noku.

• Ii-X-reyi kunye nee-CT scans: I-X-reyi yesisu okanye i-CT scan ingabonisa ngokucacileyo amathumbu amakhulu, avuvukileyo kwaye azaliswe ngumoya. Ngamanye amaxesha, kunikwa ulwelo olukhethekileyo ('i-agent yokwahlula') ukuba luselwe okanye lufakwe njengenaliti ukuze kufunyanwe imifanekiso ecacileyo.
• I-Gastrografin Enema: Olu luvavanyo olukhethekileyo kakhulu. Kuba luvavanyo kwaye ngamanye amaxesha lunyango. Apha, ulwelo olunyibilikayo emanzini olubizwa ngokuba yi-`gastrografin` lufakwa emathunjini nge-rectum, kwaye indlela oluhamba ngayo emathunjini ijongwa ngevidiyo ye-X-ray `(fluoroscopy)`. Oku kunokumisela ngokuchanekileyo ukuba kukho ukuvaleka emathunjini okanye akunjalo. Kwakhona, olu lwelo lwe-`gastrografin` luneempawu zokukhupha isisu. Ke ngoko, ngamanye amaxesha isiphumo salo sinceda ukuqala kwakhona umsebenzi wamathumbu oye wema.

Zithini iindlela zonyango zoku?

Unyango luxhomekeke ekubeni ikholoni yakho idumbile kangakanani na kwaye usemngciphekweni wokuba neengxaki. Nanini na xa kunokwenzeka, oogqirha bazama ukuyinyanga ngonyango olulula oluxhasayo (`unyango olulondolozayo`) endaweni yokusebenzisa izinto ezifana notyando.

Unyango oluGcinileyo

Ekuqaleni, olu nyango lwenziwa ngelixa kujongwa imeko yesigulana ngononophelo.

• Ukunyanga iimeko ezifihlakeleyo: Ukuba kukho imeko efihlakeleyo, njengosulelo okanye isifo sentliziyo, enyangwa kuqala.
• Ukuyeka amayeza: Amayeza ekucingelwa ukuba abangela i-Ogilvie Syndrome ayekiswa okwethutyana.
• Ukuphumza amathumbu: Ukuyekisa ngokupheleleyo ukutya okuselwayo kunye nolwelo.
• Ityuwa ye-IV: Ubungakanani bolwelo kunye neetyuwa ezifunekayo emzimbeni bunikwa ngomthambo (ii-IV fluids).
• Ukuhamba nokutshintsha izikhundla: Ukuba kunokwenzeka, khuthaza isigulana ukuba sihambe kancinci size sitshintshe izikhundla ebhedini. Oku kunokukhuthaza ukuhamba kwamathumbu.
• Ukufakwa kwetyhubhu: Ityhubhu (`ityhubhu yeNasogastric`) ifakwa ngempumlo esiswini ukuze kususwe umoya ogqithisileyo kunye nolwelo. Ityhubhu (`ityhubhu yeRectal`) ifakwa nakwi-anus ukuze kuphume umoya.

Ngexesha lonyango, oogqirha benza rhoqo ii-X-reyi kunye novavanyo lwegazi ukujonga imeko yamathumbu kunye nazo naziphi na iingxaki.

Kuthekani ukuba unyango oluxhasayo aluphumeleli?

Ukuba imeko ayiphucuki emva kweeyure ezingama-72, okanye ukuba amathumbu angaphezulu kweesentimitha ezili-12 avuleke, oogqirha baza kudlulela kwinqanaba elilandelayo.

• Ukususwa kweColonoscopic: Kule nto, kufakwa ityhubhu enekhamera eqhotyoshelweyo (i-`colonoscope`) nge-anus kwaye umoya oqokelelene kwi-colon utsalwa ngetyhubhu. Oku kunciphisa ngokukhawuleza uxinzelelo kwi-colon. Nangona kunjalo, ekubeni le yinkqubo engathandekiyo kwaye ngamanye amaxesha kukho umngcipheko omncinci wokugqobhoka kwe-colon, yenziwa ngononophelo olukhulu.
• Inaliti yeNeostigmine: Le sisikhuthazi semisipha esinamandla kakhulu. Idla ngokusetyenziselwa ukunceda izihlunu zibuyele esiqhelweni emva kokufumana i-anesthesia. Xa eli yeza linikwa njengenaliti ye-intravenous (IV) kubantu abane-Ogilvie Syndrome, izihlunu zamathumbu ziqala ukusebenza kwakhona, kwaye iziphumo ezilungileyo zifunyenwe. Nangona kunjalo, ngenxa yokuba eli yeza linokubangela ukubetha kwentliziyo okucothayo kakhulu, linikwa kuphela phantsi kweliso elibukhali likagqirha okwiyunithi yokhathalelo olunzulu (ICU) .
• Utyando (Colectomy / Colostomy): Ukuba, nangona zonke ezi ndlela zonyango, amathumbu ayaqhubeka nokudumba, okanye ukuba kukho ingxaki enkulu efana nokugqobhoka, utyando lunokuba lolona khetho lokugqibela. Kwimeko enjalo, inxalenye eyonakeleyo yamathumbu iyasikwa ize isuswe (Colectomy). Ngamanye amaxesha, kufuneka kwenziwe umngxuma wexeshana okanye osisigxina esiswini ukuze kungene ilindle. Oku sikubiza ngokuba yiColostomy.

Ngaba le meko ingasongela ubomi?

Ngaphandle kweengxaki, umngcipheko wokufa komntu one-Ogilvie Syndrome kuphela umalunga ne-15%. Nangona kunjalo, eli nani likwabandakanya nemiphumo yezinye iimeko zempilo umguli anazo.

Nangona kunjalo, ukuba kukho ingxaki enkulu efana nokugqobhoka kwamathumbu, izinga lokufa lifikelela kwi-40%. Oku kubonisa ukuba le meko inokuba yingozi kangakanani.

Eyona nto ibalulekileyo kukunika ingqalelo kwiimpawu ngokukhawuleza nje ukuba zivele, uxilonge isifo ngokukhawuleza, kwaye uqale unyango. Ukuba wenza njalo, unokuthintela iingxaki ezinkulu kwaye uphile ngokukhawuleza ngonyango olulula.