Ingaba amathumbu akho ayeka ukusebenza ngequbuliso? Masiqaphele le meko iyingozi (i-Ogilvie Syndrome)!

Ngaba wakha waziva ugcwele ngequbuliso kwaye uziva uxinezelekile esiswini sakho? Kufana nokuba kukho into ebambeke esiswini sakho, kodwa akunjalo. Lolo hlobo lwemeko engaqhelekanga, enokuba yingozi esiza kuthetha ngayo namhlanje. Ibizwa ngokuba yi-Ogilvie Syndrome. Makhe sijonge ukuba yintoni, kutheni isenzeka, indlela yokuyiqonda, kunye nendlela yokuyinyanga.

Yintoni i-Ogilvie Syndrome?

Ngamafutshane, i-Ogilvie Syndrome iyenzeka xa ikholoni yakho iyeka ukusebenza ngequbuliso ngaphandle kwesizathu esicacileyo. Oogqirha bakwayibiza ngokuba yi -acute colonic pseudo-obstruction (ACPO) . "I-pseudo-obstruction" ithetha ukuba ikholoni yakho isebenza ngokungathi ivalwe yinto ethile, kodwa eneneni , akukho nto ivalwe ngokwasemzimbeni . Ingxaki ikwinkqubo elawula intshukumo yekholoni. Oko kukuthi, iyeka ukutyhala ukutya nokusela phambili ngekholoni. Emva koko, izinto ezifana nokutya nomoya ziqokelelana ngaphakathi kwikholoni, zibangela ukuba iindonga zekholoni zande, okanye zivuthuluke. Cinga ngayo njengengxinano yezithuthi, apho iimoto ziyeka ukuhamba kwaye indlela ivalwe.

I-Ogilvie Syndrome yahluke njani kwezinye izinto ezibangela ukungabikho kwe-intestinal obstructions?

I-Ogilvy syndrome yimeko ebukhali . Oku kuthetha ukuba ifika ngequbuliso kwaye yeyokwexeshana. Ichaphazela kuphela ikholoni . Igama elithi "intestinal pseudo-obstruction" ligama eliqhelekileyo. Libhekisa kuyo nayiphi na ingxaki eyenzeka ngaphandle kokuphazanyiswa komzimba emathunjini. Abanye abantu bane-intestinal pseudo-obstructions engapheliyo , ngamanye amaxesha ngenxa yesinye isifo esihlala ixesha elide okanye imeko yokuzalwa.

Yintoni umahluko phakathi kwe-Ogilvie Syndrome kunye ne-Paralytic Ileus?

I-Paralytic ileus ikwayi-pseudo-obstruction ebukhali yamathumbu. Nangona kunjalo, idla ngokuchaphazela amathumbu amancinci namakhulu. Le meko ixhaphake kakhulu emva kotyando lwesisu . Oku kwenzeka xa amathumbu eqala ukusebenza kancinci emva kotyando. Ihlala iphela yodwa kwiintsuku ezimbalwa.

Nangona kunjalo, i-Ogilvy syndrome ichaphazela ngokukodwa ikholoni yakho, kwaye idla ngokuba yinxalenye yekholoni yakho ebizwa ngokuba yi-cecum , apho iqala khona. Ayiqhelekanga njenge-paralytic ileus, kwaye inokuba nzima ngakumbi.

Ngubani onokuthi abe ne-Ogilvie Syndrome?

Nangona oku kunokwenzeka nakubani na, kuxhaphake kakhulu kubantu abadala nakwabo baneengxaki zempilo ezingaphezulu kwesinye.. Cinga ngomntu oye watyandwa kakhulu, wabandakanyeka kwingozi, wahlaselwa yintliziyo, okanye wasuleleka kakhulu. Ezi zinto zinokubangela i-Ogilvy syndrome. Kwakhona, ukungalingani kwe-electrolyte , izifo ze-neurological , kunye nokuthatha amayeza amaninzi ngaxeshanye zizinto ezinobungozi. Zonke ezi zinto zichaphazela inkqubo yethu ye-nervous . Loo nkqubo ye-nervous yiyo exelela izihlunu ezisemathunjini ethu amakhulu ukuba zityhalele phambili ukutya.

Kuqheleke kangakanani oku?

Kuthiwa i-Ogilvy syndrome yenzeka kumntu omnye kwabayi-1000 abangeniswe esibhedlele. Ubudala obuqhelekileyo babo bachaphazelekileyo bumalunga neminyaka engama-60.

Zithini iimpawu ze-Ogilvie Syndrome?

Xa ukutya okungatyiwanga kunye nomoya ziqala ukuqokelelana emathunjini akho amakhulu, unokufumana izinto ezifana nezi:

• Ukudumba kwesisu: Ukuva isisu sidumbile kwaye sikhulu.
• Intlungu yesisu: Intlungu yesisu inokubakho.
• Ukulahlekelwa yinkanuko: Ukulahlekelwa yinkanuko yokutya.
• Isicaphucaphu nokuhlanza: Ukuziva ugula kwaye uhlanza.
• Ukudumba kunye negesi: Ukuziva ugcwele esiswini.
• Ukuqhinwa kunye/okanye urhudo: Abanye abantu banokuba nokuqhinwa, ngelixa abanye banokuba norhudo.

Khawucinge nje ngoMalume uNimal, uneminyaka engama-65 ubudala, unesifo seswekile, kwaye uneengxaki zentliziyo. Wenziwa utyando lokutshintshwa kwesinqe. Emva kweentsuku ezimbini okanye ezintathu, isisu sakhe sagcwala ngequbuliso waza waba nobunzima bokuphefumla. Xa wayechukumisa isisu sakhe, sasinzima njengelitye. Wathi wayengenamdla wokutya, kwaye wayenesicaphucaphu. Kuphela xa oogqirha bamhlola apho baqonda khona ukuba yi-Ogilvy syndrome.

Yintoni ebangela i-Ogilvie Syndrome?

Isizathu esichanekileyo asikaqondwa ngokupheleleyo. Kodwa izazinzulu zikholelwa ukuba oku kubangelwa kukungasebenzi kakuhle kwenkqubo yethu yemithambo-luvo ezimeleyo . Le nkqubo yemithambo-luvo ezimeleyo yinxalenye yomzimba wethu elawula iintshukumo zemisipha esingaziqondiyo. Ikwalawula intshukumo yamaza (i-peristalsis) etyhala ukutya phambili emathunjini ethu. Ekubeni le yimeko ebukhali, ibangelwa luxinzelelo olungaqhelekanga kwinkqubo yemithambo-luvo ezimeleyo. Nangona kunjalo, ezinye izinto zempilo nazo zinokuba negalelo kuyo.

Kukho iimeko ezininzi zempilo ezinokubangela i-Ogilvy syndrome:

• Ukuhlaselwa yintliziyo
• Ukusilela kwentliziyo okubangelwa kukungaqini kakuhle (ubuthathaka bemisipha yentliziyo ngenxa yesifo sentliziyo)
• Ukwenzakala okubuhlungu
• Usulelo oluqatha (umz. i-pneumonia okanye i-sepsis)
• Utyando lwesisu oluvulekileyo
• Utyando lwentliziyo oluvulekileyo
• Utyando lwamathambo (umz. ukutshintshwa kwesinqe)
• Ukunikezelwa ngotyando / utyando lwe-C-section

Izinto zempilo esele zikhona ezinokubangela i-Ogilvy syndrome:

• Ukungasebenzi kakuhle kwezintso
• Ukungaphumeleli kokuphefumla
• Isifo se-neurological
• Isifo sentliziyo
• Umhlaza
• Iingxaki zeMetabolic
• Ukungalingani kwe-electrolyte
• Ubudala obuphezulu
• Ukuba nobuthathaka emzimbeni
• Ukuthatha amayeza amaninzi ngaxeshanye

Amanye amayeza anxulumene ne-Ogilvy syndrome:

• Amayeza okulwa nesifo sengqondo
• Ii-Amphetamines
• Ii-Corticosteroids
• Ii-opioids (izithomalalisi zentlungu)
• Izinto ezithintela amasosha omzimba
• I-anesthesia yomqolo

Ziziphi iingxaki ezinokubakho ze-Ogilvie Syndrome?

Uninzi lwexesha, i-Ogilvy syndrome iyaziphelela okanye ngoncedo oluxhaswayo. Nangona kunjalo, ngamanye amaxesha kufuneka ungenelelo . Ukuba ayifumaneki ixesha elide, inokukhokelela kwiingxaki ezinkulu ukuba imeko iba mandundu. Izifundo zibonisa ukuba iingxaki zinokwenzeka ngakumbi ukuba ikholoni ikhulisiwe (ngaphezulu kweesentimitha ezili-12). Ububanzi obuqhelekileyo bekholoni bumalunga neesentimitha ezi-8.

Okukhona amathumbu evuleka ngakumbi, kokukhona umngcipheko uphezulu. Iingozi ezinokubakho:

• I-Ischemia: Uxinzelelo olugqithisileyo eludongeni lwekholoni lunokubangela ukuba ukuhanjiswa kwegazi kunqunyulwe . Oku kunokukhokelela ekuvuvukeni okukhulu, okubizwa ngokuba yi-ischemic colitis . Ukuba ayinyangwa, ukufa kwezicubu (i-necrosis) kunokwenzeka. Cinga ngako njengokucinezela umbhobho wamanzi ngamandla kangangokuba amanzi ayeke ukuhamba.
• Ukugqobhoka: Iindawo zezicubu ezifileyo zinokukrazuka okanye ziqhekeke lula . Ukuba kuvela ukugqobhoka kwesisu, iityhefu kunye neebhaktheriya zinokusasazeka ziye kwisisu, nto leyo ebangela usulelo olukhulu olubizwa ngokuba yi-peritonitis .
• I-Sepsis: I-Peritonitis inokusasazeka lula iye egazini (i-septicemia) . Le yimeko engxamisekileyo! I-Sepsis kuxa usulelo lusasazeka emzimbeni wonke kwayeImeko ebizwa ngokuba yi-septic shock inokwenzeka, enokubangela ukungasebenzi kakuhle kwamalungu amaninzi omzimba.

Ezi ngxaki ziyingozi kakhulu, yiyo loo nto kubalulekile ukufuna iingcebiso zonyango ngokukhawuleza nje ukuba uqaphela iimpawu ze-Ogilvy syndrome.

Ifunyanwa njani i-Ogilvie Syndrome?

Ukuxilongwa kuxhomekeke kwezi zinto zilandelayo:

• Uvavanyo lwe-X-ray luqinisekisa ukuba ikholoni ivulekile kwaye akukho ngxaki yokuvaleka kwamathumbu emzimbeni.
• Uvavanyo olukhethekileyo lokuthintela ezinye izifo ezinokubangela imeko yakho.

Loluphi uhlobo lovavanyo lwe-radiological olunokuxilonga oku?

Ukuze ufumane inkcazelo eneenkcukacha ngaphakathi kwekholoni yakho, oogqirha basebenzisa inkqubo ebizwa ngokuba yi-internal contrast agent kunye ne-radiology. Le nto yo contrast igqunywe ngaphakathi kwekholoni yakho kwaye ibonakala ngokucacileyo kwimifanekiso ye-X-ray. Le contrast inganikwa ukuba uyisele, njenge-enema, okanye njengolwelo olufakwe kwi-vein (IV). I-Contrast CT scan kunye ne-contrast fluoroscopy ziindlela ezimbini ezisetyenziselwa oku.

Kukho uvavanyo olubizwa ngokuba yi-gastrografin enema , olunokusetyenziswa ngamanye amaxesha njengonyango. Oku kuquka ukufaka isisombululo sokungafani esinyibilikayo emanzini esibizwa ngokuba yi-gastrografin kwikholoni yakho nge-rectum yakho, kunye nokuthatha ii-X-ray ze-fluoroscopic. (I-Fluoroscopy ifana ne-X-ray yevidiyo enokuyibona indlela isisombululo esihamba ngayo.) Njengesiphumo esibi, i-gastrografin inokusebenza njenge-laxative kwikholoni, incede amathumbu akho ashukume kwakhona.

Inyangwa njani i-Ogilvie Syndrome?

Unyango luxhomekeke ekubeni ikholoni yakho ivuleke kangakanani na kwaye nokuba usemngciphekweni weengxaki. Nanini na xa kunokwenzeka, oogqirha bazama ukuyinyanga ngononophelo oluxhasayo kunye nokujonga ngokusondeleyo . Oko kuthetha ukunceda umzimba uziphilise ngokwawo ngaphandle kokungenelela okuninzi. Kodwa ukuba kuyimfuneko, basebenzisa amayeza okanye iinkqubo zokunciphisa ikholoni nokunciphisa umngcipheko weengxaki. Ukuba kuvela iingxaki, zifuna unyango olungxamisekileyo.

Unyango olugcina indalo lungabandakanya:

• Ukunyanga izifo ezibangela le meko.
• Ukuyeka amayeza kunokubangela le meko.
• Ukuphumla kwamathumbu: Ukunciphisa uxinzelelo ngokungatyi ngomlomo.
• Ulwelo olufakwa emthanjeni (ulwelo lwe-IV):Ukugcina umswakama emzimbeni kunye nokulungisa ukungalingani kwe-electrolyte ngokunika izinto ezifana ne-saline emthanjeni.
• Khuthaza ukuhamba kwamathumbu ngokuhamba okanye ukutshintsha indlela osebenza ngayo.
• Umbhobho weNasogastric: Ukususa umoya ogqithisileyo kunye nolwelo esiswini.
• Ityhubhu yeRectal: I-catheter efakwa kwi-rectum ukuze isuse umoya kunye nolwelo kusetyenziswa amandla angaphantsi komhlaba.
• Ukubeka esweni imeko ngokuthatha imifanekiso rhoqo kunye novavanyo lwegazi.

Oku kudla ngokubonwa kangangeentsuku ezimbini ukuya kwezintathu (malunga neeyure ezingama-72). Nangona kunjalo, ukuba ikholoni sele ikhulile ngaphezu kweesentimitha ezili-12, okanye ukuba akukho phuculo emva kolu nyango lugcina ixesha, ugqirha unokugqiba ekubeni angenelele ukuze anciphise uxinzelelo kwikholoni.

Ungenelelo luquka:

• Ukususwa kwe-Colonoscopy: I-Colonoscopy yinkqubo yokuxilonga nonyango. Ibandakanya ukufaka ikhamera encinci ekupheleni kwetyhubhu ende ebizwa ngokuba yi-colonoscope emathunjini amakhulu nge-anus. Injongo ye-colonoscopy yokususwa kwe-compression kukukhupha umoya ogqithisileyo emathunjini amakhulu ngetyhubhu uze emva koko unike i-enema ngetyhubhu. Le nkqubo inokuphelisa ukuvaleka okungachanekanga ukuba amayeza ayasilela okanye akakhuselekanga kuwe. Nangona kunjalo, oogqirha bayayisebenzisa ngononophelo kuba kunzima ukuyenza kwaye inomngcipheko omncinci weengxaki. Kwezinye iimeko, i-colonoscope inokubangela umngxuma kwi-colon (ukugqobhoza kwamathumbu).
• Inaliti yeNeostigmine: Eli yeza linikwa nge-IV. Liyi-activator yemisipha. Lidla ngokusetyenziswa ukunceda izihlunu ziphumle emva kwe-anesthesia. Liye labonakala lisebenza "ekuvuseni" izihlunu kumathumbu amakhulu kunye nokuqalisa kwakhona i-peristalsis kubantu abane-Ogilvy syndrome. Nangona kunjalo, kuba liyeza elinamandla kakhulu , linikwa kuphela xa lijongiwe kwiyunithi yokhathalelo olunzulu (ICU) . Oogqirha baya kujonga intliziyo yakho ukuqinisekisa ukuba isantya sentliziyo yakho asinciphisi kakhulu ngelixa ufumana i-neostigmine.
• Utyando lwe-Colostomy / i-Colostomy: Ukuba i-colon yakho iyaqhubeka nokukhula nangona kukho ezi ndlela zokungenelela, okanye ukuba kukho iingxaki ezifana nokugqobhoka okanye i-necrosis, unokufuna utyando ukuze kususwe inxalenye echaphazelekayo ye-colon yakho . Eli linyathelo lokugqibela . Ngotyando lwe-colectomy, unokuba ne -colostomy yexeshana okanye esisigxina.Kusenokufuneka nokuba kwenziwe enye. Oko kukuthi, ukwenza umngxuma owahlukileyo ukuze indle idlule. Ngamanye amaxesha, i-colostomy inokuguqulwa emva kokuba utyando luphelile.

Ngaba i-Ogilvie Syndrome ingabulala?

Ewe, iingxaki zinokubulala . Ngeengxaki ezifana nokugqobhoka okanye ischemia, izinga lokufa linokuba phezulu ukuya kuma-40%. Nangona kunjalo, ezi ngxaki zenzeka kubantu abangaphantsi kwe-15%. Ngaphandle kweengxaki, izinga lokufa kwi-Ogilvy syndrome lisondele kwi-15%. Eli nani lisenokungamelani ne-Ogilvy syndrome yodwa. Kuba abantu abaninzi abafumana i-Ogilvy syndrome banezinye iimeko zempilo ezichaphazela ukufa kwabo.

Ukuvaleka kwe-colonic pseudo-obstruction yinto engalindelekanga enokubangela iingxaki ezintsha kubantu abasele bejamelene nezinye iimeko zempilo. Akukho mntu ulindele i-Ogilvy syndrome, kodwa wonke umntu kufuneka azi iimpawu . Ukuqatshelwa kwangoko yeyona nto iphambili ekuthinteleni iingxaki ezinkulu ze-Ogilvy syndrome. Ukuba akukho ngxaki, ukuchacha kunokwenzeka ngonyango olucwangcisiweyo.

Izinto ezibalulekileyo ekufuneka sizikhumbule (Umyalezo Wokuya Ekhaya)

Ngoko ke, i-Ogilvie Syndrome yimeko enokuba yingozi kakhulu kunokuba ucinga. Kodwa akukho nto inokubangela uxhalabe ngayo, kwaye ukuqaphela kunokuthintela iingxaki ezininzi.

• Ukuxilongwa: Ukuba ufumana iimpawu ezinje ngokudumba ngequbuliso, iintlungu zesisu eziqatha, ukungabi namdla wokutya, isicaphucaphu, okanye ukuhlanza, qiniseka ukuba ubona ugqirha, ingakumbi ukuba ukhulile, unezinye iingxaki zempilo, okanye usandul’ utyando.
• Izizathu: Oku kunokubangelwa sisifo esithile, utyando, okanye amayeza. Ngoko ke kubalulekile ukuxelela ugqirha wakho imbali yakho epheleleyo yezonyango.
• Iingxaki: Ukuba akunyangelwanga ngokukhawuleza, ukuncipha kokuhamba kwegazi kwikholoni kunokukhokelela ekufeni kwezicubu, ukugqobhoka kwekholoni, kunye nosulelo olubi. Ezi zinokuba yingozi ebomini.
• Unyango: Uninzi lweemeko ziyaphela ngoncedo oluxhasayo, kodwa ngamanye amaxesha i-colonoscopy, amayeza, okanye notyando lunokufuneka ukuze kuncitshiswe uxinzelelo.
• Ukufunyaniswa kwangoko kusindisa ubomi: Musa ukuzityeshela ezi mpawu nangasiphi na isizathu. Eyona nto ibalulekileyo kukuziqaphela kwangethuba uze uqale unyango.

Ukuba wena okanye umntu omaziyo unenye yezi mpawu, ungathandabuzi ukufuna ingcebiso kagqirha. Hlala usempilweni!

I- Ogilvie Syndrome, ukuvaleka kwamathumbu okukhawulezileyo, i-colon, ukungasebenzi kakuhle kwamathumbu, ukudumba, iintlungu zesisu, ukuvaleka kwamathumbu okungabonakaliyo