Ingaba ikholoni yakho inetyhefu kakhulu? (I-Megacolon enetyhefu) Masifunde ngayo.

Ngaba wakha waba nesisu esibuhlungu kakhulu, ukudumba, kunye nokuziva ungakhululekanga rhoqo emzimbeni wakho? Ngamanye amaxesha oku kungaba sisiqalo sengxaki enkulu. Namhlanje siza kuthetha ngemeko enzima kancinci, kodwa enokunyangeka ukuba iqatshelwe ngokukhawuleza. Loo nto ibizwa ngokuba yi-`(Toxic Megacolon)`. Eli gama livakala liyoyikisa kancinci, akunjalo? Kodwa masiyiqonde ngokulula le nto.

Yintoni i-`(Toxic Megacolon)`? Ngamafutshane...

Ngamafutshane, `(Toxic Megacolon)` yimeko engxamisekileyo kakhulu, eyenzeka emathunjini akho amakhulu (ekwaziwa ngokuba yi`(Colon)`). Ibangelwa kukudumba okukhulu, oko kukuthi, ukudumba okanye ukwenzakala (`(Colitis)`) kwamathumbu amakhulu.

Cinga ngale ndlela: amathumbu ethu amakhulu afana nombhobho oguquguqukayo. Ane-membrane encinci ngaphakathi. Ngokwesiqhelo, xa ufumana i-colitis, ichaphazela le membrane. Kodwa ukuba ukudumba kuba nzima kakhulu , kunokusasazeka kwiindawo ezinzulu zamathumbu, oko kukuthi, izihlunu ezikwiindonga zamathumbu.

Kwenzeka ntoni xa oku kusenzeka? Imisipha esezindongeni zamathumbu iyayeka ukusebenza kakuhle. Le misipha yiyo etyhala ukutya nomoya emathunjini. Xa iyeka ukusebenza, ukutya nomoya ziyabanjwa ngaphakathi emathunjini. Emva koko iindonga zamathumbu ziyabuthathaka, ziyanwebeka, kwaye ziyanda. Zivuthelana njengebhaluni. Eyona nto iyingozi kukuba inkunkuma eqokelelana ngale ndlela yenza ityhefu kwaye ivuza ngezo ndonga zibuthathaka iye egazini. Emva koko wonke umzimba uqala ukutyhefwa. Siyibiza le megacolon inetyhefu okanye ``Megacolon inetyhefu``.

Yintoni umahluko phakathi kwe-`(Toxic Megacolon)` kunye nezinye iintlobo ze-`(Megacolon)`?

Ngoku usenokuba ucinga, "Azikho ezinye izifo ezibangela ukuba ikholoni idumbe?" Ewe, zikhona. Ngamanye amaxesha ikholoni ingadumba ngenxa yokuthintelwa (`(Izithintelo)`), okanye ngamanye amaxesha ngaphandle kokuthintelwa (`(Izithintelo-ze-Pseudo)`). Oku kukwabizwa ngokuba yi`(Megacolon)`.

Nangona kunjalo, ingcali ye-`(Toxic Megacolon)` kukuba, njengoko bekutshiwo ngaphambili, ityhefu isasazeka emzimbeni wonke (`(Systemic Toxicity)`) . Oku akusoloko kusenzeka kwezinye iintlobo ze-`(Megacolon)`. Ngokukodwa, le meko inobungozi idla ngokubonakala kwi-`(Colitis)` eyenzeka ngokudumba kwamathumbu (`(Colitis)`, oko kukuthi, ngenxa yezifo ezahlukeneyo okanye iimeko ze-`(Inflammatory)`. Kulapho kuvela khona iimpawu ezifana noxinzelelo lwegazi oluphantsi, ukubetha kwentliziyo okukhawulezayo, kunye nokudideka.

Ziziphi iingxaki ezinkulu ezinokubakho ngenxa ye-`(Toxic Megacolon)`?

Oku kuthathwa njengengxamiseko yezonyango , kuba kunokukhokelela kwiingxaki ezininzi ezinzulu ezinokuba yingozi ebomini.

• Ukugqobhoka/ukugqabhuka kwamathumbu : Endikutshoyo kukuba iindonga zamathumbu ziba buthathaka kwaye zinwebeke. Xa oko kusenzeka, zinokugqabhuka okanye ziqhume ngokulula.
• Ukopha kakhulu esiswini kunye nokulahleka kwegazi : Amathumbu anokwenzakala kwaye angopha kakhulu.
• Usulelo oluvela emzimbeni kunye ne-sepsis: Xa ityhefu evela emathunjini ingena egazini, usulelo lunokusasazeka emzimbeni wonke, nto leyo ekhokelela kwimeko eyingozi ebizwa ngokuba yi-sepsis.
• Isifo se-Abdominal compartment syndrome: Uxinzelelo oluphezulu ngaphakathi esiswini lunokuchaphazela amanye amalungu omzimba.

Kubaluleke kakhulu: Ukuba uneempawu ezinje, eyona nto ingcono onokuyenza kukufuna ingcebiso kagqirha ngokukhawuleza.

I-Megacolon enetyhefu ingabangela njani ukufa?

Le yingxaki enzulu. Njengoko bekutshiwo ngaphambili, iindonga zekholoni, ezibuthathaka nezinwebekileyo, zinokukrazuka ngokulula kwaye zivuleke. Ukuba loo mngxuma uvela, ukopha okukhulu kunokwenzeka ngaphakathi kwesisu, kwaye izinto ezifana nendle zinokuvuza ngaphakathi kwesisu, okubangela usulelo ngaphakathi kwesisu (i-peritonitis). Olu sulelo lunokuqokelelana ngokukhawuleza egazini kwaye lutyhefe umzimba wonke, nto leyo ekhokelela kwimeko ebizwa ngokuba yi-toxic shock. Kwakhona, xa uxinzelelo ngaphakathi kwesisu lusanda kakhulu, ukuhamba kwegazi kwamanye amalungu abalulekileyo (njengezintso kunye nemiphunga) kunokuphazamiseka, kwaye anokunqongophala ioksijini kwaye ahluleke. Le yeyona nto iphambili yokufa.

Zithini iimpawu ze-`(Toxic Megacolon)`?

Kule meko, iimpawu ezahlukeneyo zinokuvela. Ezinye zazo zinokuvakala ngathi yintlungu yesisu eqhelekileyo. Kodwa ukuba uneempawu ezingaphezulu kwenye kwezi, okanye ukuba zinzima kakhulu, kufuneka ukhathazeke.

• Urhudo (oludla ngokuba negazi) : Ukuhamba kwamathumbu rhoqo, kwaye ukuba kuhamba negazi, olo luphawu oluyingozi.
• Intlungu yesisu kunye nokuthamba : Intlungu evakala ngathi isisu sakho siyacinezelwa, kwaye ibuhlungu nokuba uyichukumisa.
• Isisu esivuvukileyo : Isisu sikhulu, ngokungathi sigcwele umoya.
• Ukuqunjelwa kunye nentlungu yegesi (`(Intlungu yegesi kunye negesi)`) : Isisu sigcwele igesi, nto leyo ebangela intlungu.
• Isicaphucaphu nokuhlanza : Ukuziva unesicaphucaphu esiswini sakho, uzive ngathi uza kuhlanza.
• Isiyezi (`(Isiyezi)`)
• Ukuphelelwa ngamanzi emzimbeni : Ukulahlekelwa ngamanzi emzimbeni. Iimpawu ziquka umlomo owomileyo kunye nokuncipha kokuchama.
• Isantya sentliziyo esikhawulezayo : Ukunyuka kwesantya sokubetha kwentliziyo.
• Umkhuhlane (`(Umkhuhlane)`)
• Uxinzelelo lwegazi oluphantsi (`(Uxinzelelo lwegazi oluphantsi)`) : Ukwehla koxinzelelo.
• Ukudideka kwengqondo : Ukungakwazi ukuqonda okwenzekayo, ukuziva udidekile.
• Ukudinwa/ukungakhululeki : Ukuziva ubuthathaka.

Yintoni imbangela ephambili ye-`(Toxic Megacolon)`?

Enyanisweni, naluphi na uhlobo lwe-colitis enzima lunokubangela i-megacolon enobuthi. Nangona kunjalo, idla ngokubangelwa yimeko ebizwa ngokuba yi-inflammatory bowel disease (IBD).Isifo samathumbu esidumbileyo (IBD) ligama eliqhelekileyo leentlobo ezahlukeneyo zesifo sofuba esinganyangekiyo, oko kuthetha ukuba sihlala ixesha elide kwaye kunzima ukunyanga. Umzekelo, i-Ulcerative Colitis kunye neSifo sikaCrohn ziwela phantsi kolu didi. Ukuba ezi meko azilawulwa ngokufanelekileyo ngokutya kunye namayeza, ekugqibeleni zinokuchaphazela amaleko anzulu ekholoni, nto leyo ekhokelela kwi-Toxic Megacolon.

Ziziphi ezinye izizathu zeMegacolon enetyhefu?

`(I-Toxic Megacolon)` yingxaki ye-`(Colitis)` enzima. Ngoko ke zininzi izizathu zale `(Colitis)`. Oko kukuthi, `(I-Toxic Megacolon)` inokubangelwa ziintlobo ezahlukeneyo zeemeko ze-`(Colitis). Makhe sibone ukuba zeziphi:

• I-Ulcerative Colitis : Olu lolona hlobo luqhelekileyo lwe-IBD kwaye lukwangunobangela omkhulu we-Toxic Megacolon. I-Toxic Megacolon idla ngokuvela kwiminyaka embalwa yokuqala emva kokufunyaniswa kwesifo.
• Isifo sikaCrohn : Olu lolunye uhlobo lwe-IBD. Luchaphazela kakhulu amathumbu amancinci, kodwa lunokuchaphazela namathumbu amakhulu. Abantu abanesifo sikaCrohn nabo basengozini yokufumana i-Toxic Megacolon kwasekuqaleni kwesi sifo.
• I-Ischemic Colitis : Xa amathumbu engafumani igazi ngokufanelekileyo (I-Intestinal Ischemic Syndrome), oku kunokubangela i-Ischemic Colitis. Oku kunzima ukunyanga, kwaye kunokuqhubekela kwi-Toxic Megacolon.
• I-Radiation Colitis : Unyango lwe-radiation kwizifo ezifana nomhlaza lunokubangela i-colitis yexesha elifutshane njengesiphumo esingesihle. Nangona kunjalo, kwabanye abantu, inokuqhubeka ixesha elide kwaye ibangele iingxaki.
• Isifo Sokudumba Kwegazi Esisulelayo : Usulelo olubangelwa ziibhaktheriya, zizinambuzane, okanye ziintsholongwane lunokubangela isifo sokudumba kwegazi. Ezinye iintlobo zosulelo zinokubachaphazela ngakumbi abanye abantu. Nokuba kukutya okunobuthi okanye umkhuhlane wesisu kunokubangela isifo sokudumba kwegazi esibi kwabanye abantu. Abantu abaneenkqubo zomzimba ezibuthathaka basengozini enkulu yosulelo olufana ne-cytomegalovirus.
• I-Pseudomembranous Colitis : Olu luhlobo lwe-colitis eyosulelayo ebangelwa yibhaktheriya iClostridium difficile (C. diff). Ikwabizwa ngokuba yinto ebangela umngcipheko we-megacolon enetyhefu. Ihlala isenzeka kubantu abathatha amayeza okubulala iintsholongwane ukuze bafumane olunye usulelo. Oku kungenxa yokuba xa iibhaktheriya ezilungileyo emathunjini zibulawa ngamayeza okubulala iintsholongwane, iibhaktheriya zeC. diff ziqala ukukhula zingalawuleki. Olu sulelo lweC. diff lunokuba nzima ngokukhawuleza.

Ziziphi izinto ezibangela umngcipheko wokukhula kwe-`(Toxic Megacolon)`?

Abanye abantu banamathuba amaninzi okuba nale meko. Ngoobani bona?

• Abantu abane-`(Isifo samathumbu esivuthayo (IBD))`.
• Abantu abanezifo zokuzikhusela komzimba (oko kukuthi, izifo apho inkqubo yomzimba yokuzikhusela ihlasela iiseli zomzimba)
• Abantu abane-`(HIV/AIDS)`.
• Abantu abaye bafakelwa amalungu omzimba okanye abasebenzisa amayeza okunciphisa amajoni omzimba.
• Abantu abanesifo seswekile.
• Abantu abanesifo sezintso.
• Abantu abanesifo semiphunga esingapheliyo (iSifo seMiphunga esingapheliyo - i-COPD).
• Abantu abaneengxaki zentliziyo (`(Congestive Heart Failure)`).

Kwakhona, amanye amayeza owasebenzisayo angenza le meko "ye-Toxic Megacolon" ibe mandundu:

• Iintlobo zeentlungu zentlungu (`(Opioids)`)
• Amayeza angengowe-steroidal alwa nokuvuvukala (ii-NSAID - umz. i-Ibuprofen, i-Diclofenac)
• Amanye amayeza okudakumba (`(Amayeza okudakumba)`)
• I-Anticholinergics
• Imithi yokuthintela urhudo (sebenzisa ezi ngononophelo, kuba zinokwenza imeko ibe mandundu ngokuthintela ukuhamba kwamathumbu)
• Ukulungiswa kwamathumbu (iyeza elinikwa ukucoca isisu ngaphambi kokuhlolwa kwekholoni) (Oku kunokuba yingozi kumntu osele ene-colitis)

Ifunyanwa njani iToxic Megacolon?

Ugqirha uza kukubuza ngeempawu zakho, naziphi na izifo zangaphambili, kunye namayeza owathathayo. Olu lwazi lubalulekile kuba ezinye izifo okanye amayeza anokunyusa umngcipheko wokufumana iToxic Megacolon. Amanye amayeza, anjenge-steroids, anokuthintela iimpawu zeToxic Megacolon. Ugqirha uza kukwenza uvavanyo lomzimba.

Ngexesha lovavanyo lomzimba, ugqirha wakho uza kujonga isisu esidumbileyo, ukuthamba, kunye nokungakhululeki. Basenokusebenzisa i-stethoscope ukumamela ukuncipha kwentshukumo yamathumbu. Iimpawu zakho ezibalulekileyo (ukubetha kwentliziyo, ubushushu, kunye noxinzelelo lwegazi) ziya kuhlolwa iimpawu zetyhefu, ezinje ngomkhuhlane, uxinzelelo lwegazi oluphantsi, kunye nokubetha kwentliziyo ngokukhawuleza.

Ukongeza, uvavanyo lwegazi kunye novavanyo lwemifanekiso yesisu (umz., i-X-ray, i-ultrasound yesisu, okanye i-CT scan) kunokufuneka ukuqinisekisa ukuxilongwa. Olu vavanyo lwemifanekiso lujonga ukuba ikholoni ibanzi kangakanani na kwaye ingaba kukho naziphi na ezinye iingxaki. Uvavanyo lwegazi lunokujonga inani leeseli ezimhlophe zegazi kunye neeseli ezibomvu zegazi, kwaye lunokufumanisa ukuba kukho ukudumba okukhulu na.

Kukho iindlela ezahlukeneyo ezisetyenziswayo ukuxilonga `(iMegacolon enetyhefu)`:

• Ubungqina bokuba ikholoni ingaphezulu kweesentimitha ezi-6 ububanzi.
• Ukuba neempawu ezintathu kwezi zilandelayo ubuncinane:
• Umkhuhlane ongaphezulu kwe-100.4 Fahrenheit (38 Celsius).
• Isantya sentliziyo esidlula i-120 beats ngomzuzu.
• Ukwanda kwenani leeseli ezimhlophe zegazi.
• I-anemia (ukwehla kwenani leeseli ezibomvu zegazi).
• Ukuba nenye yezi mpawu zilandelayo ubuncinane:
• Ukuphelelwa ngamanzi emzimbeni (`(Ukuphelelwa ngamanzi emzimbeni)`).
• Ukungalingani kwe-electrolyte/fluid.
• Utshintsho kwimeko yengqondo.
• Uxinzelelo lwegazi oluphantsi (`(Uxinzelelo lwegazi oluphantsi)`).

Ukongeza, ugqirha usenokufuna ukuvavanya iisampulu zegazi okanye zendle yakho ukuze abone ukuba kukho naziphi na izifo ezithile.

Ziziphi iindlela zonyango ze-`(Toxic Megacolon)`?

Le meko ifuna iintsuku ezimbalwa zonyango esibhedlele. Injongo yonyango lokuqala kukuzinzisa imeko yakho nokunciphisa ubukhali be-colitis. Ukuba unesifo esifana ne-sepsis, unokufuna unyango kwiyunithi yokhathalelo olunzulu (ICU). Umzekelo, umoya ongeniswa ngomatshini kwiingxaki zokuphefumla okanye i-dialysis yokungasebenzi kakuhle kwezintso.

Ngaphandle koko, ezi ziindlela eziqhelekileyo zonyango lokuqala lwe-`(Toxic Megacolon)`:

• Ulwelo lwe-IV : Nyanga ukuphelelwa ngamanzi emzimbeni kwaye ulinganisele ii-electrolytes.
• Ii-antibiotics : Nyanga izifo ukuba zikhona okanye uthintele izifo ukuba zingabikho.
• `(Ii-Corticosteroids)` : Uhlobo lonyango olunikezelwa ukunciphisa ukudumba (ukudumba).
• Ukuphumla kwamathumbu : Isondlo sangaphakathi / Ukondla ngetyhubhu.

Ukuba ii-corticosteroids aziyiphuculi imeko, ugqirha angasebenzisa olunye uhlobo lwamayeza, njenge-immune modulator. Ezi zinokunceda ekunciphiseni ukusabela okugqithisileyo kwenkqubo yomzimba yokuzikhusela, okunokukhokelela ekuvuvukeni okugqithisileyo kunye nokwanda kweeseli ezimhlophe zegazi kwizicubu.

Utyando

Kuphela malunga nama-50% ezigulana ezinokunyangwa ngamayeza. Abanye banokufuna utyando, ingakumbi ukuba kukho iingxaki ezisongela ubomi. Xa benyanga umntu nge-megacolon enobuthi, oogqirha badla ngokuqhagamshelana noogqirha kwangethuba ukuze bancede benze izigqibo. Ngamanye amaxesha, ugqirha unokugqiba kwelokuba kukhuselekile ukususa inxalenye eyonakeleyo yekholoni (i-colectomy) ukuthintela ezinye iingxaki okanye iingozi.

Ukuba une-colectomy, kuya kufuneka ukuba wenze i-ostomy. I-ostomy yimbobo eyenziwe esiswini sakho ukuvumela indle ukuba idlule. Le yimbobo apho indle idlula khona xa amathumbu akho engasebenzi kakuhle. Ngokuxhomekeke kuhlobo lwe-colectomy onayo, unokufuna ukuba wenze i-ostomy okwethutyana okanye ngokusisigxina. Nokuba lixesha elifutshane okanye elide, ukuziqhelanisa ne-ostomy kunokuba lutshintsho olukhulu kwaye kube nzima kancinci, ingakumbi kwimeko kaxakeka. Kodwa uya kuba nenkxaso oyifunayo ukuze udlule kuyo.

Ngaba iMegacolon enetyhefu inokunyangeka?

Ewe, ukuba ufuna unyango kwangethuba, amathuba akho okusinda aphezulu kakhulu. Malunga nama-93% abantu abanyangwa nge-`(Toxic Megacolon)` bayachacha ngokupheleleyo. Nangona kunjalo, ukuba kukho iingxaki ezifana nokugqobhoka kwamathumbu, izinga lokusinda limalunga nama-75%. Uninzi lweengxaki zenzeka xa i-`(Toxic Megacolon)` inganyangwa ixesha elide. Ke ngoko, kubaluleke kakhulu ukuqonda ubunzulu bemeko yakho kwaye wenze ngokukhawuleza.

I-megacolon enobuthi yingxamiseko yezonyango enokuthi ivele ngequbuliso nangokungalindelekanga. Usemngciphekweni omkhulu ukuba kutshanje ufunyaniswe unesifo samathumbu esibangela ukudumba (IBD) esingalawulwa kakuhle. Nangona kunjalo, sinokwenzeka nakwisifo esinzima okanye esinye isifo solusu esibuhlungu. Qaphela naluphi na utshintsho okanye ukuba mandundu kweempawu zakho eziqhelekileyo.

Ukuba une-colitis enzima kwaye uqala ukuziva ungaphilanga okanye unetyhefu, funa ingcebiso kagqirha ngoko nangoko. Unyango lwangethuba yeyona ndlela ilungileyo yokuthintela iingxaki ezisongela ubomi. Lunokukunceda uphephe utyando. Nokuba kufuneka wenze i-colectomy engxamisekileyo kunye ne-ostomy, khumbula ukuba uya kufumana lonke uncedo olufunekayo ukuze ulungelelanise notshintsho.

Eyona nto ibalulekileyo (Umyalezo Wokuya Ekhaya)

I-Megacolon enetyhefu yimeko engxamisekileyo kakhulu, eyenzeka emathunjini amakhulu. Ibangelwa yi-colitis enzima (ukudumba/ukwenzakala kwekholoni). Ukuba uneempawu ezifana nokudumba, iintlungu zesisu ezinzima, urhudo oluphuma igazi, umkhuhlane, kunye nokubetha kwentliziyo ngokukhawuleza, musa ukuzityeshela. Le yimeko engxamisekileyo yezonyango. Ukuba ufumana unyango esibhedlele ngokukhawuleza, ungaphila ngokupheleleyo. Ke ngoko, ukuba unezi mpawu, bona ugqirha ngokukhawuleza. Okukhona ulinda ixesha elide, kokukhona uya kuba neengxaki ezininzi kwaye kokukhona uya kufa. Nyamekela impilo yakho.

I- Megacolon enetyhefu, i-Colitis, Ukudumba kwekholoni, Iintlungu zesisu, Urhudo, Utyando, Ingxamiseko