Isifo sesibindi sokuvutha (IBD) sisifo esiphezulu esichazwe ukuvuvukala kwindonga yesilonda (ulcerative colitis). Inkqubo yokuvuvukala, eyahluka ngokukhawuleza ukusuka kumntu ukuya kumntu, inokuvelisa iimpawu ezahlukeneyo emathunjini nasemzimbeni wonke.
I-colcer ulcerative ikhatyathelwe ngokubaluleka kweempawu. Ukwahlula kwakhona kunceda izigulane kwaye oogqirha balindele iziphumo zonyango oluthile, kwaye banokunceda ukufumanisa izigulane ezingenakwenzeka ukuphendula unyango lwezonyango kwaye mhlawumbi ziya kufumana utyando.
Kunyaka ngamnye, ama-10 ukuya kwe-12 amatyala amatsha e-ulcerative colitis atholakala kwi-100,000 yabantu. Uninzi lwale matyala lunomoya omnene okanye olunzima. Nangona kunjalo, iipesenti ezintlanu ukuya kweyesibhozo zine-colmatic fulitis, ebizwa ngokuba yi-acute colitis.
Iimpawu kunye neempawu ze-colym fultant ziquka:
- Izithuba ezingaphezu kwama-10 ngosuku
- Ukuphuma kwansuku zonke
- Kudinga igazi
- Iintlungu zesisu kunye neenkampu
- Amakishi aphakanyisiweyo aphezulu egazini
- Ukongeza kwenani lentliziyo (ngaphezulu kwe-90 beats ngomzuzu)
Ngaphandle kokuba ukuvuvukala kulawulwa phantsi, izigulane ezine-colitis eziphefumulayo zisengozini yokuhlakulela i-megacolon enobuthi, ifom ephezulu kakhulu ye-colitis. Kwi- megacolon enetyhefu , inqubo evuzayo yokuvuvukala ikhupha iindonga ze-muscular zekoloni ezibangela ukuba ziphazamise. Oku kwandisa umngcipheko wokuba i-colon iya kuhlanjululwa (ukwahlukana) kwaye uchithe iziqulatho zesilonda kwisisu esiswini.
Le yimeko esongela ubomi.
Indlela Ukuvuvukala kuchaphazela ngayo iBhunga
Ukuqonda impembelelo ye-colin egcweleyo, kuyimfuneko ukuqonda ukuba ukuvuvukala kukuchaphazela njani umzimba. Xa ukuvuvukala kwikholoni kubakho ngexesha elide, okanye lukhuni kwaye lukhuni, luphazamisa intembeko yamathambo kunye neeseli.
Ngaloo ndlela, xa izicubu kunye neeseli zingasebenzi, isiphumo sinokuqhawulwa, iindawo zokuzikhupha eziqhelekileyo, ukuphuma kwamanzi okanye ukuhamba.
Ekubeni ukuvuvukala kunoma yiluphi uhlobo luchaphazela umzimba wonke, izigulane ezine-colitis nazo zikwazi ukulahlekelwa yidlova, ukukhathala, i-acry body, ukungakwazi ukugxininisa, ukungondleki, ukulahleka kwesisindo, ukuphilisa ubunzima, ubuthathaka, kwaye, kwiimeko ezibi kakhulu, ukungaphumeleli. Ngokuqinisekileyo, ubunzima beempawu ziya kuhambelana nobukhulu bokuvuvukala kunye nomntu ngamnye wokunyamezela uxinzelelo.
Xa ukuvuvukala kubakho, umzimba ulawula izibonelelo zawo ekusekeleni umzimba wamasosha kunye nokulwa nomthombo wokuvuvukala. Yilapho isibindi singena khona. Ukongezelela kokusebenzisa izondlo ekudleni ukuvelisa iiprotheni kunye ne-glucose umzimba wethu kufuneka uqhubeke uphila, usebenze, ukhule kwaye uphilise, isibindi sisasebenzisa izakhi zondlovu ukwakha isimiso sethu somzimba.
Ngaphambi kokuvuvukala, isibindi siqala ukuphula amaprotheni ukwenzela ukufumana izinto ezithile ezifunekayo ukulwa nokuvuvukala. Ezi zibizwa ngokuba ngabalamli abavuthayo. Ekubeni kubakho ukuvutha okukhulu, isibindi sisebenzisa amaninzi eeprotheni zangaphakathi.
Ukuba ukuvuvukala kungagqitywanga, inkqubo iyahluma ukulawulwa kwaye ukwanda kwimilamli ebangelwayo ngoku kunokuphazamisa umzimba kunokukhusela. Olu hlobo lokuvuvukala kakhulu lubizwa ngokuthi "inetyhefu."
Ukuyeka ukuvuvukala
Ukuhlanganiswa kweendlela zokugulisa i-kliniki, i-biochemical, endoscopic, kunye ne-radiographic isetyenziselwa ukuqinisekisa ukuxilongwa kwe-ulcerative colitis, ukuqikelela ubunzima bayo, nokulawula ezinye izizathu ezithintekayo zokutshatyalaliswa kwe-colon, njenge-bhakteria okanye intsholongwane ye-virus okanye ukuhamba kwegazi.
Xa ukuxilongwa kuye kwaqinisekiswa, unyango lwe-sraidous steroid luqalile ukumisa inkqubo yokuvuvukala enethemba lokubuyisela ikoloni kumsebenzi oqhelekileyo.
Ukuxazulula ukuvuvukala kuya kumisa iimpawu kwaye kuthintele ukuhla kwe-colon failure.
Nangona kunjalo, ukuya kuma-40 eepesenti zezigulane-ngokukodwa ezo zine-colmatic colitis okanye i-megacolon-ziya kuqhubeka zifuna ukuphuculwa ngokukhawuleza okanye ukuqhutyelwa ngokukhawuleza ngenxa yobunzima begazi okanye i- colon perforation , okanye ngenxa yokuba unyango lonyango luhluleka ukulawula eso sifo.
Ukuqulunqa iSicwangciso soPhuhliso
Iimviwo zemihla ngemihla kunye nokuhlolwa kwegazi kumakishi avuzayo xa izigulane zifumana unyango olungenakuxilongwa kwimizimba zingenza ukuba oogqirha baxelele impendulo kwonyango lonyango. Ukuba isigulane asizange siphucule emva kokufumana i-steroids iintsuku ezintathu okanye ngaphezulu kwaye isadlula ezininzi izithambiso zamagazi, kubonisa umkhuhlane, kubonisa ukuvama kwesisu kunye nokwanda kwentliziyo, unyango lwezokwelapha aluphumelelanga kwaye utyando luyadingeka. Kule nkalo, oogqirha be-colorectal baya kuxoxwa ukuba baxoxe ngeendlela zokugonywa ngesigulane.
Nangona izigulane ezininzi zinethemba lokugwema ukuhlinzwa, ukuqhubeka nokunika i-immunosuppressants kwisigulane esingazange siphendule kule miyeza enamandla kwandisa ingozi yemiphumo ngaphandle kweenzuzo. Ukongezelela, ukuba ukuvuvukala kungaphenduli ngexesha elifanelekileyo, isigulane sisengozini yeengxaki ezinzulu ezivela kwi-colitis, kuquka ne-megacolon enetyhefu.
Uphando lwe-Fulminant Colitis
Ugqirha lwe-colmant colitis iquka ukususa i-colon kunye ne-rectum ukuphelisa umthombo wesifo esiyingozi. Uninzi lwezigulane ngabaviwa be- j-poch (ebizwa ngokuba yi-ileal pouch), ebenza ukuba bagcine ukunyameka kwabo besisu kunye nokusebenzisa indlela eqhelekileyo yokuphelisa inkunkuma emzimbeni.
Inkqubo ivame ukuqhutywa ngamanyathelo amathathu:
- Ikholoni isuswe kwaye isigulane sinikezwa i-ileostomy yesikhashana. Lo ngumgodi kwisisu esisisigxina singena kwisangxobo sangaphandle. Ngomthombo omkhulu wokuvuvuka uyeka, umzimba uyaqala ukuphilisa kwaye isigulane sinakho ukwakha izibonelelo zokutya.
- Emva kweenyanga ezintandathu ukuya kwezi-12, i-rectum isuswe kwaye inkqubo ye-j-poch isenziwa. Kule nqubo emitsha, inxalenye yokugqibela yesilwanyana esincinci ibuyiselwe yona ngokwayo ukuze idale "j" ibumbi elenziwe ngendlela kwaye igqitha isitulo. I-ileostomy yesikhashana ishiywe kwindawo yendawo ide iphilise isikhwama.
- Kwiinyanga ezimbini okanye ezintathu kamva, i-ileostomy ivaliwe kwaye isilwane esiluphilileyo siphinde sixhaswe kwi-anus.
> Imithombo:
> Strong SA. Ulawulo lwe-colitis enzima kunye ne-megacolon enetyhefu. Klinikhi Colon Rectal Surg. 2010; 23 (4): 274-284.
> Metcalf AM. Ulawulo olukhethiweyo nolululo olusebenzayo lwe-ulcerative colitis. Iklinikhi yokuPhupha eNyakatho Am. 2007; 87 (3): 633-631.
> Arnell TD. Ulawulo lokupanda ngokugqithisa i-colitis kunye ne-megacolon enetyhefu. Klinikhi Colon Rectal Surg. 2004; 17 (1): 71-74.
> IGrieco MB, iBordan DL, i-Geiss AC, I-AR AR I-Jr. I-megacolon enetyhefu iyinkxalabo ye-Crohn's colitis. Ann Surg. 1980; 191 (1): 75-80.