Iimpawu, Iibangela, kunye neZonyango kwiHolo kwiColon
Iyintoni imbobo okanye imbobo kwindawo yakho yekolon kwaye zeziphi iimpawu? Ngubani osemngciphekweni? Kwaye uphathwa njani?
Sibanzi
Ikholoni yakho iqulethwe ngamatye e-muscle elula kunye neembrane ezinamaqabunga. Ingqimba elingaphakathi, elibizwa ngokuba yi-mucosa, lincinci kwaye lincinci-lifana nezicubu emlonyeni wakho. Ubunzima bokubumba buya kwenzeka xa kukho umgodi kule ndawo yokulala, ngokuqhelekileyo ngenxa ye-colon ukuhlinzwa okanye isifo esiyingozi.
Umngxuma kwi-colon uvumela ukuba okuqukethwe kwekholoni kudibanise kwizinto eziqhelekileyo ezingenakunqamlezo kwisisu sakho esiswini.
Iimpawu
Iimpawu zesilonda sezilwanyana ziyahluka kwaye zifike ngokukhawuleza okanye ngokukhawuleza kuxhomekeke kwizinto ezibangela. Iimpawu zingabandakanya:
- Iintlungu zesisu (eziqhelekileyo ezinzima kwaye zichithwa)
- Ukuqhaqha kwesisu
- Ukuqhawula
- Isihlunu kunye nokuhlanza
- Utshintsho kwimfamisa yakho okanye kwimikhwa.
- Ukuphuma kwamanzi
- Umkhuhlane (ngokuqhelekileyo awukho msinya)
- IChills
- Ukukhathala
Izinto zobungozi
Iingcali zenzululwazi ziye zafumanisa ukuba izinto ezininzi zinokunyusa umngcipheko wakho wokuphuhlisa ukuxhamla. Ezi ziquka zombini izinto ezibandakanyeka ekutyunjweni okanye kwinkqubo (izizathu ze-irogenic) kunye nezifo zesifuba ezibonakalisa ukuvuvukala. Imiba yengozi ingaquka:
- Kutshanje okanye ngaphambi kwesisu.
- Ngokutsha okanye ngaphambi kokuhlinzwa.
- Umdala omkhulu kunama-75.
- Imbali yeengxaki ezininzi zezokwelapha.
- Ixinzelelo kwiisisu okanye kwintsimbi (njengengozi yemoto.)
- Imbali yezifo ezahlukahlukeneyo.
- Iimbali zesifo sezifo .
- Umhlaza weColon
- Ukusetyenziswa kwe-antioclonal anti-immunotherapy drug lilimlimab.
- Ukubambisana kwamafilosofi (izicubu ezibomvu, ngokuqhelekileyo zihambelana nokuhlinzwa kwangaphambili.)
- Ubulili besini (abafazi basenokuba ne-colon eguquguqukayo, enokubangela ukuphazamiseka ngengozi ngexesha lezonyango, kuquka i-colonoscopy.)
- Iinkqubo zokuxilonga kunye nocwangco ezibandakanya i-tract tract, isisu, okanye i-pelvis. Imiba yengozi ye-perforation ngexesha le- colonoscopy ibandakanya ukuba ngumfazi, ubudala, imbali yezifo ezahlukahlukeneyo, kunye nokukhutshwa komzimba.
Izizathu
Ubunzima bokuhamba buya kwenzeka ngokukhawuleza (ngokungalindelekanga) ngenxa yesimo sengonyango okanye kunokuba kubekho inkcenkcesho yeenkqubo ezahlukeneyo zokuxilonga kunye nokugqitywa okwenza ngengozi umgodi kwikoloni. Ingxaki, ngokukodwa ukuxhatshazwa ngokukrakra kwisisu, kubangelwa imbangela ebalulekileyo yeembilini.
Iinkqubo ezibandakanyekayo ziquka:
- I-Enema - I-tube ye-reema engafanelekanga okanye enokuthi ifakwe i-enema iyakubetha okanye iqhube i-colon.
- Ukulungiswa kwamathumbu e-colonoscopy - Ngokuqhelekileyo, ukulungiselela isilumko se-colonoscopy kunokubangela ukugqithiswa. Oku kuqhelekileyo kubantu abaneembali zokuqhaqha.
- I-Sigmoidoscopy - Nangona i-endoscope ye-sigmoidoscopy eguquguqukayo iguquguqukayo, i-perforation ihlala ingozi, kodwa inqabileyo.
- I-Colonoscopy - Isiphelo se-endoscope sinako ukuqhutyula i-colonoscopy . Ukuguqulwa kweembilini ezinxulumene ne-colonoscopy zixhaphake kakhulu kulabo abanesifo esibi kakhulu esibilwaneni kunye nalabo abasemachiza e-steroid. I-colonoscopy perforation rate ibonakala ibe malunga no-1 kubantu abayi-1400 abaye bahlola iikholoncopies kunye ne-1 yabantu abayi-1000 abanomdla we-colonoscopy (eg, ukususa i-polyp).
- Ukuhlinzwa ngamathumbu okanye i-pelvic, ngokugqithiseleyo utyando lwekoloni njengomdlavuza wekolon.
Iimbangela zokugqithiswa kwamathumbu (ngokungahambisani nokuhlinzwa okanye iinkqubo) zibandakanya:
- Izifo zesibindi sokugula / isifo se-colitis ezifana nesifo sikaCrohn kunye nesifo sezilonda zesilonda. Umngcipheko wobomi obunzima obunzima obunzima kunye nesifo sikaCrohn phakathi kwepesenti ezintathu nantathu, okwenza oku kubangelwa kakhulu.
- Isithintelo esinzima semfuyo, ingakumbi xa i-colon "ithathaka" ngesifo esicacileyo, enye inkqubo, okanye umhlaza.
- I ngxaki.
- Isifo se-Ismicic isifo (xa igazi linikezelwa kwi-colon lonakaliswe.)
- Umhlaza weColon.
- Ukungcoliswa komzimba wangaphandle - Ngokuqhelekileyo ngenxa yokungenwa kwamathambo entlanzi, kunye neengcezu zethambo, kunye nezinto ezingezona ukutya.
- Ukunyamezela kwamathumbu.
Ukuxilongwa
Ukuba ugqirha ugxeka i-bowel, uyakwazi ukuyivavanya iimvavanyo ukuze aqinisekise ukusola kwakhe. I-x-ray elula yesisu ingabonisa i-gas ngaphandle kwekoloni kodwa ayisoloko ixilongwa. Iskripthi se-CT yesisu sakho kunye okanye ngaphandle kokungafani okanye i-enema ye-barium okanye ingumngcingo inokufuneka. Inani elipheleleyo legazi lingabonisa ukuphakama kwesibalo sakho segazi elimhlophe ukuba i-perforation ibekho ngexesha elide, okanye ubungqina begazi ngenxa yokuphuma kwegazi. Amancinci amancinci ngamanye amaxesha anokuthabatha izifundo kunye nexesha lokucinga ngokuchanekileyo.
Unyango
Ukugqithiswa kweembilini kubonwa njengongxamiseko lwezonyango kwaye kufuna unyango olushushu. Ukushiya kungakhange kulandelwe, iziqulatho zesibilini zingakhupha kwaye zibangele ukuvuvukala, ukusuleleka kunye nokugqithisa esiswini sakho. Igama lobugcisa lalo li-peritonitis, eliyimpempeli elibuhlungu ekuthungeni isifo se-sepsis-okanye isifo sobonke.
Uninzi lweempembelelo lulungiswa ngokukhawuleza. Ngokuxhomekeka kwindawo kunye nobukhulu beengxolo, ugqirha unokukwazi ukuyilungisa nge-endoscope, efana neyetshenziswe ngexesha le-colonoscopy-kodwa oku akuyona inketho kuwo wonke umntu. Ukuvulwa kweembilini kungavumelekile okanye kungabikho kwisifo se- stoma kunye ne-colostomy : ukuvulwa komzimba ngaphandle kwesisu sakho apho isitofu sidonsa isikhwama esincinci kude kube yilwelwe.
Iingxaki
Iingxaki ze-perforation ezingaphendulwanga zingabandakanya:
- Ukuhlamba
- Usulelo (i-peritonitis kunye ne-sepsis)
- Ukufa
Iingxaki zixhomekeke kwimpilo ebanzi yomntu, kwakunye nexesha elithathiweyo ukuxilonga nokunyanga i-perforation.
Ukubuyisela
Ngethuba lokubuyisela ixesha lokuqala, awukwazi ukusela okanye ukutya nantoni na ngomlomo. Oku kuthiwa ukuphumla izibilini kunye nokuvumela ixesha elingaphakathi lokuphulukisa kakuhle. Uya kuba ne-nasogastric tube endaweni yokucoca iziqulatho esiswini sakho ixesha. Unokufumana i-antibatic antibiotic kunye nesondlo kwiintsuku ezimbalwa ukuba usesikhungweni. Nangona unokuba uxhalabele ukubuyela kwindlela yakho yesiqhelo, kubalulekile ukuba unike ixesha lakho lekolon ukuze uphilise kakuhle , kwaye ulandele umyalelo wakho ugqirha.
Ngaphantsi
Ubunzima bokuhamba ngegazi buya kwenzeka ngokukhawuleza, njengesifo sesifo sesisu, okanye ngexesha lotyando okanye iimvavanyo zokuxilonga. Iimpawu zingaphuma ngokukhawuleza, okanye ngokuthe ngcembe, kwaye zifanele ziqwalaselwe kunoma ubani onomngcipheko wezinto ezibangelwa ukuguqulwa kunye neemeko zobungozi kwimeko.
Xa kubanjwe ekuqaleni, kukho iindlela ezahlukeneyo zonyango ezikhoyo, kodwa kwanokuhlinzwa (okufunekayo ngokuqhelekileyo) isilonda sinokugcinwa nokulungiswa ngaphandle kwebala. Ukubuyiselwa kungathatha ixesha, kokubili ukuphilisa, kunye nokulungisa izinto ezibangele ukuphazamiseka.
> Imithombo
- > Holmer, C., Mallmann, C., Musch, M., Kreis, M., noJ Grone. UkuPhathwa kokuPhathwa kwe-Iatrogenic Perforation yeTransstinalinal Tract: Iminyaka eyi-15 yamava kwiziko elilodwa. Ingxelo Yomhlaba Yophando . Ngo-2017 uMatshi 21. (uEpub ngaphambi kokuprinta).
- > Kim, J., Lee, H., Ye, B. et al. Isiganeko soMngcipheko weeNgqungquthela zoMoya oPhezulu kwiZifo eziMzimba ezinezifo ezine-Crohn's Disease. Izifo zeNtsholongwane kunye neNzululwazi . 2017. 62 (6): 1607-1614.
- > Kothari, K., Friedman, B., Grimaldi, G., noJ. Hines. I-Nontraumatic Large Bowel Perforation: I-Spectrum ye-Etiologies kunye ne-CT Findings. Radiology yamathumbu . 2017 Meyi 10. (Epub ngaphambi kokuprinta).
- > Yamauchi, A., Kudo, S., Mori, Y. et al. Uhlalutyo olulandelayo lwe-Large Bowel Lock or Perforation eyenziwa ngokulungiswa komlomo kwiColonoscopy. I-Endoscopy International Open . 2017. 5 (6): E471-E476.