Isifo sofuba esiswini (i-IBD) isifo esiningi esichazwa ukuvuvukala emdongeni wamathumbu (ulcerative colitis). Inqubo yokuvuvukala, ehlukahluka ngokweqile kusuka komuntu kuya komuntu, ingaveza izimpawu ezihlukahlukene emathunjini nasemzimbeni wonke.
I-colitis ye-ulcerative ihlukaniswe ubukhulu bezimpawu. Ukuhlukaniswa ngezigaba nakho kusiza iziguli futhi odokotela balindele imiphumela yezokwelapha ezithile, futhi bangasiza ekutholeni iziguli ezingenakwenzeka ukuphendula ukwelashwa kwezokwelapha futhi kungenzeka ukuthi zizuze ekuhlinzekeni.
Njalo ngonyaka, amacala amasha angaba ngu-10 kuya kwangu-12 e-ulcerative colitis atholakala kubantu abayi-100,000. Iningi lalezi zimo lincane noma likhulu. Kodwa-ke, amaphesenti amahlanu kuya kwangu-8 ane-colmine egcwele, ebizwa nangokuthi i-colitis ekhulu kakhulu (okusho ukuthi kuyinto enzima).
Izibonakaliso nezimpawu ze-colin fulminant zihlanganisa:
- Izihlalo ezingaphezu kuka-10 ngosuku
- Ukusuka kwansuku zonke okuqhubekayo
- Kudinga ukumpompela igazi
- Ubuhlungu besisu nesisu
- Amakaki avuvukayo aphezulu egazini
- Ukwenyuka kwenhliziyo (ngaphezulu kwezingu-90 ngomzuzu)
Ngaphandle kokuba ukuvuvukala kulawulwa, iziguli ezine-colitis ezigcwele zibeka engozini yokuthuthukisa i-megacolon enobuthi, uhlobo olubi kakhulu lwe-colitis. E- megacolon enobuthi , inqubo yokuvuvukala enobudlova inqanda izindonga ze-muscular ikoloni eyenza ukuthi ihlukanise. Lokhu kwandisa ingozi yokuthi ikholoni izokwenziwa nge-perforate (ihlukaniswe) futhi ichithe okuqukethwe kwembilini ngaphakathi kwesigxobo esiswini.
Lesi yisimo esisongela ukuphila.
Indlela ukuvuvukala kuthinta ngayo umzimba
Ukuze uqonde umthelela we-colin fulminant, kubalulekile ukuqonda ukuthi ukuvuvukala kuthinta kanjani umzimba. Uma ukuvuvukala ekolonini kukhona esikhathini esidlule, noma kubudlova futhi kulukhuni, kuyaphazamisa ubuqotho bezincubu namaseli.
Ngakho-ke, lapho lezi zincubu namaseli engasebenzi, umphumela ungaba yizigqoko, izihlalo ezivame ukuhamba, ukuphuma, noma ukuvalelwa.
Njengoba ukuvuvukala kunoma yiluphi uhlobo kuthinta wonke umzimba, iziguli ezine-colitis nazo zingase zilahlekelwe isifiso sokudla, ukukhathala, izinhlungu zomzimba, ukungakwazi ukugxila, ukungondleki, ukulahlekelwa isisindo, ukuphulukiswa kanzima, ubuthakathaka, futhi, ezimweni ezimbi kakhulu, ukungaphumeleli. Yiqiniso, ubukhulu bezimpawu buzohambisana nobukhulu bokuvuvukala nomthamo womuntu wokubekezelela ukucindezeleka.
Uma ukuvuvukala kukhona, umzimba uqondisa izinsiza zawo ekusekeleni amasosha omzimba nokulwa nomthombo wokuvuvukala. Yilapho isibindi singena khona. Ngaphezu kokusebenzisa izakhi ezisuka ekudleni ukukhiqiza amaprotheni kanye ne-glucose umzimba wethu udinga ukusinda, ukusebenza, ukukhula nokuphulukisa, isibindi sisebenzisa futhi izakhi zokondla ekwakheni amasosha omzimba wethu.
Ngaphambi kokuvuvukala, isibindi siqala ukwephula amaprotheni aphansi ukuze uthole izinto ezithile ezidingekayo ukulwa nokuvuvukala. Lawa abizwa ngokuthi abavuvuzi bomlambu. Ngaphambi kokuvuvukala okukhulu, isibindi sisebenzisa lezi zitolo zangaphakathi zamaphrotheni.
Uma ukuvuvukala kungavaliwe, inqubo igweme ukulawulwa futhi ukwanda kwezikhulumi ezivuthayo manje kulimaza umzimba esikhundleni sokuyivikela. Lolu hlobo lokuvuvukala okukhulu lubizwa ngokuthi "oluyingozi."
Ukuvimba ukuvuvukala
Inhlanganisela yemigomo yemitholampilo, i-biochemical, endoscopic, ne-radiographic isetshenziselwa ukuqinisekisa ukuxilongwa kwe-ulcerative colitis, ukunquma ukuqina kwayo, nokulawula ezinye izimbangela ezithathelwanayo zokuvuvukala kwamakholoni, njenge-bacteria noma igciwane lesandulela ngculazi noma ukugeleza kwegazi okubi.
Uma ukuxilongwa sekuqinisekisiwe, ukwelashwa kwe-steroid emangalisa kuqaliswa ukumisa inqubo yokuvuvukala ngezinethemba lokubuyisela ikoloni emsebenzini ovamile.
Ukuxazulula ukuvuvukala kuzomisa izimpawu futhi kuvimbele ukwehla okubhekene nokuhluleka kwekhaloni.
Kodwa-ke, iziguli ezingamaphesenti angaba ngu-40-ikakhulukazi lezo ezinama-colin egcwele noma i-megacolon-enobuthi zizofuna ukuhlinzeka okuphuthumayo noma okuphuthumayo ngenxa yegazi elikhulu noma i- colon perforation , noma ngoba ukwelapha kwezokwelapha kwehluleka ukulawula lesi sifo.
Ukunquma Isu Lokulashwa
Ukuhlolwa kwansuku zonke kanye nokuhlolwa kwegazi kwamakhwala okuvuvukala okwenziwa ngenkathi iziguli zithola ukwelashwa okungenakuzivikela kungenza odokotela bakwazi ukubikezela impendulo yokwelapha kwezokwelapha. Uma isiguli singakathuthuki ngemuva kokuthola i-steroids izinsuku ezintathu noma ngaphezulu futhi sisadlula izitembu eziningi zamanzi, sibonisa umkhuhlane, sibonisa ukuma kwesisu nokukhula kwenhliziyo, ukwelashwa kwezokwelapha kwehlulekile futhi kuhlinzekwa okudingekayo. Kuleli qophelo, abahlinzayo abahlinzayo bazoxoxisana ukuze baxoxe ngezindlela zokuhlinzwa nesiguli.
Nakuba iziguli eziningi zithemba ukugwema ukuhlinzwa, ukuqhubeka nokunikeza izifo zokuzivikela kumuntu ongaphenduli kule mithi enamandla kwandisa ingozi yemiphumela engenayo ngaphandle kwezinzuzo. Ngaphezu kwalokho, uma ukuvuvukala kungaphenduli ngesikhathi esifanele, isiguli sisengozini yezinkinga ezinkulu ezivela ku-colitis, kuhlanganise ne-megacolon enobuthi.
Ukuhlinzwa kwe-Fulminant Colitis
Ukuhlinzwa kwe-colin egcweleyo kuhilela ukukhipha ikoloni kanye ne-rectum ukuqeda umthombo wokuvuvukala okunobuthi. Iningi leziguli zikhethwe yi- j-poch (ebizwa nangokuthi isikhwama se-ileal), esivumela ukuba bagcine ukuqhubeka kwabo emathunjini futhi basebenzise indlela evamile yokuqeda udoti emzimbeni.
Inqubo ivame ukwenza ngezinyathelo ezintathu:
- I-colon isusiwe futhi isiguli sinikezwe i-ileostomy yesikhashana. Lona umgodi esiswini lapho isitoli singene esikhwameni sangaphandle. Njengoba umthombo omkhulu wokuvuvukala uhambe, umzimba uqala ukuphulukisa futhi isiguli sikwazi ukwakha izinqolobane zokudla okunomsoco.
- Ngemva kwezinyanga eziyisithupha kuya kwezingu-12, i-rectum isusiwe futhi inqubo ye-j-pouch isenziwa. Kule nqubo entsha, ingxenye yokugcina yesiguli esincane iphinda ibuyele emuva ngokwayo ukuze idale "j" isitsha esakhiwe esitolo futhi sidlule esitokisini. I-ileostomy yesikhashana ishiywe endaweni kuze kube yilapho isikhwama siphulukisa.
- Ezinyangeni ezimbili noma ezintathu kamuva, i-ileostomy ivaliwe futhi isilonda esinempilo siphinde sitholakale ku-anus.
> Imithombo:
> Strong SA. Ukuphathwa kwe-acute colitis kanye ne-megacolon enobuthi. I-Clin Colon Rectal Surg. 2010; 23 (4): 274-284.
> Metcalf AM. Ukuphathwa okukhethiwe nokusebenzayo kokulonda kwe-ulcerative colitis. Umtholampilo Wokuhlinzwa North Am. 2007; 87 (3): 633-631.
> Arnell TD. Ukuphathwa kokuhlinzwa kwe-acute colitis kanye ne-megacolon enobuthi. I-Clin Colon Rectal Surg. 2004; 17 (1): 71-74.
> I-Grieco MB, i-Bordan DL, i-Geiss AC, i-Beil AR Jr. I-megacolon enobuthi iyinkimbinkimbi ye-Crohn's colitis. Ann Surg. 1980; 191 (1): 75-80.