Megacolon inosvibisa (inozivikanwawo seinochera inopisa) inogona kunge iri dambudziko rakakomba rezvirwere zvechirwere (IBD) . Ichi ndicho chinetso chinowanzoitika kakawanda nehutachi inouraya kupfuura iyo inodaro neCrohn's disease. Nhau yakanaka ndeyekuti megacolon ine chepfu inowanika uye inowanikwa muzasi ye5% yematambudziko echirwere IBD. Mamiriro acho ezvinhu anoitika apo ikoni inoparadzaniswa zvakanyanya, kana inokonzerwa, uye inopera kurasikirwa kukwana kweropa.
Pasina ropa rakakwana kuenda kumakoroni, mavara acho angava ischemic, zvinoreva kuti iri kufa.
Kurapa IBD kupera-ups vasati vakurira kunogona kubatsira mukudzivirira megacolon ine chepfu. Muzviitiko zvakawanda, vanhu vane chironda chekuonda chirwere chepachirwere vanorayirwawo kuti vachenjerere nemishonga inorwisa-diarrheal nokuti yakabatanidzwawo kune megacolon inotyisa. Ani naani ane IBD ane kurwadziwa kwepamuviri, chirwere chinoputika, uye fivhiri, anofanirwa kutsvaga kurapwa pakarepo.
Zvinokonzera
Megacolon inotyisa inogona kunge iripo kune vanhu vane zvikuru IBD. Mune zvimwe zviitiko, zvinogona kuguma nekushandisa zvakanyanya mamwe madhiragi, kusanganisira narcotics; zvinodhaka zvinoshandiswa pakununura kurwadziwa, anticholinergics; zvinodhaka zvinoshandiswa pakuora mwoyo, kuzvidya mwoyo uye kutya; uye antidiarrheals, zvakadai sa loperamide. Nokuda kwechikonzero ichi, zvinowanzokurudzirwa kuti vanhu vane ulcerative colitis havatori mishonga-anti-antidiarrheal mishonga pasina kubvumirwa kubva, uye kutarisirwa pedyo ne, gastroenterologist ine ruzivo mukurapa varwere vane IBD.
Zviratidzo
Mharidzo ye megacolon ine chepfu inosanganisira:
- Kusuruvara kwepamuviri uye unyoro
- Madzimai akapararira
- Rapid moyo rate
- Kupera kweropa
- Leukocytosis (high white blood cell count )
- Uchapupu hwehutachiona hwekoloni pamubhedha x-ray
- High fever (40 ° C [104 ° F])
- Kuderedza mvura
Vanhu vane megacolon inonyangadza vanowanzoonekwa vachirwara uye vane nhoroondo yemazuva anoverengeka ekurambana uye kurwadziwa mumimba.
Kurapa
Kurapa kwokutanga kunokosha mune megacolon inotyisa kudzivisa zvinetso zvinopisa upenyu, zvakadai sekutyisidzika, colon perforation (kubvarura murusvingo rwekoloni), peritonitis (utachiona mudumbu) uye septicemia (utachiona muropa). Kubva kusina kutenderwa, koni inogona kuparara, mamiriro ezvinhu anouraya mu 30% emhosva. Kana ichibatwa zvakanaka mumatangiro ekutanga, megacolon ine chepfu ine uwandu hwehuwandu hunopfuura 4%. Ichi ndicho chikonzero zvakakosha kuwana chero zviratidzo zvitsva zvinoongororwa nachiremba, uye kuwana zviratidzo zvakakomba zvinoshandiswa pakarepo.
Chirwere chacho chinofanira kubviswa, izvo zvinowanzoitwa kuburikidza nekupfuura bhutu kubva kunze kwemuviri kusvika mumakoloni. Kana murwere akazora mvura kana achishamiswa, kurapa kwe IV kungashandiswa kushandura electrolytes nemvura. Sezvo kupera kunogona kukonzera utachiona hwakakomba, mishonga inouraya inogona kupiwa. Corticosteroids inogona kubatsira kubvisa kuvhiringidza mukoni.
Muzviitiko zvakakomba zvisingabvumi kurapwa, chirwere chinokurumidza kana kuti colectomy yakawanda inogona kudiwa. Mu colectomy yakazara, iyo inonziwo proctocolectomy, ikoni inobviswa. A proctocolectomy inogona kusarudzwa kune vanhu vane chironda chekuonda, sezvinoitwa j-pouch zvinokwanisa kugadzirwa panguva yechipiri chekuvhiya, mushure mekudzoka kubva kune megacolon inotyisa.
I-j-pouch nzira ichavhara kudikanwa kweeostomy yekusingaperi. Sezvo proctocolectomy inoshandiswa kurapwa kwehutachiona hwehutachiona hwehutachiona, ulcerative colitis haingadzokeri mushure mekuvhiyiwa. Hazvikurudzirwi pamhosva dzechirwere cheCrohn, sezvo chirwere cheCrohn chinogona kudzoka muhomwe yealeal.
Muzviitiko zvakawanda, kana megacolon inotyisa yakanyatsorapwa, kufungidzira kwakanaka kwazvo.
Sources:
ADAM "Inotyisa Megacolon." ADAM, Inc 2004. 30 Jul 2009.