Chirwere chechirwere chinokonzera chirwere (IBD) chirwere chakawanda chinoratidzwa nekuputira mumadziro emvere (ulcerative colitis). Iyo inopisa, iyo inopesana nekuoma kubva kumunhu kumunhu, inogona kubudisa zviratidzo zvakasiyana mumatumbo uye mumuviri wose.
Kuchengetedza chirwere chinokonzerwa nehutachiona hunokonzerwa nekuoma kwezviratidzo. Chikwata chinobatsirawo varwere uye vanachiremba vanofungidzira zvinogadziriswa mune dzimwe mishonga, uye vanogona kubatsira kuziva varwere vasingakwanisi kupindura kurapwa kwechiremba uye vangangobatsirwa nekuvhiyiwa.
Gore roga roga, anenge 10 kusvika ku12 mitsva yealcercer colitis inowanikwa mune 100 000 vanhu. Ruzhinji rwezviitiko izvi ranyoro kana rakaoma. Kunyange zvakadaro, zvishanu kusvika ku8 kubva muzana zvine hutachiona hwehutachiona, inonziwo yakaoma kwazvo colitis (yakaoma inoreva kuti inouya kamwe kamwe).
Zviratidzo nezviratidzo zvekuzara kwechirwere zvinosanganisira:
- Zvinopfuura gumi zvigaro pazuva
- Zuva rega rega rinoramba richibuda ropa
- Zvinoda kuwedzerwa ropa
- Kuchepa kwepamuviri uye kuponda
- Yakawanda inopisa kuvhiringidza muropa
- Kuwedzera kwenhamba yemwoyo (zvinodarika makumi mapfumbamwe makumi mana neminomwe paminiti)
Kunze kwekuti kuvhiringidza kunoiswa pasi pesarudzo, varwere vane hutachiona hwehutachiona vari pangozi yekuva megacolon inotyisa, iyo yakanyanya kupisisa yehutachikiti. Mu megacolon inotyisa , chirwere chinopisa chinoputika chinokonzera masvingo emasvingo ekoloni achiita kuti zviparadzanise. Izvi zvinowedzera mukana wekuti hutoni huchakanganisa (kupatsanurana) uye kudimbura zviri mukati mechirwere mukati memimba.
Iyi ndiyo mamiriro ezvinhu anotyisa.
Kunyanya Kuvhiringidza Kunobata Mutumbi
Kuti unzwisise kukanganisa kwehutachiona hwehutachiona, zvakakosha kunzwisisa kuti kuvhiringidza kunobata sei muviri. Kana kuputika mumakoloni kuripo kwenguva yakareba, kana kune utsinye uye kwakanyanya, zvinokanganisa kuvimbika kwemasukisi nemasero.
Nokudaro, kana mashizha aya uye masero asingabatsiri, chigumisiro chinogona kunge chichidzvinyirira, chinowanzosununguka zvigaro, kubuda ropa, kana kusagadzikana.
Sezvo kuvhiringidza kune chero nhengo kunobatsira muviri wose, varwere vane chirwere chinogona kushaya kurasikirwa kwekudya, kuneta, muviri aches, kusakwanisa kuisa pfungwa, kusagadzikana, kushaya kurasikirwa, kuoma kurapwa, kushaya simba, uye, mumamiriro akaipisisa, kusakwanisa kubudirira. Zvechokwadi, kuoma kwezviratidzo kuchaenderana nekuoma kwekuvhiringidza uye kukwanisa komunhu kubvumira kushungurudzika.
Kana kutuka kuripo, muviri unotungamira zvigaro zvekusimbisa masimba ezvirwere uye kurwisana nemhepo yekuzvimba. Iyi ndiyo iyo chiropa chinopinda. Mukuwedzera pakushandisa michero kubva pane zvekudya kugadzira mapuroteni uye glucose muviri wedu unoda kurarama, kushanda, kukura, uye kuporesa, chiropa chinoshandisa chikafu chekudya kuti tive nesimba rekudzivirira zvirwere zvedu.
Muhupo hwekuputika, chiropa chinotanga kuputsa mapuroteni pasi kuitira kuwana zvimwe zvikamu zvinodiwa kurwisana nekuputika. Izvo zvinonzi kuvhiringidza vamiririri. Muhupo hwekugara uchingoputika kwazvo, chiropa chinoshandisa akawanda uye akawanda aya emaprotini emukati.
Kana kutuka kusina kumiswa, chirongwa chacho chinowedzera kubva kukutarisa uye kuwedzera kwevanopindira vhudzi zvino kunokanganisa muviri pane kuzvidzivirira. Iko rudzi rwekuremara kwakanyanya kunonzi "inotyisa."
Kuchengetedza Kurwisana
Kubatanidzwa kwekliniki, biochemical, endoscopic, uye remitambo yemasikirini inoshandiswa kusimbisa kuongororwa kwekuonda kweutachiona, kutarisa kuoma kwayo, uye kutonga kunze kwezvimwe zvinokonzera zvinokonzera kupisa kwekoloni, zvakadai sebhakitiriya kana utachiona hwehutachiwana kana kusava neropa ruchiyerera.
Kamwe chirwere ichi chave chichinyatsogadziriswa, intravenous steroid therapy inotanga kusimbiswa chirwere chekuvhiringidza muchitarisiko chekudzorera chikoni kuita basa rinowanzoitwa.
Kugadzirisa kupisa kunogadzirisa zviratidzo uye kudzivirira kuderera kunopera kukundikana kwekoni.
Zvisinei, kusvika ku40 muzana yevarwere-kunyanya avo vane hutachiona hwehutachiona kana kuti megacolon inopisa-vacharamba vachitsvaka chirwere chinokurumidza kana kuti chepamusoro nekuda kwekukurumidza kwekushaya ropa kana kupora perforation , kana kuti kurapwa kwechiremba kunokundikana kudzora chirwere.
Kusarudza Chirongwa Chekurapa
Kuongororwa kwezuva nezuva uye kuongororwa kweropa nekuda kwechirwere chekuvhiringidza kunoitwa apo varwere vari kugamuchira kurapwa kwemagetsi kunogona kuita kuti vanachiremba vatarise mhinduro kumushonga werapi. Kana murwere asina kuvandudza mushure mekugamuchira steroid kwemazuva matatu kana kupfuura uye achiri kutapudza masero akawanda emvura, kuratidza fivhiri, kuratidza mimba kudzima uye kuwedzerwa kwemwoyo, kurapa kwechiremba kwakundikana uye chirwere chinodiwa. Panguva ino, mahara chiralpalgoni vachabvunzurudzwa kuzokurukura chirongwa chokuvhiya nemurwere.
Kunyange zvazvo varwere vakawanda vane tariro yekurega kuvhiyiwa, kuramba vachipa miviri miviri kumurwere asina kupindura mishonga iyi ine simba inowedzera dambudziko remigumisiro isina ruzivo. Uyezve, kana kuputika kusingapindirani panguva yakakodzera, murwere ari pangozi yezvinetso zvakakomba kubva muchirwere, kusanganisira megacolon inotyisa.
Kuvhiya kweFulminant Colitis
Kuvhiya kwekuzara kwechirwere kunosanganisira kubvisa koro uye rectum kubvisa chitubu chekuvhiringidza chepfu. Ruzhinji rwevarwere vanobvumirwa ne j-pouch (inonziwo yeal pouch), iyo inovabvumira kuchengetedza kushanda kwavo kwepamuviri uye kushandisa nzira yakagadziriswa yekubvisa tsvina kubva mumuviri.
Iyo nzira inowanzoitwa mumatanho matatu:
- Ikoko inobviswa uye murwere anopiwa ileostomy yenguva pfupi. Iyi ibho mukati mechimbudzi kuburikidza nechidziro chinopinda muhomwe yekunze. Nechokuita chikuru chekuputika kwakaenda, muviri unotanga kurapa uye murwere anokwanisa kuvaka nutritional reserves.
- Pashure pemwedzi mitanhatu kusvika ku12, rectum inobviswa uye j-pouch nzira inoitwa. Mune iyi nzira inofadza, chikamu chekupedzisira chechidiki chiduku chinonamatirwa pachako pachako kuti iite "j" yakagadzirirwa danda inoshamba uye inopfuura chigaro. Izvozvoostomy yenguva pfupi yakasara munzvimbo kusvikira chikwama ichiporesa.
- Mwedzi miviri kana mitatu gare gare, ileostomy yakavharwa uye maronda ane hutano anonamatwa zvakare kune anus.
> Sources:
> Strong SA. Kutungamirirwa kweacute colitis uye megacolon inotyisa. Clin Colon Rectal Surg. 2010; 23 (4): 274-284.
> Metcalf AM. Kusarudzwa uye kushandiswa kwekushanda kweutachiona hwehutachiona. Surging Clinic North Am. 2007; 87 (3): 633-631.
> Arnell TD. Kugadziriswa kwekutonga kweAacute colitis uye megacolon inotyisa. Clin Colon Rectal Surg. 2004; 17 (1): 71-74.
> Grieco MB, Bordan DL, Geiss AC, Mushonga AR Jr. Mishonga inokonzera megacolon inobatanidza Crohn's colitis. Ann Surg. 1980; 191 (1): 75-80.