Kuchengetedza Uye Migumisiro Mishonga yeBIV Inobata pamuviri uye mwana
Ko Vakadzi Vane IBD Vachave nevana Here?
Hongu, vakadzi vane chirwere chinoputika (IBD) vanogona kuva nevana. Munguva yakapfuura, vakadzi vane IBD vakakurudzirwa kuti vasapinda pamuviri. Asi iye zvino maitiro ekugadzirisa eBD akaita kuti mwana ave nerunyararo kune vose amai nemwana. Kuva nechirwere chisingagumi apo pamuviri unoda kutarisirwa zvakanyatsonaka navanachiremba vanokwanisa, asi pamuviri ane hutano uye mwana zvose zviri nyore.
Itai Varume Nevakadzi Vakabatana neAIDS Vakaderedza Kuberekwa Kwemari Here?
Nhamba yehuwandu yevakadzi neBD yakafanana nevakadzi vane utano hwakanaka. Vakadzi vane chirwere chinokonzera Crohn chinogona kuva nekuderera kwekubereka. Kuronga kwemhuri inyaya inokosha kune chero mukadzi, asi kunyanya kune avo vane IBD. Kune mamiriro ezvinhu apo kuberekwa kunogona kusarudzwa, zvakadai panguva yekutadza-kana kana uchishandisa mamwe mishonga.
Izvo zvave zvichizivikanwa kwemakore akawanda sulfasalazine (Azulfadine), chirwere chinoshandiswa kugadzirisa mamiriro aya, chinogona kukonzera kusagadzikana kwenguva pfupi kune 60% yevarume. Sulfa chikamu chechirwere chinogona kuchinja mbeu, asi izvi zvinopindurwa mukati memwedzi miviri yekudzikisa kushandiswa kwayo. Proctocolectomy kuvhiyiwa mune varume kunogona kukonzera kusava nesimba, kunyange izvi zvisingawanzoitiki.
Maererano nekuongorora mamwe mabhuku, kusununguka kunowanikwa mune 48% yevakadzi vanovhiyiwa kurapa chironda chekurwara. Izvi zvinenge zvichida nekuda kwekuvhara muzvipembenene zvinogona kuitika mushure mekuvhiyiwa kwakanyanya kwakadaro.
Dambudziko rekushaya mwana mushure mokunge colectomy rave riri mubvunzo kwemakore anoverengeka nokuti zvidzidzo zvakawanda zvakaratidza zvakasiyana-siyana mitengo yekusabereka. Kune mimwe mitsara yakafanana yekusabereka muvarwere veCrohn's disease.
Chiitiko Chei Mishonga Inobata Pamuviri?
Vakadzi vazhinji vanotenda kuti vanofanira kusiya mishonga panguva yekuzvitakura, asi, kuramba vachishandisa mishonga yeBD inopa mukana wakanakisisa wekusachengetedza.
Mishonga yakawanda yeBD yakaratidzwa kuti yakachengeteka kuti ienderere mberi pakuberekwa, uye vazhinji vane nhoroondo yakareba yekushandiswa kwakachengeteka nevarwere. Zvokudya neDrug Administration (FDA) zvakagadzira chirongwa chekushandisa kwemishonga panguva yekuzvitakura (ona Table 1 iri pasi).
Ongororo dzekutsvakurudza dzakaratidza kuti mishonga yakawanda inowanzoshandiswa pakugadzirisa maitiro ezvokuchengetedza uye zvirwere zvakanyanya zveBD zvakachengeteka kuti vakadzi vane pamuviri vashandise kushandisa. Izvi ndezvi:
- Sulfasalazine (Azulfidine [Kuberekwa Bhuku B]
- Mafomu eMesalamine (Asacol, Pentasa, Rowasa [Mimba Bumbi B])
- Corticosteroids (prednisone [Kuberekwa Category B])
- Biologics ( Remicade , Humira , Vedolizumab , Stelara , Cimzia )
Apo Chirongwa Chirwere Chirwere Chinofanira Kuvekwa Munhu Mumwechete
Mishonga yakawanda yeBD ichava yakachengeteka kuti ienderere mberi panguva yekuzvitakura uye haifaniri kuregererwa pasina mirayiridzo yakananga ne gastroenterologist uye OB / GYN anoziva imwe nyaya yemukadzi yeBD. Kune mimwe mishonga, zvisinei, izvo zvingada kuchinjwa panguva yekuzvitakura.
Immunosuppressants. Iyo immunosuppressive drugs azathioprin (Imuran [Kuberekwa Dzimba D]) uye 6-mercaptopurine (Purinethol kana 6-MP [Bumbiro Rokutanga D]) ngayambuke muparcenta uye inogona kuonekwa mumutsara weropa.
Zvisinei, vanogona kukurudzirwa nekuchenjerera panguva yekuzvimba nemamwe vanachiremba kurwisana nekutadza kukuru. Aya madhiragi haawedzeri ngozi yekuberekwa kwekuzvarwa.
Methotrexate uye thalidomide. Methotrexate (Kuberekwa Chikwata X) uye thalidomide (Kubata Chikwata X) ndezviviri zvinodhaka zvisingabvumirwi kushandiswa panguva yekuzvitakura sezvazvinenge zvichiita mwana asina kuberekwa. Methotrexate inogona kukonzera kubvisa pamuviri uye maronda asina kukwana, uye inofanira kumira kwemwedzi mitatu isati yatanga, kana zvichibvira. Thalidomide inonyatsozivikanwa nekukonzera kukanganisa kwemakumbo pamwe nezvimwe zvipingamupinyi zvemuviri muchechi.
Kushandisa kunongobvumirwa chete nekugadzirisa kusununguka kwekuberekwa uye kuve nekudzivirira pamuviri nguva dzose.
Metronidazole. Metronidazole ( Flagyl [Kuberekwa Bhuku B]], an antibiotic inowanzoshandiswa kurapa zvinetso zvinowanzobatanidzwa neBD, inogona kunge isina kuchengeteka kumucheche mushure mokutanga kwemitatu. Chimwe chidzidzo chakaratidza kuti metronidazole haina kukonzera kukanganisa kuberekwa mukutanga kwekutanga, asi hapana zvidzidzo zvemazuva mazhinji zvakaitwa. Nhepfenyuro shomanana dzechirwere ichi inowanzoshandiswa panguva yekudzivirira, kunyange zvazvo nguva dzakawanda dzichiri kukakavadzana.
Kubata Kunobatsira Sei Nzira yeBD?
Dzidzo yeBD munguva yose yekuzvitora inowedzera kuramba yakafanana nemamiriro ezvinhu panguva yekuberekwa. Nokuda kwechikonzero ichi, zvakakosha kune vakadzi vari kufunga nezvekudzivirira kuchengetedza hurongwa hwavo hwekurapa nekushanda kuunza, kana kuchengeta, chirwere chavo mukuregererwa.
Pakati pevakadzi vanotora apo IBD yavo isingashandisi, chetatu chinowedzera, chetatu chakaipa, uye chetatu chiitiko chisina kuchinja muhosha yavo. Pakati pevakadzi vanoberekwa apo varwere vavo vane chirwere chepachirwere chinopisa, vaviri-chetatu vacharamba vachiwana zvirwere zvinoshanda.
Vanachiremba vanogona kubata chirwere chakasimba cheBD icho chinoitika panguva yekudzivirira pasina kurongwa zvikuru. Kuwana kukanganwirwa kunokosha kubatsira kubatsira kuti mimba ive yakasimba sezvinogona.
Dhiyabhorosi 1 - FDA Mishonga yemishonga
| Chikamu | Tsanangudzo |
| A | Zvidzidzo zvakakwana, zvakanyatsochengetedzwa mumadzimai ane pamuviri hazvina kuratidza huwandu huwandu hwokuti vana vasati vazvarwa. |
| B | Zvidzidzo zvezvipfuwo hazviratidzi uchapupu hwekukuvadza kumucheche, zvisinei kana pasina huno hwakakwana, zvidzidzo zvinochengetedzwa zvakanaka mumadzimai ane pamuviri. KANA zvidzidzo zvezvipfuwo zvinoratidza kukanganisa, asi zvakakwana, zvidzidzo zvakarongedzwa zvakanaka mumadzimai ane pamuviri zvakakundikana kuratidzira njodzi kumucheche. |
| C | Zvidzidzo zvemhuka zvakaratidza kuipa kwakashata uye hapachina hutano hwakakwana, hwakarongedzwa zvakanaka mumadzimai ane pamuviri. KANA Pasina zvidzidzo zvezvipfuwo zvave zvichiitwa, hakuna huno hwakakwana, hunodzidziswa zvakanaka mumadzimai ane pamuviri. |
| D | Kudzidza, kukwana, kunyatsochengetedzwa kana kucherechedza, mumadzimai ane pamuviri vakaratidza ngozi kune fetus. Zvisinei, kubatsira kwechirwere kunogona kupfuura zvakanyanya kuisa njodzi. |
| X | Zvidzidzo, zvakakwana zvakarongedzwa zvakanaka kana kucherechedza, mumhuka kana vakadzi vakazvitakura vakaratidza uchapupu hwakanaka hwekuberekwa kusina kunaka. Mutengo unopesana nevakadzi vanove kana vanogona kutora pamuviri. |
Kune Matambudziko Api Nehupombwe Uye IBD?
Kune vakadzi vane ulcerative colitis uye chirwere cheCrohn mukuregererwa, njodzi dzekusiya pamuviri, kuberekwa uye kuberekwa kusina kufanana kwakafanana neyavo vakadzi vane utano. Chirwere chechirwere cheCrohn panguva yekuumbwa kana panguva yekutora pamuviri kunobatanidza nehuwandu hwekuparara kwepamuviri uye kuberekwa kusati kwapera.
Hemorrhoids inetso yakawanda kune vakadzi vane pamuviri, uye kusvika kusvika ku50 muzana yevakadzi vanotambura kuburikidza navo. Zviratidzo zveBD, zvakadai sedharare kana kuvigwa, zvinogona kuwedzera mungozi yehemorrhoids. Kune mishonga yakasiyana-siyana inogona kupera hemorrhoids yakadai seKegel maitiro, kuchengetedza nzvimbo yakakonzerwa yakachena, kudzivisa kugara uye kumira kwenguva yakareba kwenguva uye kusimudza zvakasimba kana kuenzanisa, uchishandisa petroleum jelly kuti inononore rectum nekudzivirira kufamba kwechirwere, kugara pane hombe yekusunungura kubva kunopisa, kugara mumvura inopisa yakakwana kuti ivhare hemorrhoids, uye uchishandisa suppositories kana marashi.
Is IBD Inotora Kuenda Kuvana?
Vamwe vanhu vane IBD vanogona kuramba vasina vana nekuda kwekufunganya kuti vana vanogona kugamuchira nhaka yavo. Mumakore achangobva kupfuura, pane zvakakosha pane pfungwa yokuti IBD inomhanya mumhuri uye inogona kunge yakabatana nemamwe magenhi. Vatsvakurudzi havana mhinduro dzakananga pamusoro pekuti IBD yakapfuura sei pakati pezvizvarwa, asi kune kumwe kutsvakurudza pamusoro pemikana yevana vanogamuchira nhaka yevabereki vavo.
Ikoko kunoratidzika kuva nemusungo wakasimba wekugamuchira Crohn's disease kupfuura ulcerative colitis, kunyanya mumhuri yechiJudha. Zvisinei, vana vane mubereki mumwe chete ane Crohn's disease vane mamiriyoni manomwe kusvika ku9 kubva muhutano hwehupenyu hwekuvandudza mamiriro acho ezvinhu, uye ingangova pangozi ye10% yekuvandudza imwe nzira yeBD. Kana vose vabereki vane IBD, ngozi iyi inowedzera kusvika 35%.
Chii Chinobatsira Musati Mucherechedza kana Muhutano?
Vakadzi iko zvino vakakurudzirwa kuti miviri yavo igadzirire kuve nepamuviri nekuwedzera kudya kwe folic acid, kurega kusvuta, kuwedzera kurapwa, nekudya zvakanaka. Kune vakadzi vane IBD, chinhu chinonyanya kukonzera nguva yehutumbi uye hutano hwecheche ihwo hutano hwemabasa. Kurega chero mishonga inogona kunge inokuvadza kumucheche inenge ichinyanya kukosha inokosha zvakare. Mimba yakarongerwa apo IBD iri mukuregererwa ine mukana mukuru kune imwe yenzira yakanaka.
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