Ukudumba okubangelwa sisifo sephepha

I-Pseudomembranous colitis ibhekisa kukudumba okanye ukudumba kwamathumbu amakhulu (ikholoni) ngenxa yokugqitha Clostridioides ezahlukeneyo (C eyahlukileyo) iibhaktheriya.

Olu suleleko ngunobangela oqhelekileyo wotyatyazo emva kokusetyenziswa kweyeza lokubulala iintsholongwane.

Inkqubo ye- C eyahlukileyo Iibhaktheriya zihlala zihlala emathunjini. Nangona kunjalo, uninzi lwezi ntsholongwane lunokukhula xa uthatha amayeza okubulala iintsholongwane. Iibhaktheriya zikhupha i-toxin eyomeleleyo ebangela ukudumba kunye nokopha kuludwe lwekholoni.

Nayiphi na i-antibiotic inokubangela le meko. Amachiza ajongene nengxaki ixesha elininzi yi-ampicillin, clindamycin, fluoroquinolones, kunye ne-cephalosporins.

Ababoneleli ngononophelo lwempilo esibhedlele banokudlulisa le bhaktiriya komnye umntu baye komnye.

I-Pseudomembranous colitis ayiqhelekanga ebantwaneni, kwaye inqabile kwiintsana. Ngokuqhelekileyo kubonakala kubantu abasesibhedlele. Nangona kunjalo, iya isiba yinto eqhelekileyo kubantu abathatha ii-antibiotics kwaye abekho esibhedlele.

Izinto zomngcipheko zibandakanya:

• Ukwaluphala
• Ukusetyenziswa kweantibiotic
• Ukusetyenziswa kwamayeza anciphisa amajoni omzimba (njengamayeza e-chemotherapy)
• Utyando lwamva nje
• Imbali ye-pseudomembranous colitis
• Imbali yesifo se-ulcerative colitis kunye nesifo seCrohn

Iimpawu zibandakanya:

• Iimpawu zesisu esiswini (kancinci ukuya kubukhali)
• Izitulo zegazi
• Ifiva
• Khuthaza ukuba ube nokunyakaza kwamathumbu
• Urhudo lwamanzi (amaxesha ama-5 ukuya kwali-10 ngosuku)

Olu vavanyo lulandelayo lunokwenziwa:

• Colonoscopy okanye sigmoidoscopy eguqukayo
• I-Immunoassay ye-C difficile toxin kwisitulo
• Uvavanyo lwesitulo esitsha njengePCR

I-antibiotiki okanye elinye iyeza elibangela imeko kufuneka limiswe. I-Metronidazole, i-vancomycin, okanye i-fidaxomicin zihlala zisetyenziselwa ukunyanga ingxaki, kodwa amanye amayeza anokusetyenziswa.

Izisombululo ze-Electrolyte okanye ulwelo olunikezwa ngomthambo lunokufuneka ukunyanga ukungabikho komzimba ngenxa yokuhambisa. Kwiimeko ezinqabileyo, utyando luyafuneka ukunyanga usulelo oluya lubi ngakumbi okanye olungaphenduliyo kwiintsholongwane.

Ixesha elide i-antibiotics inokufuneka ukuba C eyahlukileyo luyabuya usulelo. Unyango olutsha olubizwa ngokuba yi-fecal microbiota transplant ("stool transplant") luye lwasebenza kwizifo ezibuyayo.

Umboneleli wakho unokucebisa ukuba uthathe iiprobiotic ukuba usulelo luyabuya.

Imbonakalo ilungile kwiimeko ezininzi, ukuba akukho ngxaki. Nangona kunjalo, ukuya kuthi ga ku-1 kosulelo lusenokubuya kwaye ludinga unyango olungaphezulu.

Iingxaki zinokubandakanya:

• Ukuphelelwa ngamanzi emzimbeni ngokungalingani kwe-electrolyte
• Ukugqitywa (komngxunya) ikholoni
• Megacolon enetyhefu
• Ukufa

Tsalela umnikezeli wakho ukuba unale mpawu ilandelayo:

• Nasiphi na isitulo segazi (ngakumbi emva kokuthatha amayeza okubulala iintsholongwane)
• Iziqendu ezintlanu okanye nangaphezulu zohudo ngosuku ngaphezulu kweentsuku ezi-1 ukuya kwezi-2
• Iintlungu ezinzima zesisu
• Iimpawu zokuphelelwa ngamanzi emzimbeni

Abantu abaye bafumana i-pseudomembranous colitis kufuneka baxelele ababoneleli babo ngaphambi kokuba bathathe i-antibiotics kwakhona. Kukwabaluleke kakhulu ukuhlamba izandla kakuhle ukunqanda ukudlulisela intsholongwane kwabanye abantu. Ucoceko olunxilisayo alusoloko lusebenza C eyahlukileyo.

I-colitis ehambelana ne-Antibiotic; Isifo sokukrala kwebele (pseudomembranous); Isifo sokuqunjelwa; C difficile-pseudomembranous

• Inkqubo yokwetyisa
• Inkqubo yokugaya ukutya

UGerding DN, uJohnson S. Clostridial usulelo. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 280.

IGerding DN, iVB encinci. Donskey CJ. Clostridiode ezahlukeneyo (ngaphambili IClostridium difficleusulelo. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier; 2020: isahluko 243.

UKelly CP, u-Khanna S. Urhudo onxulumene ne-Antibiotic kunye iclostridioides difficile usulelo. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Gastrointestinal and Liver Disease. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2021: isahl. 112.

UMcDonald LC, uGerding DN, uJohnson S, et al. Izikhokelo zoqheliso lwezonyango ze-clostridium difficile Usulelo kubantu abadala nasebantwaneni: Uhlaziyo luka-2017 nguMbutho wezifo eziSulelayo waseMelika (IDSA) kunye noMbutho wezeMpilo kwi-Epidemiology yaseMelika (SHEA). KwiKlinikhi yosulelo lweDis. 2018; 66 (7): 987-994. IINKCUKACHA: 29562266 pubmed.ncbi.nlm.nih.gov/29562266/.