Iindidi zemegacolon, indlela yokuchonga nokunyanga

Umxholo

• Iimpawu eziphambili kunye neempawu
• Izizathu eziphambili
• 1. Megacolon ezelwe
• 2. Megacolon ifunyenwe
• 3. Megacolon enetyhefu

I-megacolon kukudumba kwamathumbu amakhulu, kuhamba nobunzima ekupheliseni ilindle kunye neegesi, ezibangelwa zizilonda kwiziphelo zemithambo-luvo. Inokuba sisiphumo sesifo sokuzalwa komntwana, esaziwa ngokuba sisifo sikaHirschsprung, okanye sinokufunyanwa kubomi bonke, ngenxa yesifo sikaChagas, umzekelo.

Olunye uhlobo lwe-megacolon lubangelwa kukudumba okunamandla kunye nokuqina kwamathumbu, okubizwa ngokuba yigyacolon enetyhefu, edla ngokuphuhliswa ngabantu abanesifo sokukrala kwamathumbu, esibangela ukwanda kwamathumbu, umkhuhlane, ukubetha kwentliziyo okukhawulezileyo kunye nomngcipheko wokufa.

Ngokulahleka kokucheba kunye nokuhamba kwamathumbu kwesi sifo, iimpawu kunye neempawu ziyavela, njengokuqhinwa okuba mandundu ngokuhamba kwexesha, ukugabha, ukudumba kunye nentlungu esiswini. Nangona lungekho unyango, i-megacolon inokunyangwa ngokwesizathu sayo, kwaye ibandakanya ukukhululeka kweempawu, kusetyenziswa laxatives kunye nokuhlamba amathumbu, okanye ekusebenzeni kotyando ukususa indawo echaphazelekayo yamathumbu, ukulungisa indlela eqinisekileyo yokutshintsha.

Iimpawu eziphambili kunye neempawu

Ngenxa yokungakwazi ukuhamba kwesisu, iimpawu kunye neempawu ze-megacolon zibandakanya:

• Ukuqunjelwa emathunjini, okanye ukuqhina, okuya kusiba mandundu ngokuhamba kwexesha, kwaye kunokufikelela kwisiphelo esipheleleyo sokuphelisa ilindle kunye neegesi;
• Kufuneka usebenzise laxatives okanye ukuhlamba amathumbu ukukhupha;
• Ukudumba nokungahambi kakuhle isisu;
• Isicaphucaphu nokugabha, ezinokuba nzulu kwaye zisuse nokuqulethwe lilindle.

Ubunzulu bezi mpawu buyahluka ngokobunzulu besifo, kungoko iimpawu zinokuqatshelwa kwiintsuku zokuqala zobomi, njengakwimeko ye-megacolon, okanye inokubonakala emva kweenyanga okanye iminyaka yokuqalisa, bafumana i-megacolon, kuba esi sifo sihamba kancinci.

Izizathu eziphambili

Megacolon inokwenzeka ngenxa yezizathu ezininzi ezinokuvela ekuzalweni okanye ekufumanekeni ubomi bonke. Oonobangela abaqhelekileyo zezi:

1. Megacolon ezelwe

Olu tshintsho, olwaziwa ngokuba sisifo sikaHirschsprung, sisifo esizalwa nosana, ngenxa yokunqongophala okanye ukungabikho kwemicu yentsimbi emathunjini, ethintela ukusebenza kwayo ngokufanelekileyo ekupheliseni ilindle, eliqokelelana kwaye libangele iimpawu.

Esi sifo sinqabile, sibangelwa lutshintsho kwimfuzo, kwaye iimpawu sele zivele kwiiyure zokuqala okanye kwiintsuku zokuqala kokuzalwa. Nangona kunjalo, ukuba utshintsho kunye neempawu zincinci, kungathabatha iiveki okanye iinyanga ukusichonga ngokuchanekileyo isifo kwaye, kwezi meko, kuqhelekile ukuba umntwana abe nokulibaziseka ekukhuleni, ngenxa yesakhono sokufunxa esincinci sezondlo ukutya ukutya.

Uqinisekisa njani: ukuxilongwa kwe-megacolon yokuzalwa kwenziwa ngokujonga iimpawu zomntwana ngugqirha, ukwenza uvavanyo lomzimba, ukongeza ekufuneni iimvavanyo ezinje nge-x-ray yesisu, i-opaque enema, i-anorectal manometry kunye ne-rectal biopsy, evumela Esi sifo siza kuqinisekiswa.

Unyango njani: Ekuqaleni, kungenziwa utyando lwe-colostomy okwethutyana ukuvumela umntwana ukuba aphelise ilindle ngengxowa encinci ethe nca esiswini. Emva koko, utyando olucwangcisiweyo lucwangcisiwe, malunga neenyanga ezili-10 ukuya kwezi-11 ubudala, ngokususwa kwenxalenye yamathumbu angalunganga kunye nohlengahlengiso lokuhamba kwamathumbu.

2. Megacolon ifunyenwe

Esona sizathu siphambili kunye nokufumana i-megacolon sisifo seChagas, imeko eyaziwa ngokuba yi-chagasic megacolon, eyenzeka ngenxa yezilonda kwiziphelo zamathumbu emathunjini ezibangelwa kukusuleleka kwiprotozoanI-Trypanosoma cruzi, idluliselwa ngokuluma komchebi wezinambuzane.

Ezinye izinto ezibangela ukwanda kunye nokusebenza kwamathumbu okuye kwafunyanwa kubomi bonke zezi:

• Umvakalelo yokitazo;
• I-neuropathy yeswekile;
• Ukonzakala komqolo;
• Izifo ze-Endocrinological ezinje ngehypothyroidism, pheochromocytoma okanye porphyria;
• Utshintsho kwii-electrolyte zegazi, ezinje ngokusilela kwi-potassium, isodiyam kunye neklorine;
• Izifo zenkqubo efana ne-scleroderma okanye i-amyloidosis;
• Amanxeba emathunjini, abangelwa yi-radiotherapy okanye i-ischemia yamathumbu;
• Ukusetyenziswa okungapheliyo kokuqunjelwa iziyobisi, ezinje nge-anticholinergics kunye ne-anti-spasmodics, okanye i-laxatives;

I-megacolon inokuba ikuluhlobo olusebenzayo, apho esona sizathu singaziwayo, kodwa esivela mhlawumbi ngenxa yokuqhinwa okungapheliyo, okuqatha kwamathumbu okunganyangwa ngokufanelekileyo kwaye kubi ngokuhamba kwexesha.

Uqinisekisa njani: ukuze kuchongwe i-megacolon efunyenweyo, uvavanyo lwe-gastroenterologist okanye i-coloproctologist luyimfuneko, ngubani oza kuhlalutya imbali yeklinikhi kunye novavanyo lomzimba, kunye noku-odola iimvavanyo ezinje nge-x-ray yesisu, i-opaque enema kwaye, kwimeko zokuthandabuza njenge kwisizathu sesifo, i-biopsy yamathumbu, evumela ukuqinisekiswa.

Unyango njani: unyango lwenziwe ukuvumela ukupheliswa kwendle kunye neegesi emathunjini, kwaye, ekuqaleni, kungenziwa ngoncedo lwe-laxatives, njengeLactulose okanye iBisacodyl, umzekelo, kunye nokuhlamba amathumbu, nangona kunjalo, xa iimpawu kakhulu kunye nokuphucula okuncinci, i-coloproctologist isusa utyando kwinxalenye echaphazelekayo yamathumbu.

3. Megacolon enetyhefu

I-megacolon enetyhefu yinkxalabo ebukhali kunye nobuzaza bolunye uhlobo lokudumba kwamathumbu, ikakhulu ngenxa yesifo sikaCrohn okanye isifo sesilonda esibuhlungu, nangona sinokudityaniswa nalo naluphi na uhlobo lwe-colitis, nokuba kungenxa yamathumbu emathumbu, i-diverticulitis, isisu samathumbu okanye umhlaza wekolon. isithintelo.

Ngexesha lemeko yemegacolon enetyhefu, kukho ukudumba okukhulu kwamathumbu okukhawulezayo, okuziqhelanisa nobunzima kwaye obangela umngcipheko wokufa, ngenxa yokukrala okukhulu okwenzekayo emzimbeni. Ukongeza, iimpawu kunye neempawu ziyavela, ezinje ngomkhuhlane ongaphezulu kwe-38.5ºC, ukubetha kwentliziyo ngaphezulu kwe-120 ukubetha ngomzuzu, ukugqitha kweeseli ezimhlophe zegazi kwigazi, i-anemia, ukuphelelwa ngamanzi emzimbeni, ukudideka kwengqondo, ukuguqulwa kwee-electrolyte zegazi kunye nokuhla koxinzelelo lwegazi.

Uqinisekisa njaniUkuqinisekiswa kwemegacolon enetyhefu kwenziwa luvavanyo lonyango ngohlalutyo lwe-x-ray yesisu, ebonisa ukudumba kwamathumbu okungaphezulu kwe-6 cm ububanzi, uvavanyo lomzimba kunye neempawu kunye neempawu zeklinikhi.

Unyango njani: unyango lujolise ekulawuleni iimpawu, endaweni ye-electrolyte yegazi, ukusebenzisa i-antibiotics kunye namanye amayeza ukunciphisa ukuvuvukala kwamathumbu, njenge-corticosteroids kunye ne-anti-inflammatories. Nangona kunjalo, ukuba esi sifo siyaqhubeka nokuba mandundu, kunokuboniswa utyando lokususa ngokupheleleyo amathumbu amakhulu, njengendlela yokuphelisa ukugxila kokudumba kunye nokuvumela umntu ochaphazelekayo ukuba achache.