Izinhlobo zemegacolon, ukuthi ungazikhomba kanjani futhi uzelaphe kanjani

-Delile

• Izimpawu nezimpawu eziyinhloko
• Izimbangela eziyinhloko
• 1. I-megacolon yokuzalwa
• 2. IMegacolon itholakele
• 3. I-megacolon enobuthi

IMegacolon ingukuhlanza kwamathumbu amakhulu, kuhambisana nobunzima ekuqedeni indle namagesi, okubangelwa yizilonda emaphethelweni ezinzwa emathunjini. Kungaba ngumphumela wesifo sokuzalwa somntwana, esaziwa njengesifo sikaHirschsprung, noma singatholwa impilo yonke, ngenxa yesifo sikaChagas, ngokwesibonelo.

Olunye uhlobo lwe-megacolon kungenxa yokuvuvukala kwamathumbu okunamandla futhi okunzima, okubizwa ngokuthi i-megacolon enobuthi, okuvame ukwakhiwa ngabantu abanezifo ezivuthayo zamathumbu, kubangele ukwanda kwamathumbu, umkhuhlane, ukushaya kwenhliziyo okusheshayo kanye nengozi yokufa.

Ngokulahleka kwezingcindezi nokunyakaza kwamathumbu kulesi sifo, izimpawu nezimpawu ziyavela, njengokuqunjelwa okuba kubi ngokuhamba kwesikhathi, ukuhlanza, ukuqunjelwa nobuhlungu besisu. Yize lungekho ikhambi, i-megacolon ingelashwa ngokuvumelana nembangela yayo, futhi iqukethe ukukhululeka kwezimpawu, kusetshenziswa ama-laxatives kanye nokuwashwa kwamathumbu, noma ekusebenzeni kokuhlinzwa ukukhipha ingxenye ethintekile yamathumbu, ukulungisa izinguquko ezicace ngokwengeziwe.

Izimpawu nezimpawu eziyinhloko

Ngenxa yomthamo wokuhamba kwamathumbu okhubazekile, izimpawu nezimpawu ze-megacolon zifaka:

• Ukuqunjelwa emathunjini, noma ukuqunjelwa, okuya kuba kubi ngokuhamba kwesikhathi, futhi kungafinyelela esitobhini esiphelele sokuqeda indle namagesi;
• Udinga ukusebenzisa ama-laxatives noma ukuhlanza amathumbu ukukhipha;
• Ukuvuvukala nokungahambi kahle isisu;
• Isicanucanu nokuhlanza, okungaba kubi futhi kuqede nokuqukethwe yindle.

Ukuqina kwalezi zimpawu kuyehluka kuye ngobukhulu besifo, ngakho-ke izimpawu zingabonwa ezinsukwini zokuqala zokuphila, njengasendabeni yemagacolon ezelwe, noma ingabonakala ngemuva kwezinyanga noma iminyaka yokuqala, njengase ithole i-megacolon, njengoba isifo siqhubeka kancane.

Izimbangela eziyinhloko

I-Megacolon ingenzeka ngezizathu eziningana, ezingavela kusukela ekuzalweni noma zitholakale kuyo yonke impilo. Izimbangela ezivame kakhulu yilezi:

1. I-megacolon yokuzalwa

Lokhu kuguqulwa, okwaziwa njengesifo sikaHirschsprung, yisifo esizalwa nengane, ngenxa yokushoda noma ukungabikho kwemicu yezinzwa emathunjini, evimbela ukusebenza kwayo okufanele ukuqeda indle, eqoqana futhi idale izimpawu.

Lesi sifo asivamile, sibangelwa izinguquko zofuzo, futhi izimpawu sezivele zivele emahoreni noma ezinsukwini zokuqala ngemuva kokuzalwa. Kodwa-ke, uma izinguquko nezimpawu zimnene, kungathatha amasonto noma izinyanga ukukhomba kahle lesi sifo futhi, kulezi zimo, kujwayelekile ukuthi ingane ibambezeleke ekukhuleni, ngenxa yamandla amancane okuncipha kwezakhi zomzimba izingane ukudla.

Ungaqinisekisa kanjani: ukuxilongwa kwe-megacolon engokwemvelo kwenziwa ngokubheka izimpawu zengane ngudokotela, ukwenza ukuhlolwa komzimba, ngaphezu kokucela izivivinyo ezifana ne-x-ray yesisu, i-opaque enema, i-anorectal manometry ne-rectal biopsy, evumela lesi sifo kufanele siqinisekiswe.

Indlela yokwelapha: ekuqaleni, ukuhlinzwa okwesikhashana kwe-colostomy kungenziwa ukuvumela ingane ukuthi iqede indle ngesikhwama esincane esinanyathiselwe esiswini. Ngemuva kwalokho, kuhlelwe ukuhlinzekwa okucacile, okunezinyanga eziyi-10-11 ubudala, ngokususwa kwengxenye yamathumbu engasebenzi kahle nokulungiswa kokuhamba kwamathumbu.

2. IMegacolon itholakele

Imbangela enkulu kanye ne-megacolon etholakele yi-Chagas Disease, isimo esaziwa njenge-chagasic megacolon, esenzeka ngenxa yezilonda emaphethelweni wezinzwa zamathumbu ezibangelwa ukutheleleka nge-protozoanI-Trypanosoma cruzi, kudluliswa ngokuluma komgundi wezinambuzane.

Ezinye izimbangela zokuhlanza nokuyeka ukusebenza kwamathumbu okutholakala kuyo yonke impilo yilezi:

• Ukukhubazeka kobuchopho;
• I-neuropathy yesifo sikashukela;
• Ukulimala komgogodla;
• Izifo ze-Endocrinological ezifana ne-hypothyroidism, i-pheochromocytoma noma i-porphyria;
• Izinguquko kuma-electrolyte egazi, njengokushoda kwe-potassium, i-sodium ne-chlorine;
• Izifo zesistimu ezifana ne-scleroderma noma i-amyloidosis;
• Izibazi zamathumbu, ezibangelwa i-radiotherapy noma i-ischemia yamathumbu;
• Ukusetshenziswa okungapheli kokuqunjelwa kwezidakamizwa, njenge-anticholinergics kanye ne-anti-spasmodics, noma ama-laxatives;

IMegacolon ingaba futhi yohlobo olusebenzayo, lapho imbangela ngqo ingaziwa, kepha okungenzeka ukuthi ivela ngenxa yokuqunjelwa okungapheli, okunzima kwamathumbu okungalashwa kahle futhi kubi ngokuhamba kwesikhathi.

Ungaqinisekisa kanjani: ukuze kutholakale i-megacolon etholakalayo, ukuhlolwa kwe-gastroenterologist noma i-coloproctologist kuyadingeka, ozohlaziya umlando womtholampilo nokuhlolwa komzimba, noku-oda izivivinyo ezifana ne-x-ray yesisu, i-opaque enema futhi, ezimweni zokungabaza njengoba imbangela yalesi sifo, i-biopsy yamathumbu, evumela ukuqinisekiswa.

Indlela yokwelapha: ukwelashwa kwenziwa ukuvumela ukuqedwa kwendle namagesi ngamathumbu, futhi, ekuqaleni, kungenziwa ngosizo lwama-laxatives, njengeLactulose noma iBisacodyl, ngokwesibonelo, nokuwashwa kwamathumbu, kepha lapho izimpawu okukhulu futhi ngokuthuthuka okuncane, i-coloproctologist isusa ukuhlinzwa engxenyeni ethintekile yamathumbu.

3. I-megacolon enobuthi

I-megacolon enobuthi iyinkinga ebucayi futhi ebucayi yohlobo oluthile lokuvuvukala kwamathumbu, ikakhulukazi ngenxa yesifo sikaCrohn noma i-ulcerative colitis, yize ingahlotshaniswa nanoma yiluphi uhlobo lwe-colitis, noma ngabe kungenxa yesisu samathumbu, i-diverticulitis, i-ischemia yamathumbu noma umdlavuza wekoloni. ukuvinjelwa.

Ngesikhathi sesimo se-megacolon enobuthi, kukhona ukwanda okukhulu kwamathumbu okunokuvela okusheshayo, okunzima futhi okubangela ingozi yokufa, ngenxa yokuvuvukala okukhulu okwenzeka emzimbeni. Ngaphezu kwalokho, kuvela izimpawu nezimpawu, ezifana nomkhuhlane ongaphezu kuka-38.5ºC, ukushaya kwenhliziyo okungaphezu kokushaywa okungu-120 ngomzuzu, ukweqisa kwamaseli amhlophe egazini egazini, i-anemia, ukuphelelwa amanzi emzimbeni, ukudideka kwengqondo, ukuguqulwa kwama-electrolyte egazi bese kwehla umfutho wegazi.

Ungaqinisekisa kanjani: ukuqinisekiswa kwe-megacolon enobuthi kwenziwa ngokuhlolwa kwezokwelapha ngokuhlaziywa kwe-x-ray yesisu, ekhombisa ukwanda kwamathumbu okungaphezulu kuka-6 cm ububanzi, ukuhlolwa komzimba kanye nezimpawu nezimpawu zomtholampilo.

Indlela yokwelapha: ukwelashwa kuhlose ukulawula izimpawu, ukufaka ama-electrolyte egazi, ukusebenzisa ama-antibiotic neminye imithi yokwehlisa ukuvuvukala kwamathumbu, njenge-corticosteroids kanye ne-anti-inflammatories. Kodwa-ke, uma lesi sifo siqhubeka nokuba sibi, kungahle kukhonjiswe ukuhlinzekwa kokukhishwa ngokuphelele kwamathumbu amakhulu, njengendlela yokuqeda ukugxila kokuvuvukala nokuvumela umuntu othintekile ukuthi alulame.