Mitundu ya megacolon, momwe mungadziwire ndi kuchiritsira

Zamkati

• Zizindikiro zazikulu
• Zoyambitsa zazikulu
• 1. Megacolon wobadwa nawo
• 2. Megacolon anapeza
• 3. Megakoloni woopsa

Megacolon ndikutuluka kwa m'matumbo akulu, limodzi ndi zovuta kuthetsa ndowe ndi mpweya, zomwe zimayambitsidwa ndi zotupa m'mitsempha yam'mimba. Zitha kukhala zotsatira za matenda obadwa nawo a mwana, omwe amadziwika kuti Hirschsprung's disease, kapena atha kupezeka moyo wonse, chifukwa cha matenda a Chagas, mwachitsanzo.

Mtundu wina wa megacolon umachitika chifukwa cha kutupa kwam'mimba komanso koopsa, kotchedwa megacolon ya poizoni, yomwe nthawi zambiri imapangidwa ndi anthu omwe ali ndi matenda otupa m'matumbo, omwe amachititsa kutsekula kwamatumbo, malungo, kugunda kwamtima komanso chiwopsezo cha kufa.

Ndikuchepa kwa mabala ndi matumbo m'matendawa, zizindikilo ndi zizindikilo zimawoneka, monga kudzimbidwa komwe kumawonjezeka pakapita nthawi, kusanza, kuphulika komanso kupweteka m'mimba. Ngakhale kulibe mankhwala, megacolon itha kuchiritsidwa molingana ndi chifukwa chake, ndipo imakhala ndi mpumulo wazizindikiro, pogwiritsa ntchito mankhwala ofewetsa tuvi tolimba ndi kutsuka m'mimba, kapena pochita opareshoni kuchotsa gawo lomwe lakhudzidwa m'matumbo, kuwongolera njira zosinthira.

Zizindikiro zazikulu

Chifukwa cha kusayenda bwino kwa matumbo, zizindikilo za megacolon ndi monga:

• Kudzimbidwa m'mimba, kapena kudzimbidwa, komwe kumawonjezeka pakapita nthawi, ndipo kumatha kufikira poyimitsa kuthetseratu ndowe ndi mpweya;
• Muyenera kugwiritsa ntchito mankhwala ofewetsa tuvi tolimba kapena kutsuka m'mimba kutuluka;
• Kutupa ndi kusapeza bwino m'mimba;
• Nseru ndi kusanza, zomwe zingakhale zazikulu ngakhalenso kuchotsa zomwe zili m'ndowe.

Kukula kwa zizindikirozi kumasiyanasiyana malinga ndi kukula kwa matendawa, kotero zizindikirazo zimatha kuzindikiridwa m'masiku oyamba amoyo, monga momwe zimakhalira ndi megacolon yobadwa, kapena imatha kuwoneka patatha miyezi kapena zaka zoyambira, monga adapeza megacolon, matendawa amapita pang'onopang'ono.

Zoyambitsa zazikulu

Megacolon amatha kuchitika pazifukwa zingapo, zomwe zimatha kubadwa kuyambira kubadwa kapena kupezeka moyo wonse. Zomwe zimayambitsa kwambiri ndi izi:

1. Megacolon wobadwa nawo

Kusinthaku, komwe kumatchedwa Hirschsprung's disease, ndi matenda omwe amabadwa ndi mwanayo, chifukwa chakuchepa kapena kupezeka kwa mitsempha yamatumbo m'matumbo, yomwe imalepheretsa kugwira bwino ntchito kuthetseratu ndowe, zomwe zimadzikundikira ndikupangitsa zizindikilo.

Matendawa ndi osowa, amayamba chifukwa cha kusintha kwa majini, ndipo zizindikilo zimatha kuoneka kuyambira maola kapena masiku oyamba atabadwa. Komabe, ngati zosinthazi ndizochepa, zimatha kutenga masabata kapena miyezi kuti adziwe matendawa, ndipo, nthawi zambiri, mwanayo amachedwa kukula, chifukwa chakuchepa kokwanira kwa michere ana zakudya.

Momwe mungatsimikizire: matenda a congenital megacolon amapangidwa poyang'ana zizindikiro za mwanayo ndi dokotala, kumuyesa mwakuthupi, kuphatikiza pakupempha mayeso monga x-ray ya pamimba, enema opaque, manorery anorectal ndi rectal biopsy, zomwe zimalola matenda kutsimikiziridwa.

Momwe muyenera kuchitira: poyamba, opareshoni yakanthawi kochepa ya colostomy imatha kuchitidwa kuti mwana athe kutulutsa ndowe kudzera m'thumba laling'ono lomwe lamata pamimba. Kenako, opaleshoni yotsimikizika yakonzedwa, pafupifupi miyezi 10-11 yazaka, ndikuchotsa matumbo opunduka ndikukonzanso matumbo.

2. Megacolon anapeza

Choyambitsa chachikulu ndikupeza megacolon ndi Chagas Disease, vuto lomwe limadziwika kuti chagasic megacolon, lomwe limachitika chifukwa cha zotupa m'matumbo am'mimba oyambitsidwa ndi matenda a protozoanTrypanosoma cruzi, opatsirana ndi kuluma kwa wometa tizilombo.

Zina mwazomwe zimayambitsa kuchepa komanso kuyimitsidwa kwamatumbo komwe kumapezeka m'moyo wonse ndi:

• Cerebral palsy;
• Matenda a shuga;
• Msana kuvulala;
• Matenda a Endocrinological monga hypothyroidism, pheochromocytoma kapena porphyria;
• Kusintha kwa ma electrolyte amwazi, monga kuchepa kwa potaziyamu, sodium ndi klorini;
• Matenda achilengedwe monga scleroderma kapena amyloidosis;
• Zipsera zam'mimba, zoyambitsidwa ndi radiotherapy kapena ischemia yamatumbo;
• Kugwiritsa ntchito mankhwala osokoneza bongo nthawi zonse, monga anticholinergics ndi anti-spasmodics, kapena mankhwala ofewetsa tuvi tolimba;

Megacolon itha kukhalanso ya mtundu wa magwiridwe antchito, momwe sizimadziwika chifukwa chake, koma zomwe zimayambira chifukwa cha kudzimbidwa kwamatumbo kwanthawi yayitali, komwe sikuchiritsidwa bwino ndipo kumawonjezeka pakapita nthawi.

Momwe mungatsimikizire: kuti mupeze megacolon yomwe mwapeza, kuwunika kwa gastroenterologist kapena coloproctologist ndikofunikira, yemwe angafufuze mbiri yazachipatala ndikuwunika kwakuthupi, ndikuyitanitsa mayesero monga x-ray yamimba, enema opaque ndipo, kukayikira ngati chifukwa cha matenda, matumbo a m'mimba, kulola kutsimikizira.

Momwe muyenera kuchitira: Chithandizochi chimachitidwa kuti chilole kuthetseratu ndowe ndi mpweya m'matumbo, ndipo, koyambirira, zitha kuchitika mothandizidwa ndi mankhwala ofewetsa tuvi tolimba, monga Lactulose kapena Bisacodyl, mwachitsanzo, komanso kutsuka m'matumbo, komabe, mwamphamvu komanso pang'onopang'ono, katswiri wama coloproctologist amachotsa opaleshoni mbali yomwe yakhudzidwa ndi m'matumbo.

3. Megakoloni woopsa

Megacolon woopsa ndi vuto lalikulu komanso lamatenda am'mimba, makamaka chifukwa cha matenda a Crohn kapena ulcerative colitis, ngakhale atha kuphatikizidwa ndi mtundu uliwonse wa colitis, mwina chifukwa cha torsion wam'mimba, diverticulitis, m'mimba ischemia kapena khansa ya m'matumbo. kutchinga.

Pakati pa megacolon ya poizoni, matumbo amatuluka kwambiri omwe amasintha mwachangu, mwamphamvu ndipo amayambitsa ngozi yakufa, chifukwa cha kutupa kwakukulu komwe kumachitika m'thupi. Kuphatikiza apo, zizindikilo zimawoneka, monga kutentha thupi pamwamba pa 38.5ºC, kugunda kwa mtima kopitilira 120 kumenyedwa pamphindi, kuchuluka kwama cell oyera m'magazi, kuchepa magazi, kusowa kwa madzi, kusokonezeka kwamaganizidwe, kusintha kwa ma electrolyte amwazi ndikutsika magazi.

Momwe mungatsimikizire: kutsimikizira kwa megacolon wa poizoni kumapangidwa ndi kuwunika kwachipatala pofufuza m'mimba x-ray, yomwe imawonetsa matumbo otambalala kuposa masentimita 6 m'lifupi, kuwunika kwakuthupi ndi zizindikiritso zamatenda.

Momwe muyenera kuchitira: Chithandizo chake ndikuthandizira kuwongolera zizindikilo, m'malo mwa ma electrolyte amwazi, kugwiritsa ntchito maantibayotiki ndi mankhwala ena ochepetsa kutupa kwamatumbo, monga corticosteroids ndi anti-inflammatories. Komabe, ngati matendawa akupitilirabe kukulira, opaleshoni yochotsa matumbo onse yayikulu imatha kuwonetsedwa, ngati njira yochotsera chidwi cha kutupa ndikulola wokhudzidwayo kuti achire.