IBD yakawanda inowanzo:
• Kurwara kwehutachiona (YAK) - kunokanganisa hutumbu hukuru, kazhinji huchitanga kubva pamusana;
• Chirwere cheCrohn - chinogona kukanganisa chero chikamu chemuviri wepamuviri: kubva pamuromo wemuromo kusvika kune anus. Muchivhiringidziro, huwandu hwose hwemukati hwomukati hunowanzobatanidzwa.
Zvinokonzera uye kuderedza
Pasinei nenhamba yakawanda yeongororo yezvesayenzi, zvikonzero zvekuvandudzwa kweVZK hazvina kunyatsojekeswa. Maererano nerimwe rondedzero, zvirwere zveBD zvinokonzerwa nehutachiona kana mabhakitiriya anopinda mudumbu kubva kune zvakatipoteredza uye anokonzera kushungurudzika kwechirwere chinokonzerwa nehutachiwana hwemukati hutachiona. Ulcerative colitis yakanyoreswa munyika dzose dzenyika, kupararira kwayo 50-80 mhosva ne100 000 yevanhu. Chirwere ichi chinokanganisa vanhu vezera ripi neripi, asi boka rezera remakore gumi nemashanu kusvika makumi mana rinowanzosangana naro. Kuwedzera kwehuwandu pakati pevarume nevakadzi kwakangofanana. Munenge 15% yevarwere, hama dzepedyo (vabereki, hama kana hanzvadzi) vakatamburawo nechirwere ichi. Maererano nekutsvakurudza, zviviri-zvitatu zvevarwere vane Crohn's disease utsi. Kusvuta ndeye chete inogadziriswa yakagadziriswa chikonzero chemamiriro ekunze anokanganisa chiitiko cheBD. Mune dzimwe nyika dzakabudirira, kupararira kwechirwere cheCrohn chirwere chema 30-4-0 mamiriyoni zana evanhu vese. Chirwere cheCrohn uye ulcerative colitis inoratidzirwa nedzidzo dzinowanzoitika (zvikamu zvekuwedzera kwechirwere chinoteverwa ne nguva dzekudzivirira kutadza). Kushungurudzika uye zvirwere zvehutachiona ndizvo zvinowanzokonzera kudzoka.
Zviratidzo zvechirwere zve ulcerative colitis ndezvi:
• kugara uchida kukurudzira neine zvakawanda;
• kusanganiswa kweropa kana kukonzera mumucheka;
• kurwadziwa kwepamuviri kwakanyanya, kuderera mushure mekutsauka;
• huwandu malaise uye kuneta;
• fivha uye kurasikirwa kwechido.
Zviratidzo zvechirwere cheCrohn chinenge chakasiyana. Izvi zvinokonzerwa nechikonzero chokuti chero chikamu chemuviri wepamuviri chinogona kuchinjwa mune chirwere ichi. Apo chirwere cheCrohn chinogona kuonekwa:
• chigaro chisina kusimba nechinokonzerwa neropa;
• kutapudza marwadzo mudumbu;
• kuora muviri;
• Utachiona hwemukati, dzimwe nguva hunoita kuti mucheche udzivirire;
• kuumbwa kwefistula (masangano asina kukodzera pakati pezvimwe nhengo umo mukati memukati mukati maro inopinda pedyo nemakumbo, somuenzaniso, mumukaka kana mukadzi).
Mukuwedzera, chirwere cheCrohn chinogona kukanganisa mucous membrane yemuromo, mafundo, mapfundo mashoma. Vamwe varwere vanobatanidza kuwedzera kwechirwere nekushandiswa kwezvimwe zvekudya, asi hapana kudya kwakakwana kwakakurudzirwa kune varwere vane IBD. Kuongororwa kwechipi nechipi chechirwere cheBD group chinowanzotarisirwa ne laboratory data uye kuongororwa kwemurwere. Mushure mekunyatsogadziriswa kwemannesis uye kuongorora kwepanyama, kusanganisira kuongororwa kwemunwe kwe rectum, reumeroscopy inowanzopiwa, ichibvumira kuongorora mukati mukati me rectum uye chikamu chezasi chemukati mako. Mukuita izvi, chimbo chinokosha (sigmoidoscope) chinowanikwa kuburikidza ne anus, zvichikuita kuti uongorore mumumbosa mukati uye utore mhando yezvinyorwa zvinyorwa zvinyoronyoro.
Survey chirongwa
Pasinei nemigumisiro ye sigmoidoscopy, zvidzidzo zvinotevera zvinowanzoitwa:
• kuongororwa ropa (kusanganisira kuvapo kwezviratidzo zvekuvhiringidza);
• Mifananidzo yematumbo kushandisa bhaum enema. Mumazuva acho hutumbu hunodururwa ne-laxative. Pazuva rekudzidza, sarudzo yeBabum inotanga kuburikidza ne rectum, iyo inonzi X-ray kusiyana kwezvinhu, iyo inobvumira kuziva nzvimbo dzekuvhiringidza kana kuderedza mumatumbo. Kana uchifungidzirwa neCrohn's disease, chikamu chepamusoro chemukati chinongororwawo. Muchiitiko ichi, murwere anotora bharum kusimudzirwa mukati, izvo zvinoita kuti zvioneke kutarisa utumbo hudiki;
• Colonoscopy. Muchidzidzo chino, chidimbu chakakura chechigadziriso chinoshandiswa nechiedza chinoshandiswa kuburikidza ne anus uye inobvumira kuongorora mucosa yemukumbo mukuru uye rectum. Nekubatsira kwayo, haugoni kungoongorora nzvimbo dzemukati dzisingakwanisi kugadziriswa ne sigmoidoscopy, asi zvakare kana zvichidikanwa, ita zvinyorwa zvechivi. Kana iwe uchifungidzira kukundwa mumatumbo ekumusoro, rumwe rudzi rwekupedzisira kuongorora runorayirwa: gastroduodenoscopy. Mukuita iyi nzira, endoscope yakakosha, inonzi gastroscopy, inowanikwa kuburikidza nemoyo mukati mudumbu uye duodenum. Gastroscope inoshandura fiber optic tube inokubvumira kuti uongorore zvikamu zvose zvepamu. Chifananidzo chacho chinoshandiswa kune chinyorwa chekuona. Iyi nzira inoshandiswa kune zvose kuongororwa kweBD uye nekushambadzira kusinganzwisisiki kwokuvhiya. Nzira dzekurapwa kweBD dzinokonzerwa kubva pamuromo kutora steroid kugadzirira kunopindira, iyo inoshandiswa mumatambudziko akaoma. Pasinei nokuti hazvibviri kurapwa kwakakwana, varwere vazhinji vanogona kutungamirira mararamiro anoshanda. Mushure mekuongororwa kweBD, murwere anoonekwa ne gastroenterologist, kazhinji panzvimbo yekugara.
Kurapa nesteroid
Kuti abvise kuvhiringidza nekuwedzera kweBDD kunyorera steroid zvinodhaka nenzira yehwendefa, enemas kana suppositories. Varwere vanowanzotya kusarudzwa kwe-steroid, vachifunga kuti idzi ndidzo dzakasimba dzinogona kukonzera zvisingadiwi, kunyanya nekugamuchirwa kwenguva refu. Zvimwe zvinokonzerwa nemishonga iyi zvinosanganisira kuumbwa kwechiso chakafanana nemwedzi, kuwedzera kuwanda, kushaya simba kwemasumbu uye kuwedzerwa ropa. Izvozvo zvinokonzerwa nezvizvarwa zvitsva zve steroid zvingave zvisingatauri, zvisinei, zvisinei, hazvifaniri kumira kuti uzvitore, sezvo muviri unotora nguva yekudzorera chimiro chekuita steroid hormone.
Kubviswa kwekuputika
Mushure mekubviswa kwechiratidzo chekutanga chechirwere chacho, 5-aminosalicylic acid inogadzirwa (nenzira ye monotherapy kana pamwe chete nesteroids) inoumba hwaro hwekurapa kweBD. Dzinosanganisira sulfasalazine, mesalazine uye olsalazine. Kutungamirirwa kwavo kunodzivirira kudzoka kwechirwere ichi, nokudaro zvichipa kuregererwa kwakasimba. Iyi mishonga inogona kushandiswa nenzira yehwendefa, enemas kana kuti makenduru uye haine chiito chakadai chakadai steroids. Nzira dzakakosha dzeboka iri dzinosanganisira kuora mwoyo, kuputika, musoro uye anemia. Kuziva kusawirirana kwavo, murwere anogara achiongororwa neropa. Imwe mishonga ine simba rinopesana nokuputika ndeye azathioprine. Iyo inoshandiswa pakurega kushivirira kuderedza kuderedza steroid, pamwe chete nevarwere vane zvakaoma kutarirwa IBD. Paunotora ichi chirwere, iwe unodawo kugara uchiongorora kuverenga ropa. Chidiki chevarwere vane IBD vanoda kurapwa. Kana chirongwa chinokwana chirongwa chisina kutevedzwa, mukana wekudiwa kwekupindira kwekuvhiya kunowedzera.
Heavy forms
Nokusaremekedzwa chirwere chekurwara, zviratidzo zvekurapwa kunoitwa munenge makumi matatu muzana yevarwere. Kurapa kunobatsira kunoshandiswa kana zvichibvira kudzima kuoma kukuru nekubatsirwa kwepamusoro mishonga yemishonga, uyewo nekuderera kukuru muhupenyu hwomurwere. Mukuwedzera, chirwere chinodikanwa kana zviratidzo zvekutanga zvehutachiona huri mumatumbo zvinowanikwa.
Mhando dzebasa
Muchitachiona cheCrohn, chirwere chokuvhiya chinonyanya chinangwa chekubvisa matambudziko nekubvisa nzvimbo dzakaputika mumatumbo. Kune vakawanda varwere vane ulcerative colitis, kusarudzwa kwesarudzo ndiko kunonzi reconstructive protocollectomy, iyo inosanganisira kubvisa chikamu chemukati mudumbu guru ndokubva yaumba "pocket" kubva mumukati mumugero yakabatana ne anastomosis kune anus. Kuvhima kunoitwa mumatanho maviri, kusiyana neye colectomy, umo mukati guru uye rectum zvinobviswa panguva imwechete, uye kubviswa kwechigaro kunoitwa kuburikidza ne ileostoma mune imwe saga. Kunyatsokodzera kurapwa kunoita kuti zvikwanise kugadzirisa zvakanakisisa dzidzo yeBD mune varwere vazhinji, asi zvirwere izvi hazvigoneki. Mune varwere vakadaro, mune mamwe mamiriro ezvinhu, njodzi yekuva nemaronda anouraya emukati inowedzera.
Mungozi yekuva nekenza yemakoloni kana rectum inowedzera nekubatanidzwa kwemukumbo wose (kana chikamu chikuru) mukuputira, uyewo nekuwedzera kwehutachiona hwechirwere. Ngozi yehutachiona hunogona kuderedzwa nekugara uchipora colonoscopy, iyo inobvumira kuona kuchinja kwakanyanyisa pakutanga. Zvakakosha kucherechedza kuti kune varwere vane runyoro IBD, zvakanyanya kuderera. Kakawanda kazhinji, kuchinja kwakaipa kunowanzoenderana nemamiriro ehutachiona hweCrohn, iyo inowedzera pasina kukundwa kwemukumbo mukuru.
Forecast
IBDs inoratidzika nenzira isingaperi, uye kuratidzwa kwavo mumurwere mumwe nomumwe kune mumwe nomumwe. Muchikamu chinoshanda, chirwere chinogona kukonzera kusagadzikana kukuru, asi nechisarudzo chakanaka chemishonga inodhaka, tichifunga nezvekugara kwechirwere chechirwere ichi, varwere vakawanda vanochengetedza kukwanisa kushanda zvakakwana, pasinei nekusagona kwekurapa kwakakwana. Penguva yekuregererwa, murwere ane IBD anogona kutungamirira hupenyu hwehupenyu. Pakati pevarwere kune pfungwa yokuti kuwedzera kweBD kuonekwa "pamatambudziko", izvo hazvina kururama. Kutaura zvazviri, kudzokazve kwechirwere kunogona kutungamirira kukutya kukuru kwekutya uye kunyange kuora mwoyo, kunyanya apo murwere anomanikidzwa kuti aende kushanyira chimbuzi. Nokudaro, munguva yekuwedzera, tsitsi nekunzwisisika pane chikamu chemhuri yemurwere uye vashandi pamwe navo vanokosha zvikuru. Kana mukadzi ari kuronga pamuviri, mukana wekutora pamuviri wakakwirira munguva yekuregererwa. Munguva yekudzivirira, kunogona kuva nekuwedzera kwechirwere ichi, asi kazhinji kunowanikwa nenzira isina simba uye kupindura zvakanaka kumishonga yemishonga. Chiyero chekubatsira uye njodzi yekutora steroids panguva yekuzvitakura inofungidzirwa seyakanaka, sezvo mikana yekuvandudza migumisiro munguva iyi yakaderera zvakakwana.