Recurrent chronic pathology of the gastrointestinal tract (GIT), uas yog tus cwj pwm los ntawm kev tsim ntawm thaj chaw necrotic thiab ulcers, nrog rau kev mob ntawm txoj hnyuv mucosa, hu ua ulcerative colitis. Nws cov tsos mob tau tshwm sim los ntawm kev tsis muaj zog, mob plab, mob plab, thiab lwm yam. Hmoov tsis zoo, tsis muaj txoj hauv kev kho tshiab uas yuav hloov pauv txoj hauv kev paub txog kev kho tus kab mob.
Etiology ntawm tus kab mob
Qhov tseeb ua rau mob plab ulcerative tsis tau txheeb xyuas. Cov kev xav hauv qab no tsim nyog mloog:
- Qhov no yog kab mob autoimmune. Raws li qhov tshwm sim ntawm kev cuam tshuam rau qee qhov ua rau muaj kev cuam tshuam, nrog rau kev tshuaj ntsuam genetic predisposition nyob rau hauv lub cev ntawm ib tug neeg, ib tug txheej txheem yog activated uas yog qhia tawm tsam nws tus kheej antigens.
- Kev cuam tshuam ntawm ib puag ncig. Raws li qhov laj thawj tseem ceeb, qhov xwm txheej kis tau raug txiav txim siab.
- Cov tsos mob ntawm tus kab mob colitis yog tshwm sim los ntawm kev tsis txaus ntawm lub cev tsis muaj zog hauv lub plab zom mov. Kev phemCov xwm txheej ua rau muaj qhov tsis txaus ntseeg cov lus teb, uas yog tsim los ntawm kev kis tau lossis caj ces tsis ua haujlwm hauv cov txheej txheem ntawm kev tiv thaiv kab mob.
Raws li saum toj no, muaj ntau yam txaus ntshai:
- autoimmune;
- xov xwm;
- kab mob;
- tshuaj lom neeg, lom neeg, lub cev thiab lwm yam ua rau ua rau mob.
Diagnosis
Txhawm rau kom paub meej cov kab mob, cov kev kuaj hauv qab no tau ua:
- ntiv tes.
- Lub colonoscope yog siv los tshuaj xyuas cov hnyuv mucosa thiab coj biomaterial rau histology.
- Txoj ntshav suav qhia cov qe ntshav liab qis thiab cov qe ntshav dawb siab.
- Thaum kuaj quav, kuaj pom muaj cov qe ntshav dawb thiab ntshav liab thiab kuaj kab mob kab mob. Tsis tas li ntawd, qhov kev tshuaj ntsuam no tso cai rau koj kom tsis suav nrog lwm yam pathologies.
- MRI lossis CT tuaj yeem siv los saib cov hnyuv kom meej.
- X-ray nrog tus neeg sawv cev sib txawv. Txoj kev no yog ua tiav nrog cov tsos mob tshwm sim txhawm rau tshem tawm cov hnyuv perforation.
- Ultrasound ntawm lub plab hnyuv plab.
- Tham nrog tus kws kho mob endocrinologist, rheumatologist, gynecologist, kws kho mob dermatologist yog tias tsim nyog.
Kev faib tawm
Colitis yog qhov txawv ntawm nws qhov ntev:
- tag nrho - txoj hnyuv loj cuam tshuam tag nrho;
- distal - pom proctitis;
- sab laug-sab - cuam tshuam ib feem (nce mus rau sab xis khoov) ntawm txoj hnyuv.
Raws li qhov mob hnyav ntawm cov cim qhia ntawm cov kab mob ulcerative colitis:
- hnyav;
- nruab nrab;
- easy.
Raws li qhov xwm txheej ntawm tus kab mob, cov ntaub ntawv hauv qab no yog qhov txawv:
- xob laim;
- ntsim;
- recurrent chronic - exacerbations tshwm sim txhua rau lub hlis;
- txuas ntxiv - protracted exacerbation.
Symptoms
Lub tsev kho mob ntawm cov kab mob tsis tshwj xeeb yog cov cim qhia hauv zos thiab dav. Thawj tshwm sim:
- mob plab;
- cem quav;
- ntshav los ntawm txoj hnyuv;
- mob plab;
- xav kom txhob quav ntsej.
Los ntawm cov tsos mob, muaj:
- nausea;
- ntua;
- poob phaus;
- fever;
- kev qaug zog.
Qhov hnyav ntawm qhov tshwm sim ntawm cov tsos mob ntawm cov kab mob ulcerative colitis nyob rau hauv cov neeg laus yog nyob ntawm qhov mob hnyav thiab plab hnyuv puas. Nrog rau qhov nruab nrab, tus neeg mob muaj cov tsos mob hauv qab no:
- nce me ntsis hauv qhov kub;
- faus;
- mob plab ntawm qhov mob cramping;
- tsib mus rau rau ib hnub kev yaum kom tso quav;
- ntshav-steaked quav;
- muaj qhov tshwm sim ntawm kev mob caj dab, erythema nodosum thiab qee qhov cim qhia tsis cuam tshuam nrog tus kab mob hauv qab.
Nyob rau hauv mob hnyav ulcerative colitis ntawm txoj hnyuvCov tsos mob tshwm sim raws li hauv qab no:
- raws plab uas muaj ntshav ntau los yog cov quav;
- mob nrog rau tus cwj pwm ua ntej defecation;
- ntshav ntshav vim ntshav poob loj;
- fever;
- poob qis.
Muaj peev xwm txhim kho cov teeb meem uas ua rau lub neej muaj teeb meem - los ntshav hnyav vim yog lub plab zom mov. Cov neeg mob uas muaj daim ntawv fulminant ntawm tus kab mob muaj ib qho kev kawm tsis zoo. Rau kev kho mob ntawm cov ntaub ntawv nruab nrab ntawm cov kab mob ulcerative nonspecific, cov tshuaj hormonal nrog cov tshuaj tiv thaiv kab mob yog siv.
Kev nyuaj siab
Txhua yam teeb meem uas tshwm sim hauv cov kab mob no tau muab faib ua kab ke thiab hauv zos. Cov tom kawg tshwm:
- Mob toxic dilatation ntawm txoj hnyuv, uas yog suav hais tias yog ib qho ntawm cov teeb meem loj ntawm tus kab mob. Qhov yuav tsum tau ua ua ntej rau qhov tshwm sim yog toxicosis tshwm sim los ntawm cov txheej txheem ulcerative necrotic. Thaum lub sij hawm tom ntej no mob hnyav, cov hnyuv cuam tshuam tag nrho los yog nws seem nthuav. Nyob rau hauv thawj theem ntawm mob toxic dilatation, intensive kev kho mob yog qhia. Kev phais raug pom zoo thaum kev kho mob tsis zoo.
- Tshuaj plab hnyuv perforation. Xws li ib tug teeb meem yog suav hais tias yog ib tug tshwm sim ntawm kev tuag nyob rau hauv lub fulminant daim ntawv ntawm tus kab mob, raws li zoo raws li nyob rau hauv ntxiv rau mob toxic dilatation. Cov phab ntsa ntawm txoj hnyuv ua thinner thiab poob lawv txoj haujlwm tiv thaiv nyob rau hauv kev cuam tshuam ntawm cov txheej txheem necrotic loj heev. Pathogenic microflorayog activated thiab txhawb kev tsim ntawm perforation. Nyob rau hauv lub sij hawm ntev ntawm ulcerative colitis, xws li ib tug teeb meem yog heev tsawg. Kev saib xyuas kev kho mob tsis siv, kev phais yog qhia.
- mob plab hnyuv loj. Cov nyhuv no yog qhov tsawg heev. Nrog kev xaiv kev kho mob zoo siv hemostatics thiab tshuaj tiv thaiv kab mob, nws tuaj yeem tswj tau yam tsis muaj kev phais. Nyob rau hauv cov ntaub ntawv ntawm lub sij hawm lub plab hnyuv ntshav poob, cov kws kho mob pom zoo kom phais.
- Neoplasms ntawm txoj hnyuv loj. Raws li kev txheeb xyuas kev kho mob, kev pheej hmoo ntawm mob qog noj ntshav nce ntxiv nrog lub sijhawm ntawm tus kab mob ntau tshaj kaum xyoo, thiab tshwj xeeb tshaj yog thaum tus kab mob tau kuaj pom thaum yau.
Kev kho mob tseem ceeb
Cov tshuaj tiv thaiv kab mob yog cov kev kho mob yooj yim rau kev kho mob ntawm cov kab mob ulcerative hauv cov neeg laus, cov tsos mob uas tau piav qhia saum toj no. Cov tshuaj feem ntau yog Sulfasalazine, Hydrocortisone, Prednisolone, Budesonide, Fluticasone. Cov tshuaj thib ob muab cov kev mob tshwm sim me me thiab, tsawg dua li lwm cov tshuaj hormonal, inhibit qhov hypothalamic-pituitary-adrenal system. Kev siv ntev ntawm corticosteroids ua rau muaj kev phiv tshwm sim:
- mob ntshav qab zib;
- obese;
- osteoporosis;
- mob ntshav siab;
- Qhov tsim ntawm kev yaig thiab mob hauv plab thiab plab hnyuv.
Cov tshuaj "Sulfasalazine" thawj zaug siv rauKev kho mob ntawm ulcerative colitis ntawm txoj hnyuv nyob rau hauv lub forties ntawm lub xyoo pua xeem. Cov tshuaj tsis tsuas yog tshem tawm cov txheej txheem inflammatory, tab sis kuj muaj kev ceeb toom. Nyob rau hauv lub cev ntawm ib tug neeg, "Sulfasalazine" lov mus rau hauv sulfapyridine thiab 5-aminosalicylic acid, uas thaiv inflammatory mediators thiab modulates tiv thaiv kab mob. Ua tsaug rau kev siv cov tshuaj no, kev ua haujlwm ntawm lub plab hnyuv epithelial tau rov qab los, thiab kev puas tsuaj rau cov hnyuv tau txo qis. Ntxiv nrog rau Sulfasalazine, cov kws kho mob nquag sau tshuaj nrog cov khoom xyaw nquag mesalazine, uas muaj cov npe lag luam sib txawv thiab hom txheej txheej uas ua kom ntseeg tau tias nws tso tawm hauv ntau qhov chaw ntawm lub plab zom mov. Qhov zoo tshaj plaws, raws li kws kho mob, yog Salofalk. Thaum lub sij hawm lub sij hawm ntawm active o, ib tug loj koob tshuaj yog muab, ces nws yog txo mus rau ib tug noj koob tshuaj. Lub sijhawm txais tos yog teem rau tus kheej. Kev siv cov tshuaj saum toj no yog cov kev kho tseem ceeb uas tuaj yeem siv los tshem tawm cov tsos mob ntawm cov kab mob ulcerative colitis thiab kho cov kab mob me me rau cov neeg laus.
tshuaj kho lwm yam
Raws li ib txoj hauv kev ntxiv, koj tuaj yeem siv cov decoctions los ntawm cov khoom siv cog tshuaj, uas muaj cov nyhuv hemostatic thiab tiv thaiv kab mob:
- lichen;
- burnet;
- licorice;
- grey alder;
- nettle.
Qee qhov xwm txheej, kev siv pej xeem txoj hauv kev ncua kev zam txim. Tsis tas li ntawd, nws muaj peev xwm coj ntses roj ntawm qhov ncauj thiab siv rauua tsaug.
Lwm yam tshuaj los txo cov tsos mob thiab kho tus mob ulcerative colitis
Rau lub hom phiaj no, cov tshuaj tua kab mob siv tau uas tuaj yeem hloov kho lub cev tiv thaiv kab mob thiab muaj kev nyuaj siab rau cov kab mob plab hnyuv anaerobic. Cov kev cai no tau ntsib los ntawm Metronidazole. Txawm li cas los xij, kev siv tshuaj ntev ntev ntawm qhov ncauj ua rau muaj kev pheej hmoo ntawm kev phiv tshuaj. Qhov kev nyab xeeb tshaj plaws yog kev siv tshuaj nyob rau hauv daim ntawv ntawm kev ncua kev tswj hwm rectally. Yog hais tias muaj teeb meem tshwm sim nyob rau hauv daim ntawv ntawm toxic dilatation ntawm txoj hnyuv, cov tshuaj nram qab no raug pom zoo: Ampicillin, Clindamycin, Cefobid. Ntawm cov tshuaj tiv thaiv kab mob, Cyclosporine yog siv los kho tus kab mob. Nws tau raug pov thawj tias kev txhaj tshuaj txhaj tshuaj ntau ntawm cov tshuaj no ua rau muaj kev tshem tawm ntawm yuav luag 80% ntawm cov neeg mob hnyav. Feem ntau ntawm cov kev mob tshwm sim ntawm cov tshuaj yog me me thiab txo qis thaum cov tshuaj txo qis. Txawm li cas los xij, thaum ua ntawv thov, kev txhim kho ntawm cov kab mob herpetic ntawm txoj hlab pas, convulsions, ntsws abscess, thiab lwm yam yog ua tau.
Los ntawm cov tshuaj tiv thaiv kab mob monoclonal rau TNF-α, cov tshuaj "Infliximab" tau sau tseg.
Kev Noj Qab Haus Huv
Kho cov kab mob plab hnyuv, cov tsos mob uas peb tau txiav txim siab, yog ua los tawm tsam keeb kwm ntawm kev noj haus uas muaj ntau yam nta:
- cov zaub mov noj los ntawm tus neeg mob yuav tsum maj mam thiab tsis muaj coarse fiber;
- tsis suav tag nrho cov khoom siv mis nyuj, zaub tshiab thiab txiv hmab txiv ntoodaim ntawv, txhua yam zaub mov kaus poom, pickles thiab marinades;
- kev noj zaub mov yuav tsum muaj qhov sib npaug ntawm carbohydrates, rog, proteins, vitamins thiab kab kawm;
- xav muab cov zaub mov feem ntau - txhua ob mus rau peb teev noj cov zaub mov me me;
- zaub mov kub yuav tsum nyob nruab nrab ntawm 30 - 35 degrees;
- tag nrho cov zaub mov yuav tsum tau steamed;
- sib zaub ua ntej noj;
- thaum nyob hauv tsev kho mob, noj plaub lub rooj noj mov.
Nyob rau hauv kev ua txhaum ntawm kev nqus cov kab mob thiab qhov tsis txaus ntawm cov vitamins hauv tus neeg mob lub cev, nws raug nquahu kom noj cov vitamins-mineral complexes. Parenteral noj zaub mov yog qhia nyob rau hauv kev kho mob ntawm cov mob hnyav.
Txoj kev kho mob ntawm cov kab mob ulcerative hauv cov neeg laus
Nyob ntawm daim ntawv ntawm tus kab mob, muaj ntau txoj kev kho mob sib txawv:
- Nrog me me - Prednisolone tau muab tshuaj rau ib hlis, thiab tom qab ntawd, maj mam txo cov tshuaj, nws raug tso tseg. Microclysters nrog kev npaj hormonal yog nqa tawm hauv chav kawm luv luv txhua lub lim tiam. Sulfasalazine los yog Mesalazine noj los ntawm qhov ncauj nyob rau lub sijhawm ntev.
- Nrog rau nruab nrab - kev kho mob, zoo li hauv daim ntawv dhau los, tab sis cov tshuaj siv ntau dua. Tsis tas li ntawd, kev noj zaub mov nruj, uas txhais tau hais tias tsis lees txais cov khoom noj mis nyuj thiab cov khoom noj muaj protein ntau, thiab txwv tsis pub muaj fiber ntau.
- Thaum mob hnyav, kev kho mob ntshav qab zib yog siv cov tshuaj rau kev noj zaub mov hauv parenteral, albumin, plasma, qe ntshav liab, saline.kev daws teeb meem thiab qabzib.
Qhov teeb meem loj hauv kev kho mob ulcerative colitis yog tsis kam (ua pa) thiab kev vam khom ntawm cov tshuaj hormones. Hauv cov neeg mob zoo li no, muaj qhov ua tau zoo ntawm kev saib xyuas kev kho mob. Hauv txhua daim ntawv, cov tshuaj tua kab mob thiab kev kho mob sib xyaw yog qhia. Ntawm cov lus qhia tseem ceeb hauv kev kho tus kab mob yog cov hauv qab no:
- restoration ntawm kev tiv thaiv kab mob;
- nce kev nyuaj siab;
- normalization ntawm kev tswj hwm neuroendocrine;
- restoration ntawm plab hnyuv microflora.
kev kho mob phais
hom kev kho mob no tau pom zoo los ntawm tus kws kho mob thaum tsis muaj cov txiaj ntsig ntawm kev kho tshuaj, thaum muaj xwm txheej ceev thiab cov ntaub ntawv muaj txiaj ntsig ntawm pathology.
Cov lus qhia rau kev phais mob hauv cov kab mob ulcerative colitis tau muab faib ua qhov tseeb thiab txheeb ze. Cov yav tas muaj xws li ib tug tsis tu ncua relapsing, mob ntev ntawm tus kab mob rau ntau xyoo. Qhov tseeb yog:
- plab hnyuv;
- mob plab hnyuv loj;
- xav tias perforation;
- mob qog noj ntshav thiab lwm yam mob.
Kev kho mob ntawm cov menyuam yaus
Cov tsos mob ntawm ulcerative colitis ntawm txoj hnyuv tshwm nyob rau hauv cov tub ntxhais hluas tiam. Tus kab mob nyob rau hauv cov me nyuam yog tus yam ntxwv los ntawm ib tug zuj zus kev kawm thiab cov teeb meem loj heev ua rau kev tsis taus. Txawm hais tias muaj ntau txoj hauv kev, muaj qee qhov sib txawv hauv kev kho mob pathology hauv cov neeg laus thiab menyuam yaus. Lawv muaj feem xyuam rau cov yam ntxwv ntawm kev loj hlob ntawm tus me nyuam,tsis muaj kev paub txaus hauv kev kho mob siv tshuaj hauv pawg neeg mob no. Kev kho mob muaj xws li:
- khoom noj khoom haus;
- kev kho yooj yim nrog sulfonamides, salicylates thiab cov tshuaj hormones;
- tshuaj tua kab mob;
- tshuaj tiv thaiv kab mob;
- immunomodulators;
- tshuaj kho mob.
Ib yam kev kho mob rau cov me nyuam ua tau zoo yog kev thaj yeeb ntawm lub cev thiab lub hlwb. Kev ua si sab nraum zoov yuav tsum txwv. Tau txhawb kom taug kev sab nraum zoov. Lub txaj so yog qhia rau kev qaug zog, metabolic ntshawv siab, tsis muaj zog, kub.
Kev phais yog ua raws li cov lus qhia hauv qab no:
- colonic perforation;
- colon carcinoma;
- stunting ntawm tus menyuam tawm tsam keeb kwm ntawm kev kho mob uas siv, uas tsis ua rau muaj txiaj ntsig;
- nrawm colitis.
Zoo kawg
Cov tsos mob ntawm cov kab mob plab hnyuv loj feem ntau tshwm sim hauv cov neeg laus hnub nyoog 20 txog 40 xyoo, thiab cov poj niam cov pej xeem raug kuaj pom tus kab mob no ntau dua li kev sib deev muaj zog. Kev mob raws plab thiab nquag ntuav kom tso quav yuav txo tau lub neej zoo ntawm ib tug neeg thiab tej zaum yuav ua rau muaj kev tsis taus vim kev tsis taus. Feem ntau, tus kab mob no nrog dysbacteriosis. Kev kho mob yog tus kheej, nyuaj, txhawm rau tiv thaiv cov teeb meem thiab ua tiav kev zam txim.
