Ulcerative colitis (UC) yog kab mob ua mob uas ua rau mob (ua rau mob) nyob rau sab hauv sab hauv ntawm txoj hnyuv loj thiab qhov quav. Nws yog ib ntawm ib pawg ntawm cov kab mob raug xa mus rau feem ntau yog mob plab hnyuv lossis IBD. UC muaj cov tsos mob zoo sib xws los saib xyuas, thiab thaum tsis muaj kev paub kho, kev kho thaum ntxov yog tus yuam sij rau kev zam lub sijhawm ntev.
Cov kauj ruam
Ntu 1 ntawm 3: Paub txog Cov tsos mob ntawm Ulcerative Colitis
Kauj Ruam 1. Saib ntshav hauv koj cov quav
Cov tsos mob feem ntau ntawm UC yog ntshav hauv cov quav (quav). Tej zaum nws yuav yog cov ntshav liab tshiab, sib tov nrog cov hnoos qeev lossis cov dej ntws tawm ntawm cov quav tawv. Cov quav ntshav qhia tias los ntshav hauv lub plab zom mov qhov chaw. Yog tias nws yog xim liab liab ces nws qhia tias ntshav los ntawm txoj hnyuv lossis qhov quav.
- Cov ntshav kuj tseem tuaj yeem nrog cov pus (cov qe ntshav dawb tuag).
- Ntshav hauv cov quav kuj yog cov tsos mob tshwm sim ntawm txoj hnyuv thiab mob qog noj ntshav.
- Ntshav uas zoo li kas fes zom los ntawm lub plab zom mov sab saud, xws li lub plab lossis txoj hnyuv.
Kauj Ruam 2. Sau tseg yog tias koj muaj dej raws plab raws plab
Ntau hom teeb meem hauv lub plab zom mov ua rau raws plab, yog li nws tsis tshwj xeeb rau UC, tab sis lub sijhawm ntawm nws yog qhov tseem ceeb. Cov dej raws plab tom qab noj mov lossis thaum tsaus ntuj yog qhia txog UC. Qhov no tshwm sim vim tias cov hnyuv nrawm thawb cov khoom zom zaub mov dhau los ntawm thaj chaw ulcerated kom tsis txhob ua rau mob hnyav.
- Txawm hais tias mob hnyav (lub sijhawm luv) feem ntau dhau mus sai, raws plab raws li ntev li ob peb lub lis piam yog qhov cim ntawm teeb meem zom zaub mov tseem ceeb.
- Yog tias qhov quav ua rau o tuaj sai heev los ntawm UC, cov hnyuv yuav ua rau cov txheej txheem zom zaub mov qeeb kom tseg qhov quav los ntawm kev tuav cov quav rau lub sijhawm ntev. Yog li ntawd, cem quav tuaj yeem tshwm sim tom qab mob plab ntev.
- Kev raws plab tuaj yeem ua rau lub cev qhuav dej sai, yog li ua kom koj tus kheej muaj dej txaus los ntawm kev haus yim 8-ounce tsom iav ntawm cov dej huv txhua hnub.
Kauj Ruam 3. Ua tib zoo saib mob plab
Nrog rau kev mob plab los ntawm kev mob raws plab, lwm qhov cim ntawm UC yog qhov tsis meej pem lossis mob hauv plab. Qhov mob yog los ntawm qhov mob ua paug los ntawm cov txheej mucosal ntawm txoj hnyuv loj/hnyuv. Tsis muaj ntau txoj hlab ntshav xaus zoo li lwm qhov chaw ntawm koj cov tawv nqaij, qhov mob tsis meej thiab feem ntau piav raws li qhov mob me me-rau-nruab nrab.
- Hom mob no txawv ntawm qhov tshwm sim los ntawm Crohn tus kab mob (lwm hom IBD) lossis mob plab hnyuv, uas feem ntau hnov zoo li hauv qab sab xis ntawm lub plab.
- Qhov mob plab mob ntawm UC feem ntau tsis mob siab los ntawm kev tso quav (noj quav).
Kauj Ruam 4. Saib xyuas kom tsis qab los noj mov thiab poob phaus
Nrog UC, lub cev tiv thaiv kab mob tau ua haujlwm tas li thiab sim kho qhov txhab, thiab mob raws plab thiab mob plab feem ntau ua rau xeev siab. Thiaj li, cov neeg uas muaj UC feem ntau poob lawv cov qab los noj mov, noj tsawg dua thiab pib poob qhov hnyav. Cov neeg uas muaj UC feem ntau zam kev noj zaub mov kom txo qis kev mob plab hnyuv, txawm hais tias feem ntau nws tsis ua rau mob zoo dua. Qhov xwm txheej no tuaj yeem ua rau lub sijhawm qis ntawm kev mob qog noj ntshav, hu ua cachexia.
- Noj me me, noj zaub mov zoo nrog rau cov khoom tsim tshiab, muaj cov nplej tag nrho thiab ntses ntshiv. Zam kev ua zaub mov kom huv thiab huv, tshwj xeeb yog hom ntsim, thiab khoom siv mis.
- Los ntawm kev tsis noj mov, cov neeg uas muaj UC muaj kev pheej hmoo siab ntawm kev tsim cov zaub mov tsis zoo. Yog li ntawd, txiav txim siab ntxiv nrog cov vitamins thiab minerals.
- Kev qaug zog ntev thiab ua npaws me ntsis yog lwm yam nrog UC uas ua rau tsis qab los noj mov thiab poob phaus.
Ntu 2 ntawm 3: Kev Txheeb Xyuas Kab Mob Colitis Kho Mob
Kauj Ruam 1. Teem caij nrog koj tus kws kho mob
Yog tias koj pom ib qho ntawm cov tsos mob hais txog plab hnyuv, teem sijhawm nrog koj tus kws kho mob hauv tsev kom sai li sai tau. Koj tus kws kho mob yuav tsis yog tus kws tshaj lij sab hauv, tab sis lawv tuaj yeem kuaj cov quav thiab xa koj mus kuaj ntshav txhawm rau pab txheeb xyuas kev kuaj mob ntawm UC. Lwm yam mob uas ua rau muaj cov tsos mob zoo sib xws rau UC suav nrog: Crohn tus kab mob, mob plab hnyuv, kab mob celiac, mob qog noj ntshav, mob plab hnyuv (kab mob, kis kab mob, kis kab mob), zaub mov lom thiab mob plab hnyuv.
- Cov qe ntshav liab thiab cov qe ntshav dawb (vim muaj kev tiv thaiv kab mob) hauv koj cov quav tuaj yeem qhia UC. Cov quav quav kuj tseem tuaj yeem pab txiav tawm lwm yam mob, tshwj xeeb yog mob plab.
- Kev kuaj ntshav raug xaj kom tshuaj xyuas ntshav tsis txaus (qhov tshwm sim ntawm UC vim los ntshav sab hauv thiab poob ntawm cov qe ntshav liab thiab hlau) thiab muaj peev xwm kis tau.
- Tsawg albumin lossis protein hauv cov qauv ntshav yog qhov pom tshwm sim hauv cov neeg mob uas muaj UC hnyav.
Kauj Ruam 2. Tau txais kev xa mus kuaj txoj hnyuv loj
Koj tus kws kho mob tuaj yeem xa koj mus rau tus kws kho mob tshwj xeeb (kws kho mob plab) kom tau txais txoj hnyuv loj, uas yog kev kuaj mob uas tso cai rau pom kev pom ntawm koj cov nyuv tag nrho uas siv lub cev nyias, hloov pauv tau, lub teeb raj nrog lub koob yees duab thaum kawg. Qhov "dav" yog qhov tseeb rau kev kuaj mob UC thiab txiav txim siab tias tus kab mob zoo li cas. Cov kab mob sib sib zog nqus mus thoob plaws hauv cov mucosal hauv ob sab phlu yog qhia txog UC, hos Crohn tus kab mob yog tus yam ntxwv tsis tu ncua (tsis tu ncua) mob uas tuaj yeem tshwm sim nyob txhua qhov chaw ntawm GI txoj hnyuv.
- Txog kev kuaj txoj hnyuv, tus neeg mob tso rau ntawm lub rooj thaum tus kws kho mob nkag mus rau hauv qhov quav thiab maj mam coj nws los ntawm lub qhov quav thiab mus rau hauv txoj hnyuv loj (txoj hnyuv).
- Yog tias tus kws kho mob xav tias UC, lawv yuav kuaj cov ntaub so ntswg (biopsy) ntawm tus neeg mob txoj hnyuv/qhov quav nrog qhov muaj thiab saib nws hauv qab lub tsom iav rau cov cim qhia.
Kauj Ruam 3. Ua kom paub lwm yam kev kuaj mob
Koj tsev neeg tus kws kho mob/kws kho mob lub plab tseem tuaj yeem xaj lwm qhov kev kuaj mob txhawm rau txiav txim siab lossis txiav tawm UC, xws li sigmoidoscopy, xoo hluav taws xob hauv plab, CT scan, MRI thiab/lossis chromoendoscopy. Txheeb nrog koj daim phiaj xwm kev pov hwm kev noj qab haus huv kom paub tseeb tias cov kev xeem no tau them rau hauv koj li phiaj xwm.
- Sigmoidoscopy hloov pauv tau zoo ib yam li txoj hnyuv me me - tsuas yog rau qhov kawg ntawm koj txoj hnyuv hu ua sigmoid. Yog tias koj txoj hnyuv loj heev, koj tus kws kho mob tsuas ua tau sigmoidoscopy los cawm koj qhov tsis xis nyob.
- Yog tias koj cov tsos mob hnyav, koj tus kws kho mob yuav siv lub plab xoo hluav taws xob nrog cov khoom sib piv los txiav tawm qhov teeb meem, xws li txoj hnyuv hnyuv.
- Ib qho CT scan tuaj yeem paub qhov txawv ntawm UC thiab lwm hom IBD thiab tseem tuaj yeem txiav txim siab ntau npaum li cas ntawm cov hnyuv tau mob/ua rau mob.
- Ib qho chromoendoscopy siv qhov dav thiab txau cov xim kom pom qhov txawv txav ntawm cov ntaub so ntswg hloov pauv hauv txoj hnyuv, vim tias muaj kev pheej hmoo loj cuam tshuam nrog UC yog mob qog noj ntshav.
Ntu 3 ntawm 3: Kho Tus Mob Ulcerative Colitis
Kauj Ruam 1. Pib nrog tshuaj tua kab mob
Thaum tsis muaj tshuaj kho tau UC, ntau tus tuaj yeem txo cov tsos mob thiab txhim kho tus neeg lub neej zoo. Cov tshuaj tiv thaiv kab mob feem ntau yog thawj qib hauv kev kho mob UC thiab lwm hom IBD. Feem ntau lawv pib nrog suav nrog: aminosalicylates thiab tshuaj corticosteroid, xws li prednisone thiab hydrocortisone.
- Sulfasalazine (Azulfidine) yog aminosalicylate uas muaj txiaj ntsig zoo hauv kev tiv thaiv cov tsos mob ntawm UC, tab sis nws zoo li ua rau muaj ntau qhov tshwm sim.
- Lwm cov aminosalicylates suav nrog mesalamine, balsalazide thiab olsalazine. Txhua yam muaj nyob rau hauv qhov ncauj thiab qhov quav (qhov quav).
- Koj yuav tsum tau siv lub qhov quav, uas cuam tshuam nrog yaug cov tshuaj yaj rau hauv koj lub qhov quav siv lub raj mis tshwj xeeb.
- Corticosteroids feem ntau tsuas yog siv rau mob hnyav-rau-hnyav UC uas tsis teb zoo rau lwm yam kev kho mob. Lawv tsuas yog muab lub sijhawm luv luv, tab sis tseem yuav ua rau muaj kev phiv ntau ntxiv, suav nrog: lub ntsej muag puffy, txo kev tiv thaiv kab mob, tawm hws hmo ntuj, tsis tsaug zog thiab mob pob txha.
Kauj Ruam 2. Tham nrog koj tus kws kho mob txog kev tiv thaiv kab mob tiv thaiv kab mob
Cov tshuaj muaj zog no txo qhov mob thiab ua rau lub cev tiv thaiv kab mob, uas yog qhov muaj txiaj ntsig yog tias mob plab tshwm sim los ntawm kev tiv thaiv kab mob autoimmune (kev tiv thaiv tsis haum). Cov tshuaj tiv thaiv kab mob no feem ntau yog noj los ntawm qhov ncauj. Corticosteroids kuj tseem siv ua ke nrog cov tshuaj tiv thaiv kab mob tiv thaiv kab mob, uas suav nrog: azathioprine, mercaptopurine, cyclosporine, infliximab, adalimumab, golimumab thiab vedolizumab.
- Azathioprine (Azasan, Imuran) thiab mercaptopurine (Purinethol, Purixan) yog cov tshuaj tiv thaiv kab mob feem ntau siv rau UC thiab lwm hom IBD. Txawm li cas los xij, cov tshuaj no tuaj yeem nyuaj rau koj lub siab thiab txiav txiav.
- Cyclosporine (Gengraf, Neoral, Sandimmune) feem ntau yog tseg rau cov xwm txheej ntawm UC uas tsis teb zoo rau lwm yam tshuaj. Cov kev mob tshwm sim loj feem ntau tshwm sim nrog kev siv cyclosporine.
- Infliximab (Remicade), adalimumab (Humira) thiab golimumab (Simponi) yog lub npe hu ua qog necrosis factor (TNF) -alpha inhibitors lossis biologics, thiab pom zoo rau nruab nrab-rau-hnyav UC. Lawv ua haujlwm los ntawm nruab nrab cov protein tsim los ntawm koj lub cev tiv thaiv kab mob.
- Vedolizumab (Entyvio) yog cov tshuaj tsis ntev los no tau pom zoo rau UC. Nws ua haujlwm los ntawm kev thaiv cov qog nqaij hlav los ntawm kev mus rau qhov chaw ntawm qhov txhab thiab ua rau tej yam tsis zoo.
Kauj Ruam 3. Xav txog kev phais tsuas yog qhov kawg
Kev phais feem ntau tuaj yeem tshem tawm lossis kho UC, tab sis feem ntau nws txhais tau tias tshem koj tag nrho txoj hnyuv thiab qhov quav hauv cov txheej txheem hu ua proctocolectomy. Muaj ntau zaus, koj tseem tuaj yeem ua tus txheej txheem ua tiav (ileoanal anastomosis) uas tshem tawm qhov xav tau hnav lub hnab ntim khoom rau koj cov quav. Txawm li cas los xij, hauv lwm qhov xwm txheej, ib lub hnab txuas rau qhov qhib hauv koj lub plab (ileal stoma) txhawm rau khaws cov quav.
- Kev rov zoo los ntawm cov txheej txheem proctocolectomy yuav siv sijhawm 4-6 lub lis piam.
- Tsis muaj txoj hnyuv, muaj peev xwm rov nqus dej thiab tsim cov vitamin B12 los ntawm cov kab mob phooj ywg tau cuam tshuam loj heev. Kev tiv thaiv kab mob feem ntau txo qis thiab.
Lub tswv yim
- Qhov tseeb ua rau UC tsis paub, tab sis cov kws kho mob ntseeg tias lub cev tiv thaiv kab mob ua haujlwm ntau dhau, cov noob caj noob ces thiab ib puag ncig ib puag ncig txhua yam ua lub luag haujlwm.
- Nco ntsoov haus dej ntau. Nws yog ib qho tseem ceeb kom nyob twj ywm thaum koj tab tom daws teeb meem zom zaub mov.
- UC tuaj yeem tshwm sim rau txhua lub hnub nyoog, txawm hais tias nws feem ntau pib ntawm hnub nyoog 15-30 xyoo.
- UC nyiam khiav hauv tsev neeg thiab muaj ntau dua ntawm cov neeg Caucasians ntawm cov neeg European thiab cov neeg Yudais.
- Saib xyuas kom tsim cov pob liab liab ntawm koj cov tawv nqaij. Kwv yees li 10% ntawm cov neeg mob UC muaj tus mob hu ua erythema nodosum - ntau qhov sib txawv ntawm cov pob liab liab ntawm lub puab tsaig, pob taws, pem hauv ntej pob tw thiab caj npab.
- Yog tias koj raug kuaj mob koj yuav xav saib mus rau hauv txoj hauv kev kom ua rau mob plab mob plab thaum lawv tshwm sim.
