Daaweynta Cudurka Dhiigga Caabuqa

Daaweynta Cudurka Dhiigga Dhiigga (IBD)

Cudurrada mindhicirrada (IBD) , oo ay ku jiraan cudurada Crohn, xannuunka ulcerative, iyo unugyada aan caadiga ahayn, waa cudurrada daba dheeraadka ah ee nidaamka dheef-shiidka. Xilligan ma jiraan wax daawo ah oo nooc kasta oo IBD ah, laakiin waxaa jira fursado daaweyn oo wax ku ool ah. Halkan waxaan ka wadahadlaynaa daaweynta la oggolaaday laba nooc oo ugu muhiimsan ee IBD: Cudurka cudurrada Crohn iyo colitis-ka. Bukaanka qaba unug aan caadi ahayn (oo lagu qiyaasay inay ku jiraan 10 boqolkiiba bukaannada qaba IBD) ayaa sida caadiga ah la siiyaa daaweyn loo oggolaaday colitis sambabada.

> U fiirso sida ay coli boogtu u saameeyso caloosha.

Waxaa jira daawooyin badan oo loo ogolaaday isticmaalka dadka qaba cudurka Crohn iyo colitis sambabada. Qaar ka mid ah, si kastaba ha ahaatee, waxaa loo oggol yahay oo kaliya hal ama mid kale. Maandooriyayaashu waxay leeyihiin siyaabo kala duwan oo loo shaqeeyo laguna siiyo, sidaa darteed bukaanka iyo dhakhtarka gaasku waxay wada shaqeyn karaan si ay u helaan ikhtiyaarka oo kaliya maaha inay si macquul ah u maamulaan calaamadaha, laakiin waxay ku habboon yihiin hab nololeedka bukaanka.

• Ku-Xaadida Taariikhda Tallaalka Tallaalka ayaa Muhiim u ah Dadka leh IBD

• Maxay kala duwan yihiin inta u dhaxeysa 6-da nafaqeyn ee loogu talagalay IBD?

Warka fiicani waa in haddii hal daawo ama nooc ka mid ah daawooyinka aan la qaban shaqada, waxaa jira daroogo kale oo isku fasal ah, ama fasal kale, kuwaas oo lagu tijaabin karo xiga. Xitaa woxoogaa wanagsan waa in daawooyin dheeraad ah loo abuuro daaweynta IBD, waxaana jira rajo ka weyn tan ka hor inta aan la helin daaweyn si fiican u shaqeysa si loo maareeyo calaamadaha IBD iyo sababaha halista ah ee IBD.

Qaliinka sidoo kale waa hab lagu daaweeyo IBD, iyo labadaba cudurrada Crohn iyo cagaarshowlaha, noocyada kala duwan ee qaliinka waxaa loo isticmaalaa daaweyn. Si kastaba ha noqotee, nooca qaliinka loo isticmaalo wuxuu noqon doonaa mid kala duwan oo ku saleysan haddii loo baahdo in lagu daaweeyo cudurka Crohn ama colitis sambabada.

Sababtoo ah siyaabo kala duwan ayaa cuduradani u saameeyaan nidaamka dheef-shiidka iyo sida qalliinku u hagaajiyo calaamadaha iyo tayada nolosha ee bukaannada. Inkastoo fikirka qalliinka uu yahay mid murugo leh, waxaa loo isticmaalaa kaliya marka daaweynaha kale la isku dayay mana shaqeynayo.

Ujeedooyinka daaweynta IBD

Waxaa jira daawooyin kala duwan oo loo isticmaalo daaweynta IBD. Daawooyinkan waxaa sida caadiga ah looga hadlaa fasallada, waxayna ku jiraan antibiotics, bayooloji, corticosteroids, iyo immunomodulators. Daaweynta daawooyinka waxay leedahay laba gool oo kala duwan: si aad u heshid kor u kicideed iyo xakameyn, ka dibna sii wadida is-dhaafsiga iyo ka hortagidda in badan oo fara badan. Daawooyinka qaarkood ayaa loo isticmaalaa mid ka mid ah hadafyadan ama kuwa kaleba, qaarna waxaa loo isticmaalaa labadaba.

Ma jiro hal heer oo daaweyn ah oo loo isticmaalo qof kasta oo leh IBD. Waxaa jira tilmaamo ay bixiyaan bulshooyinka caafimaadka, laakiin daaweyntu maaha mid hal-buuxa ah oo dhan. Daaweyntu waxay ubaahantahay in loo qaabeeyo si loo daboolo baahida bukaan socodka.

Si kastaba ha ahaatee, hadana, go'aanada ku saabsan doorashooyinka daaweynta waxay ku saleysan yihiin caddaynta cilmibaarista.

Daaweynta Cudurka Qaaxada ee Crohn

Daawooyinka Cudurka Crohn

Daawooyinka loo isticmaalo daaweynta cudurka Crohn waxaa ka mid ah:

Antibiotics

• Cipro (ciprofloxacin)
• Flagyl (metronidazole)

Immunomodulators

• 6-mercaptopurine (Purinethol, 6-MP)
• Azathioprine (Imuran iyo Azzan)
• Folex, Rheumatrex (methotrexate)
• Prograf (Tacrolimus)
• Sandimmune, Nuuraal (Baaskiilad A)

Corticosteroids

• Cortenema (hydrocortisone)
• Deltasone ( prednisone )
• Dhaqdhaqaaqa (budesonide)
• Medrol (methylprednisolone)
• Kombiyuubka-HC (hydrocortisone acetate, xajmiga malawadka)

Qalabaynta Biyoolojiyada

• Cimzia (certolizumab pegol)
• Entyvio (vedolizumab)
• Humira (adalimumab)
• Inflectra (infliximab-dyyb)
• Qaadashada (Infliximab)
• Stelara (ustekinumab)
• Tysabri (natalizumab)

Qalliinka Cudurka Crohn

Caadi ahaan qalliin ayaa la sameeyaa kaddib marka daawooyinka aysan ka caawin karin caabuqa ama ay jiraan dhibaatooyin. Nooca qaliinka la sameeyo waxaa lagu saleyn doonaa meesha uu ku yaalo cudurka Cudurka Crohn uu keeno iyo inta uu faafo.

Qaliinka ma noqon doono daawo loogu talagalay cudurka Crohn iyo, dadka qaarkiis, bararka cudurka Crohn waa cudur ku soo noqda meel kale.

Qalliinka Cudurka cudurrada Crohn marwalba way fiicnaanaysaa, xaaladaha qaarkoodna waxaa laga yaabaa in lagu sameeyo farsamooyin yar yar oo farsamo (sida qalliinka laparoscopic ) ee waqtigooda dhimman waqtiga isbitaalka iyo waqtiga soo kabashada. Halkan waxaa ku qoran qaar ka mid ah noocyada ugu badan ee qaliinka loo sameeyey si loo daaweeyo cudurka Crohn:

• Soo jiidid : Nooca ugu caansan ee qalliinka loo sameeyo si loo daaweeyo cudurka Crohn waa calaamad. Resection waa marka qayb ka mid ah mindhicirrada ama xiidmaha cudurrada laga saaro, iyo labada daraf ee unugyada caafimaadka leh ayaa mar labaad la isku tolaa (oo loo yaqaan 'anastomosis'). Tan waxaa lagu sameyn karaa mindhicirka yar ama mindhicirka weyn .
• Cudurka Strokeureplasty : Cudurka 'Crohn' wuxuu sababi karaa unugyo nabarro ah oo la dhisi karo wuxuuna sababi karaa cirridka mindhicirka. Marka qayb ka mid ah mindhicirka uu noqdo mid cidhiidhi ah, waxaa laga yaabaa in mar kale la furo inta lagu jiro qalliinka adag.
• Cudurka qanjidhka 'Proctocolectomy' : Qaar ka mid ah dadka qaba cudurka Crohn ee aan cudurka ku jirin malawadka, waxaa laga yaabaa in la sameeyo baaritaanka xajmiga. Xiidanka waaweyn ayaa la saarayaa dhamaadka mindhicirka yarna wuxuu ku xiran yahay futada. Taas macnaheedu waa in stoma aysan loo baahneyn saxarada ayaa laga qaadi karaa hoosta. Qaliinka noocan ah waxaa badanaa lagu sameeyaa kaliya koox gaar ah oo bukaan ah. Qalliinkan waxaa sidoo kale loo yaqaannaa isoanal anastomosis.

• Tilmaamahaaga si aad ugu gudubto koorso barmaamij ah

• Maxaa Looga Hortagayo IBD Waa Inay Ogaato Cipro

• Qalliinka Ostomy : Qaar ka mid ah dadka qaba cudurka Crohn ee saameeya xiidanka waxay yeelan doonaan qalliin si ay u abuuraan cudurka asostomy. Tani waa marka cirbadda laga saaro oo laga saaro caloosha caloosha. Saxaro ayaa jidhka ka soo baxaysa iyada oo loo marayo dhuunta meeshii ugu hooseysa, iyo qalabka ostomy ayaa lagu xirtaa caloosha si ay u qabato. Inta badan dadka qaba cudurka Crohn ma u baahan doonaan qalliinka ostomy.

Cudurrada Daaweynta Colitis

Daawooyinka loogu talagalay Cudurka Ulcerative Colitis

Daawooyinka loo isticmaalo daaweynta bakteeriyada sambabada waxaa ka mid ah:

Aminosalicylates (5-ASA)

• Azulfidine (sulfasalazine)
• Asacol , Pentasa, Lialda, Apriso , Delzicol (mesalamine)
• Canasa (dabeecadda mesalamine)
• Colazal (balsalazide)
• Dipentum (olsazine)
• Rowasa (mesalamine enemas)

Immunomodulators

• 6-mercaptopurine (Purinethol, 6-MP)
• Azathioprine (Imuran iyo Azzan)
• Sandimmune, Nuuraal (Baaskiilad A)
• Tacrolimus (Prograf)

Corticosteroids

• Cortenema (hydrocortisone enema)
• Deltasone ( prednisone )
• Dhaqdhaqaaqa (budesonide)
• Medrol (methylprednisolone)
• Kombiyuubka-HC (hydrocortisone acetate, xajmiga malawadka)
• Uceris (budesonide)

Qalabaynta Biyoolojiyada

• Entyvio (vedolizumab)
• Humira (adalimumab)
• Inflectra (infliximab-dyyb)
• Qaadashada (Infliximab)
• Simponi (golbalab)

Qalliinka Cudurka Ulcerative Colitis

Crohn's iyo Colitis Foundation of America ayaa qiyaastay in meel kasta oo udhaxeysa 23 boqolkiiba iyo 45 boqolkiiba dadka bukaanka qabta ee qafilan ay qalliin ku sameeyaan. Xalalka qalliinka loogu talagalay xannuunka ulcerative mar walba waxaa ka mid ah saarista mindhicirka weyn (colectomy), iyadoo la abuurayo labadaba ama stambo gudaha ah si loo qaado saxaro. Fursadaha qalliinka loogu talagalay xanuunka ulcerative waxaa ka mid ah:

• Protocolectomy oo la sameynaayo duubka miskaha : Ka dib marka xiidanka la saaro si loo daaweeyo koleejaha boogta, duubka gudaha waxaa laga sameeyaa qaybta ugu dambeysa ee mindhicirka yar (xaydha). Maqaarkaan, ma jiro bacda dibedda dibedda ah ama stoma sababtoo ah buunku wuxuu u dhaqmaa sidii malawadka. Meelaha Pelvic waxaa lagu sameyn karaa qaabab kala duwan, laakiin midka ugu badan ee la isticmaalo waa jajabka. Qaliinkan waxaa sidoo kale loo yaqaannaa anastomosis, ama IPAA.
• Protocolectomy oo la sameynaayo byostomy : Kadib kolkaygu, qaar ka mid ah bukaanka qaba ulcerative colitis waxay qabteen dhamaadka byostomi. Caloosha waxaa loo sameeyaa caloosha marinka saxarada iyo qalabka ostomy ayaa lagu xiraa stoma. Fikradda ah in dhabar-xannibaado ayaa u muuqata mid cabsi-galin, laakiin bukaannada badankood ee qaba colitis-ka waxay leeyihiin nolol tayo sare leh ka dib markii la sameeyo qalliinka kuuriya iyo si fiican u sameeyaan naaskooda.

Ereyga

Waxaa jira fursado badan oo caafimaad iyo qalliin ah oo la heli karo maanta si loo daaweeyo cudurka Crohn ee cudurkeenaha iyo ulcerative colitis weligiisba ka hor. Daawooyinka la heley sanadihii la soo dhaafay ayaa ah kuwo wax ku ool ah, waxaana jira wax badan oo la baranayo.

Qaybta ugu muhiimsan ee daaweynta IBD si guul leh iyo helitaanka rafcaan qaadashadu waa in uu arko dhakhtarka gawracatada si joogta ah isla markaana u qaato dawada wakhtigeeda. Iyada oo daawooyinka kala duwan ee la heli karo, bukaanno badani waxay keeni karaan caabuq, ka hortagga dhibaatooyinka, iyo hagaajinta tayada noloshooda.

> Ilo:

> Bandarandari BM, Kroser JA. "Caabuq Dhiiga Caabuqa." Kuliyada American Gastroenterology. Maarso 2010, Maarso 2011. Xarunta Cleveland Clinic Foundation. 26 Sebtembar 2013.

> Braegger CP, Nicholls S, Murch SH, Stephens S, MacDonald TT. "Tumor necrosis factor alpha ee saxaro ahaan sida calaamadda caabuqa mindhicirka." Lancet. 1992; 339: 89.

> Crohns & Colitis Foundation of America. "Qalliin loogu talagalay Cudurka Cudurka & Cudurka Cudurka Dhiiga." CCFA.org. 31 Aug 2010.

> Terdiman JP, Gruss CB, Heidelbaugh JJ, Sultan S, Falck-Ytter YT, Guddiga Agaasinka Cilmi- "Machadka Ururka American Gastroenterological Association ee Tilmaamaha Isticmaalka Isticmaalka Thiopurines, Methotrexate, iyo Anti-TNF-a Daroogooyinka Biyoolojiga ah ee Induction iyo Dayactirida Xilliga Cudurka Kaadi-bararka Cudurka." Gastro. 2013; 145: 1459-1463.