Cudurada ugu badan ee mareenka caloosha iyo mindhicirka ayaa si wanaagsan u daaweynaya daaweynta mana keenaan dhibaatooyin khatar ah. Khatarta ugu weyn waa caabuq joogto ah, koox ahaan oo ay ka mid yihiin terminaal ama cillad bararka leh (granulomatous, enteritis region).
Cudurka jeermiska (Crohn's disease) - ayaa sababa
Dhakhaatiirtu weli ma ogaan sababta dhabta ah ee cudurkani uu soo baxo, waxaa jira aragtiyo asalkiisu yahay asalkiisa. Sababaha la soo jeediyey ee kudka:
- isbeddellada hidda;
- xanuunka ootimmoga;
- caabuqa viral ama bakteeriyada.
Cudurka cudurrada Crohn - qoondaynta
Waxaa jira noocyo badan oo ka mid ah cudurka la sharraxay, kuwaas oo loo qaybiyey kooxo dhowr ah iyada oo ku xiran degsiimada geeddi-socodka bararka, darnaanta, dabeecada iyo arrimo kale. Marka la eego heerarka casriga ah ee caalamiga ah, baradhada terminaalka ah (Crohn's disease) waxaa lagu qeexay 4 shuruudood:
- da'da bukaanka;
- phenotype ee cudurka;
- degsiiminta caabuqa;
- darnaanta jirrada.
Kooxaha da'da:
- ilaa 16 sano (A1);
- laga bilaabo 17 ilaa 40 jir (A2);
- ka dib 41 sano (A3).
Cudurka jirrada ee Crohn waxay ku xiran tahay astaamaha:
- inflammatory (B1) - cudurku ma aha mid adag, mararka qaarkood lesbiillada perianal ayaa ku biira;
- Dhibaato ama dharbaaxo (B2) - derbiyada mindhicirka ayaa la cidhiidhyaa, waxaa jira balaarin ka hor ama aan aheyn xannibaad;
- Qaadashada (B3) - waxaa ku jira fistulas, barar barar iyo nabaro.
Noocyada cudurada ee loo yaqaan "pathology" ayadoo loo marayo:
- Ilkaha (L1) - IYO;
- colitis (L2) - xiidmaha waaweyn ee u dhexeeya indhoolaha iyo toosan;
- isqaadsiin (L3) - meel kasta oo u dhaxaysa malawadka iyo qaybta korantada ee mindhicirka weyn;
- xubnaha jirka maskaxda sare (L4).
Noocyada cudurrada ee darnaanta:
- iftiin;
- dhexdhexaad ah;
- sare;
- cafis;
- sii xumaanayso;
- dib u soo noqoshada dambe.
Cudurka bararka xiidka - calaamadaha
Xaaladaha caafimaad ee cudurrada la soo bandhigay waxay u dhigmaan darajada, degaanka iyo muddada hannaanka bararka, inta badan soo noqoshada iyo waxyaabo kale. Waxaa jira calaamado aan calaamado lahayn oo la socota qandhada qorraxda - calaamadaha dabeecadda guud:
- qandho ama hoos u dhac;
- daciifnimo;
- daal joogto ah;
- miisaanka jirka oo hoos u dhacay;
- xanuunka caloosha;
- la'aanta cunto xumo;
- Shubanka oo soconaya wax ka badan 6 toddobaad.
Terminal catarrhal ileitis
Cudurkan noocan ah waxaa lagu gartaa caabuqa oo kaliya xuubka xabka ee xubnaha jirka ee caloosha iyo mindhicirka. Cudurka cudurrada Crohn ee foomka catarrhal waxaa laga yaabaa inay la socdaan calaamadaha mindhicirrada iyo xayawaanka. Kooxda koowaad ee muujinta calaamadaha waxaa ka mid ah:
- xanuunka, adigana ku dhejisid cadaadis daran ;
- lallabbo;
- anorexia;
- matag;
- garaacid;
- shuban joogto ah.
Calaamadaha darawalnimada ee cudurka Crohn:
- dareen-celis, uveitis ama keratitis;
- stomatitis aptthous;
- sclerosing cholangitis ;
- cirrhosis;
- pyelonephritis;
- hoos u dhaca dufanka beerka;
- cholelithiasis;
- cystitis;
- hydronephrosis;
- cholangiocarcinoma;
- amyloidosis ee kelyaha;
- nephrolithiasis.
Terminalku waa barar
Gudaha maskaxda iyo gumeysiga, tiro badan oo ka mid ah dabaqyada Peyer ayaa ku yaal. Kuwani waa qanjidhada qanjirada ee gaarka ah, oo loogu talagalay soo saarida tallaalka immunoglobulin. Terminal Ileritis ayaa inta badan saameeya dhismooyinka noocaas ah, taas oo keentay calaamadaha hore loo soo sheegay iyo astaamaha kiliiniga ee dheeraad ah:
- u nuglaanshaha caabuqyada soo noqnoqda, gaar ahaan infakshanka fayraska;
- isdilosing spondylitis;
- nodal erythema;
- pyoderma gangrenous;
- xanuunka;
- hababka la isku qurxiyo;
- monoarthritis;
- peritonitis;
- koorsooyin fisti ah;
- caloosha gudaha ee caloosha;
- cidhiidhiga lumen iyo xiidmaha mindhicirka;
- korodh joogta ah heerkulka jirka.
Terminal-ka qiiqa
Cudurkaan Crohn waxaa lagu gartaa samaynta boogaha qoto dheer ee xuubka xuubka jirka ee xubnaha maskaxda caloosha. Caabuqnimada oo lagu daro hababka nabaad-ilaalinta ayaa loo tixgeliyaa mid ka mid ah noocyada ugu khatarsan ee kudhaca bistooliga, taas oo horseedi karta cawaaqibyo halis ah oo nolol-halis ah. Cudurka Crohn ee Cudurka - Calaamadaha:
- dillaacidda derbiyada xiidmaha;
- dhiigbax gudaha ah;
- megacoloon sun ah;
- cirridka sababtoo ah infekshanka labaad.
Cudurka cudurrada Crohn - Cilad-sheegid
Sawirka bukaan-socodka ah ee qandhadu waa mid aan gaar aheyn, sidaa daraadeed marka ugu horeysa waa in dhakhtarka gaasku uu ka saaro cuduro kale oo badan oo leh calaamado la mid ah. Waa muhiim in la kala saaro cudurada dheef-shiidka, oo ay weheliyaan shuban, iyo cudurada Crohn - cudurka dabiiciga ah waxaa lagu sameeyaa xanuunka noocaas ah:
- mesenteritis;
- appendicitis;
- salmonellosis;
- enteritis;
- shigellosis;
- colitis;
- qaaxada mindhicirka;
- xanuunka;
- gonorrheal ama chlamydial proctitis;
- amebiasis;
- Lymphoma ee xiidmaha.
Hababka qalabka iyo qalabka waxaa loo isticmaalaa si loo xaqiijiyo gawaarida:
- colonoscopy;
- endoscopy iyo biopsy;
- shaxanka dhalada caloosha;
- magan-galka magnetic ama xajmiga sawir-qaadidda ee xiidmaha oo kala duwan.
Cudurka cudurrada Crohn - baadhitaanno
Cilmi-baarista shaybaarka ayaa sidoo kale ka caawisa sidii loo ogaan lahaa ogaanshaha saxda ah Habka ugu muhiimsan ee lagu ogaado cudurka Crohn waa baaritaan dhiig:
- loogu talagalay antibodies to cerevisaces cerevisae (loo yaqaan ASCA);
- caadi ahaan;
- biochemical;
- immunological.
Intaa waxaa dheer, falanqaynta saxarada ayaa la sameeyaa:
- bakteeriyada;
- illaa heerka kalprotectin;
- duurjoogta.
Cudurka jirrada ee Crohn - daaweynta
Sababtoo ah maqnaanshaha sababo macquul ah ee loo yaqaan "pathology" ee dheer, ayaa daaweynta gaarka ah ee ka-hortagida aan weli la horumarin. Dhammaan fursadaha, sida loo daweeyo cudurka Crohn, karkariyo si ay u joojiyaan geedi socodka bararka, ka hortagga dhibaatooyinka iyo soo noqoshada. Hababka ugu muhiimsan ee daaweynta waa daawo iyo cunto. Iyadoo ay jirto cawaaqib xun oo ka yimaada qandhada qalliinka, waxaa la sameeyaa qaliin qalliin.
Cudurka cudurrada Crohn: daaweynta - daroogooyinka
Jihada ugu muhiimsan ee daaweynta cudurku waa ka-saaritaanka caabuqa iyo dib-u-dhiska habka dheef-shiidka caadiga ah. Qalitaanka Ileitis - daaweynta waxaa ku jira wakiilada farmaajo ee soo socda:
- glucocorticoids - Prednisolone, Methylprednisolone;
- Salismylates - Mesazalin, Sulfasazalin;
- immunosuppressants - Methotrexate, Azathioprine;
- hormoonka hoormoonka - Budesonide, Beklazone;
- antibiotics - Rifaximin, Ciprofloxacin ;
- diyaarinta nafleyda ee injineernimada hidaha - Etanercept, Infliximab iyo kuwo kale.
Cudurka bararka xundhurta ayaa sii wadi doona in la baaro, sidaas darteed cilmi-baarayaashu waxay si joogto ah u raadsadaan siyaabo cusub oo loola tacaali karo qandhada. Fursadaha qadada waa:
- xannibaadayaasha xayiraadaha isdhexgalka - Vedolizumab;
- noolaal bixiyaha ama bakteeriyada hidde-baddelan;
- sorbents;
- acid linoleic acid;
- Tirinta DNA;
- diyaarinta nanotechnology;
- enzymes;
- plasmapheresis;
- stem cells - polychrome;
- gelinta qolka hyperbaric;
- macneheedu waa marijuana - Naltrexone;
- qulqul-dareynta;
- tallaalada ka soo horjeeda jiritaanka mindhicirka caabuqa;
- diyaargarowga ku salaysan ukumaha dixiriga porcine (TSO) iyo kuwa kale.
Cudurka Crohn
Dhammaan bukaanka qaba dhakhtarka gawracan ee leh calaamadaha la tilmaamay waa in lagu meeleeyaa cunto gaar ah. Cunto loogu talagalay qanjidhka terminal waxaa la doortaa iyada oo la tixgelinayo nooca cudurka iyo jiritaanka dhibaatooyinka. Si sahlan bayaanka loo yaqaan 'pathology-ka', cuntada badan ayaa loo oggol yahay in la isticmaalo. Nafaqeynta cudurka Crohn waxay ku lug leedahay marka laga reebo:
- burka iyo alaabada la dubo;
- cunto fudud;
- Maraqyo badan;
- qudaarta iyo khudradda dalagga;
- alaabta la cabbo;
- caanaha iyo caanaha;
- hilibka dufanka leh, kalluunka;
- cunto qasacadaysan;
- shaciir, masago, qoryo luul;
- digirta;
- macmacaan kasta;
- khudaarta;
- cabitaanno qabow iyo cabitaanno;
- Kookaha ama kafee caano.
Cuntada lagu taliyey:
- suxuunta ka sameysan kalluunka dufan yar ama hilibka duqadda ah, caadka la kariyey ama la kariyey (soufflé, cutlets iyo kuwa kale);
- rusks ka soo bur ah fasalka ugu sareeya;
- kalluunka ama ka daadi jiis cusub;
- maraq yar ama aan lahayn dufan leh oo lagu daro jilicsanaanta ukunta, kalluunka qamadiga ah, maraqa badarka (muuska, bariis);
- ukumaha (la kariyey jilicsan-la kariyey, qasacad baraf ah);
- subagga, sida buuxinta suxuunta;
- tufaaxa la shiilay;
- oatmeal, bariis, booris caano ah oo biyo ah oo ku jira qaabka qashinka;
- shaah cagaaran;
- kafee ama kookaha biyaha;
- cabitaanka miraha berry;
- casiir khudradda laga sameeyey;
- dhunkasho;
- maraq ka mid ah.
Haddii aad u baahato, dhakhtarku wuxuu saxeexi karaa noocyada kala duwan ee cuntooyinka (miiska 4 sida waafaqsan Pevzner) sida ku xusan xuduudaha soo socda:
- sifooyinka udubqaadaha;
- khatarta calaamadaha cudurka;
- darnaanta calaamadaha;
- joogitaanka cudurada wadnaha iyo dhibaatooyinka;
- fiicnaanshaha qof;
- saameynaha daaweynta daroogada.
Cudurka jeermiska (Crohn's disease) - daaweynta daaweynta dadka
Cunnado badan oo kala duwan ayaa ka caawiya in ay si degdeg ah u joojiyaan geedi-socodka bararka iyo soo celinta dheef-shiid habboon. Talo-siinta dadweynaha sida loo daweeyo qandhadu waa in lagu daraa daweynta dawooyinka. Si gaar ah, daaweynta dabiiciga ah waxay leedahay saameyn aad u yar, markaa waxaa loo isticmaalaa sidii tallaabooyin caafimaad oo dheeri ah.
Shaah kedis ah
Waxyaabaha ay ka kooban tahay:
- ubaxa farmashiyaha chamomile - 30-35 g;
- karkaraya - 200-210 ml.
Diyaarinta, isticmaal:
- Ku shub alaabta ceeriin khudradda leh biyo kulul.
- Ku adkeyso 1-3 saacadood.
- Cab cabirka oo dhan daawada intaadan cunin.
- Ku celi ilaa 5-6 goor maalintii.
Dib-u-soo-kabashada shubanka
Waxyaabaha ay ka kooban tahay:
- Midhaha bilberry - 100-140 g;
- biyaha - 1 litir.
Diyaarinta, isticmaal:
- Karkari dhuuban biyo karkaraya 10 daqiiqo.
- Sifee natiijada ka soo baxda.
- Cabitaanka sakhradda ee maalintii.
Galmada Spasmolytic
Waxyaabaha ay ka kooban tahay:
- xididdada marshmallow waa 100-150 g;
- biyaha - 50-80 ml.
Diyaarinta, isticmaal:
- Biyo raaci oo jarjar yar oo walxo cayriin ah.
- Ku shub biyo qabow ee saxan qoto dheer, sidaa darteed dareeraha wuxuu daboolaa oo keliya xididada.
- Ku adkeyso 6-10 saacadood.
- Ku daadi xakamaynta soo baxa weel gaar ah.
- Cab 2 tsp 2-4 jeer maalintii, ku dar daawada galaas biyo ah.
Decoction Antiulcer
Waxyaabaha ay ka kooban tahay:
- Rootiyada xididdada la kariyey - 2-3 g;
- biyaha - 150-200 ml.
Diyaarinta, isticmaal:
- Karkari khudradda cagaaran khudradda karkaraya (10-15 daqiiqo).
- Ku adkeyso nus saac.
- Sifee xalka.
- Cabbe u diyaarso inta u dhaxaysa cuntooyinka saddex jeer maalintii.
- Iska ilaali in ka badan hal bil, ka dibna qaado nasasho oo sii wad.
Xanuunka Crohn - Cawaaqibta
Xanuunka cudurka lagu baaro wuxuu leeyahay koorso joogta ah, sidaa daraaddeedna waxay u socotaa si joogto ah waxayna u keentaa xaalado khatar ah. Cudurka bararka xiidka - dhibaatooyinka:
- ka soo bixidda saxarada meel u dhow caloosha;
- dhirfiska ;
- boogaha xuubabka xuubka ah;
- dysbiosis;
- kansarka mindhicirka;
- xayawaanka;
- fistulas
Sababtoo ah xad gudub nacfiga nafaqada, cudurka Barill wuxuu la socdaa:
- daal oo leh miisaan xoog leh;
- hypovitaminosis;
- dysbacteriosis.
Cudurka cudurrada Crohn - Prognosis
Si buuxda u daaweyneysa qandhada qandhada, qofku waa inuu u hoggaansamaa cunto kasta mar kasta, ku lug yeesho daaweynta iyo ka hortagga cudurada. Inkastoo qofku uu xakameyn karo oo kaliya cudurka Crohn -ka ayaa ah natiijada noloshu ku habboon tahay:
- u hoggaansamaan talooyin ku saabsan qaabeynta cuntada;
- ka tagida macaamilka;
- booqashada joogtada ah ee dhakhtarka gaasta;
- daaweynta waqtigeeda iyo ka hortagga dhibaatooyinka.