Interstitial cystitis: ndichiyani?

La interstitial cystitis ndi matenda a chikhodzodzo chosowa koma cholepheretsa chomwe chasintha dzina lake. Panopa amatchedwa painful bladder syndrome. Amadziwika ndi ululu m'munsi pamimba ndi kulakalaka kukodza pafupipafupi, usana ndi usiku. Zowawa izi ndi zikhumbo zokodza nthawi zambiri zimakhala zovuta kwambiri, nthawi zina zimakhala zosapiririka, mpaka kuti interstitial cystitis ikhoza kukhala chilema chenichenicho, kulepheretsa anthu kuchoka m'nyumba zawo. Ululuwu umathanso kukhudza mkodzo (njira yomwe imanyamula mkodzo kuchokera kuchikhodzodzo kupita kunja) komanso, mwa amayi, kumaliseche (onani chithunzi). Kukodza (ku kukodza) pang'ono kapena kuchotseratu zowawa izi. Interstitial cystitis imakhudzanso makamaka akazi. Itha kulengezedwa pazaka zilizonse kuyambira zaka 18. Pakalipano, palibe mankhwala a matendawa, omwe amaganiziridwa kukhala osatha.

Samalani kuti musasokoneze interstitial cystitis et chotupa : "classic" cystitis ndi matenda a mkodzo omwe amayamba chifukwa cha mabakiteriya; interstitial cystitis si osati matenda ndipo chifukwa chake sichidziwika.

Kukula

Malinga ndi Interstitial Cystitis Association of Quebec, pafupifupi 150 aku Canada akukhudzidwa ndi matendawa. Zikuwoneka kuti interstitial cystitis sichichitika kawirikawiri ku Ulaya kusiyana ndi ku North America. Komabe, n’kovuta kupeza chiŵerengero cholondola cha chiwerengero cha anthu amene akhudzidwa, popeza nthendayo njosadziŵika bwino. Akuti pali anthu pakati pa 1 ndi 7 omwe ali ndi interstitial cystitis pa anthu 10 ku Ulaya. Ku United States, matendawa amakhudza munthu mmodzi mwa anthu 000.

Interstitial cystitis imakhudza pafupifupi 5 mpaka 10 kuposa akazi kuposa amuna. Nthawi zambiri amapezeka azaka zapakati pa 30 mpaka 40, ndipo 25% mwa omwe amakhudzidwa amakhala osakwana zaka 30.

Zimayambitsa

Mu interstitial cystitis, khoma lamkati la chikhodzodzo ndi malo omwe amawonekera zotupa zotupa. Zilonda ting'onoting'ono zomwe zili m'kati mwa chikhodzodzo zimatha kutuluka magazi pang'ono ndikupangitsa ululu ndi chilakolako chotulutsa mkodzo wa acidic m'chikhodzodzo.

Chiyambi cha kutupa komwe kumawonedwa mu interstitial cystitis sichidziwika bwino. Anthu ena amagwirizanitsa kuyambika kwake ndi opaleshoni, kubala mwana, kapena matenda aakulu m’chikhodzodzo, koma nthaŵi zambiri zimawonekera popanda choyambitsa. Interstitial cystitis mwina ndi matenda osiyanasiyana, kuphatikizapo zifukwa zingapo.

ambiri maganizo akuganiziridwa. Ochita kafukufuku amadzutsa anthu omwe ali ndi ziwengo, zomwe zimachitika zosintha kapena vuto la mitsempha mu khoma la chikhodzodzo. Sichilekanitsidwa kuti zinthu zotengera cholowa nazo zimathandizira.

Nawa nyimbo zomwe zimatchulidwa kwambiri:

• Kusintha kwa khoma la chikhodzodzo. Pazifukwa zina, chitetezo chamkati mwa chikhodzodzo (maselo ndi mapuloteni) chimawonongeka mwa anthu ambiri omwe ali ndi interstitial cystitis. Chosanjikiza ichi nthawi zambiri chimalepheretsa zinthu zomwe zimatulutsa mkodzo kuti zisakhudze khoma lachikhodzodzo.
• Wosagwira bwino ntchito intravesical zoteteza wosanjikiza. Kwa anthu omwe ali ndi interstitial cystitis, chitetezo ichi sichigwira ntchito bwino. Choncho mkodzo ukhoza kukwiyitsa chikhodzodzo ndi kuyambitsa kutupa ndi kutentha thupi, monga kumwa mowa pabala.
• Chinthu chotchedwa AFP kapena antiproliferative factor Amapezeka mumkodzo wa anthu omwe ali ndi interstitial cystitis. Zitha kukhala zolakwa, chifukwa zikuwoneka kuti zimalepheretsa kukonzanso kwachilengedwe komanso nthawi zonse kwa maselo omwe ali mkati mwa chikhodzodzo.
• Matenda a autoimmune. Kutupa kwa chikhodzodzo kumatha chifukwa cha kukhalapo kwa ma antibodies owononga khoma la chikhodzodzo (autoimmune reaction). Ma antibodies otere apezeka mwa anthu ena omwe ali ndi interstitial cystitis, osadziwikiratu ngati ndi omwe amayambitsa kapena chifukwa cha matendawa.
• Hypersensitivity kwa mitsempha mu chikhodzodzo. Kupweteka kwa anthu omwe ali ndi interstitial cystitis kungakhale kupweteka kwa "neuropathic", ndiko kuti, ululu wobwera chifukwa cha kusagwira ntchito kwa mitsempha ya chikhodzodzo. Choncho, mkodzo wochepa kwambiri ungakhale wokwanira "kukondweretsa" mitsempha ndi kuyambitsa zizindikiro zowawa m'malo mongomva kupanikizika.

Evolution

Matendawa amakula mosiyana ndi munthu. Pachiyambi, a zizindikiro zimakonda kuwonekera kenako kuzimiririka paokha. Nthawi za chikhululukiro imatha miyezi ingapo. Zizindikiro zimayamba kukulirakulira pakapita zaka. Pamenepa, kupweteka kumawonjezeka ndipo chilakolako chofuna kukodza chimakhala chochuluka.

Muzochitika zowopsa kwambiri, matendawa amafunika kukodza zitha kuchitika mpaka nthawi 60 mu maola 24. Moyo waumwini ndi wamagulu umakhudzidwa kwambiri. Ululu nthawi zina umakhala waukulu kwambiri moti kukhumudwa ndi kukhumudwa kungachititse anthu ena kuvutika maganizo, ngakhale kuvutika maganizo. kudzipha. Thandizo lochokera kwa okondedwa ndilofunika kwambiri.

matenda

Malinga ndi a Mayo Clinic ku United States, anthu omwe ali ndi interstitial cystitis kulandira matenda awo pafupifupi 4 zaka pambuyo isanayambike matenda. Ku France, kafukufuku yemwe adachitika mu 2009 adawonetsa kuti kuchedwa kwa matendawa kunali kotalikirapo ndipo kumafanana ndi zaka 7,5.²¹. Izi sizosadabwitsa chifukwa interstitial cystitis imatha kusokonezeka mosavuta ndi zovuta zina zaumoyo: matenda a mkodzo, endometriosis, matenda a chlamydial, matenda a impso, chikhodzodzo "chochuluka", ndi zina zambiri.

Le matenda ndizovuta kukhazikitsa ndipo zitha kutsimikiziridwa pambuyo poti zifukwa zina zonse zomwe zingatheke zitachotsedwa. Komanso, ndi chikondi kachiwiri osadziwika bwino madokotala. Zimachitikabe kuti ndi woyenerera ngati "vuto lamalingaliro" kapena longoyerekeza ndi madokotala angapo asanatulukire, pomwe mbali yamkati ya chikhodzodzo chotupa ikunena kwambiri.

Nawa mayeso omwe amapezeka kwambiri kuti azindikire interstitial cystitis:

• Kupenda kwamadzi. Chikhalidwe ndi kusanthula kwa mkodzo zitha kudziwa ngati pali UTI. Pankhani ya interstitial cystitis, palibe tizilombo toyambitsa matenda, mkodzo ndi wosabala. Koma pakhoza kukhala magazi mu mkodzo (hematuria) nthawi zina ngakhale pang'ono (pang'onoting'ono hematuria mmene timaona maselo ofiira pansi pa maikulosikopu, koma palibe magazi ndi maso). Ndi interstitial cystitis, maselo oyera amagazi amapezekanso mumkodzo.

• Cystoscopy ndi hydrodistension ya chikhodzodzo. Awa ndi mayeso kuyang'ana khoma la chikhodzodzo. Kuwunikaku kumachitika pansi pa anesthesia. Chikhodzodzo chimayamba kudzazidwa ndi madzi kuti khomalo lituluke. Kenako, catheter yokhala ndi kamera imayikidwa mumkodzo. Dokotala amayang'ana mucosa poyang'ana pawindo. Amayang'ana kukhalapo kwa ming'alu yabwino kapena kutaya magazi pang'ono. Wayitanitsidwa glomerulation, magazi ang'onoang'onowa amadziwika kwambiri ndi interstitial cystitis ndipo amapezeka mu 95% ya milandu. Nthawi zina zocheperako, pamakhala zilonda zomwe zimatchedwa Zilonda za Hunner. Nthawi zina adotolo amachita biopsy. Minofu yochotsedwayo imawonedwa pansi pa maikulosikopu kuti iwunikenso.
• Kuwunika kwa urodynamic kumaphatikizapo ukuyesa cystometry ndi urodynamic Angathenso kuchitidwa, koma mayesowa sakhala ocheperapo, chifukwa sali achindunji ndipo motero sathandiza kwambiri ndipo nthawi zambiri amawawa. Pankhani ya interstitial cystitis, timapeza ndi mayesowa kuti kuchuluka kwa mphamvu ya chikhodzodzo kumachepa komanso kuti chilakolako chofuna kukodza ndi kupweteka kumawonekera pang'onopang'ono kusiyana ndi munthu amene akudwala interstitial cystitis. Komabe, kuyezetsa kumeneku kumapangitsa kuti zitheke kuzindikira kuwonjezereka kwa chikhodzodzo (chikhodzodzo chochuluka) matenda ena ogwira ntchito omwe amachititsanso kufuna kukodza.
• Potaziyamu sensitivity test. Pang'ono ndi pang'ono kuchitidwa, chifukwa osati mwachindunji ndi 25% zabodza zoipa (mayeso amasonyeza kuti munthuyo alibe interstitial cystitis pamene 25% ya milandu ndi!) cystitis pamene satero).

Pogwiritsa ntchito catheter yomwe imalowetsedwa mumkodzo, chikhodzodzo chimadzaza ndi madzi. Pambuyo pake, imachotsedwa ndikudzazidwa ndi yankho la potaziyamu chloride. (Lidocaine gel imayikidwa koyamba kuzungulira khomo la mkodzo kuti achepetse kupweteka kwa kulowetsa catheter.) Pa sikelo ya 0 mpaka 5, munthuyo amasonyeza momwe akumvera mwamsanga. kukodza ndi kukula kwa ululu. Ngati zizindikiro zikuchulukirachulukira poyesedwa ndi njira ya potaziyamu kolorayidi, zitha kukhala chizindikiro cha interstitial cystitis. Nthawi zambiri, palibe kusiyana pakati pa njira iyi ndi madzi.