Pseudomembranous mob plab

Pseudomembranous colitis yog hais txog qhov o lossis mob ntawm cov hnyuv (hnyuv loj) vim tias muaj ntau dhau ntawm Clostridioides difficile (C difficile) cov kab mob.

Tus mob no yog ib qho ua rau raws plab tom qab siv tshuaj tua kab mob.

Tus C difficile cov kab mob feem ntau nyob hauv txoj hnyuv. Txawm li cas los xij, ntau dhau ntawm cov kab mob no yuav loj tuaj thaum koj noj tshuaj tua kab mob. Cov kab mob muab cov co toxin uas ua rau mob thiab los ntshav hauv txoj hnyuv tws.

Txhua yam tshuaj tua kab mob tuaj yeem ua rau tus mob no. Cov tshuaj muaj lub luag haujlwm rau cov teeb meem feem ntau yog ampicillin, clindamycin, fluoroquinolones, thiab cephalosporins.

Cov kws saib xyuas kev noj qab haus huv hauv tsev kho mob tuaj yeem hla tus kab mob no los ntawm ib tus neeg mus rau lwm tus.

Mob caj pas pseudomembranous tsis tshua muaj tshwm rau cov menyuam yaus, thiab muaj tsawg heev rau cov menyuam mos. Nws yog feem ntau pom muaj nyob hauv cov neeg uas nyob hauv tsev kho mob. Txawm li cas los xij, nws tau dhau los ua cov neeg siv tshuaj tiv thaiv kab mob thiab tsis nyob hauv tsev kho mob.

Yam txaus ntshai muaj xws li:

• Muaj hnub nyoog laus dua
• Tshuaj tua kab mob kev siv
• Siv cov tshuaj uas ua rau lub cev tsis muaj zog tiv thaiv kab mob (xws li tshuaj kho mob)
• Kev phais niaj hnub no
• Keeb kwm mob pseudomembranous mob plab
• Keeb kwm ntawm ulcerative colitis thiab Crohn kab mob

Cov tsos mob muaj xws li:

• Mob plab (mob me rau mob heev)
• Ntshav los tso quav
• Ua npaws
• Txhawb kom muaj plab nyhuv
• Quav dej raws plab (feem ntau 5 txog 10 zaug hauv ib hnub)

Cov kev xeem hauv qab no tuaj yeem ua:

• Kev kuaj mob hnyuv lossis hloov sigmoidoscopy
• Siv tshuaj tiv thaiv Immunoassay rau C difficile toxin hauv cov quav
• Cov kev kuaj quav tshiab dua xws li PCR

Cov tshuaj tua kab mob los yog lwm yam tshuaj uas ua rau tus mob yuav tsum tau nres. Metronidazole, vancomycin, lossis fidaxomicin feem ntau yog siv los kho qhov teeb meem, tab sis lwm yam tshuaj kuj tseem siv tau.

Kev daws teeb meem hauv tshuab hluav taws xob los yog kua uas tso rau ntawm txoj leeg ntshav tuaj yeem kho lub cev qhuav dej vim yog zawv plab. Muaj qee zaus, yuav tsum tau muaj kev phais mob txhawm rau kho tus mob uas haj yam tsis zoo lossis tsis teb tshuaj tua kab mob.

Ntev ntev li cov tshuaj tiv thaiv yog tias muaj C difficile kis rov qab. Ib txoj kev kho mob tshiab hu ua fecal microbiota hloov ("hloov quav") kuj tseem muaj txiaj ntsig zoo rau cov mob uas rov qab los.

Koj tus kws khomob yuav qhia tau rau koj tias koj yuav tsum noj probiotics yog tias tus kabmob rov qab los.

Qhov kev txheeb xyuas tau zoo nyob rau hauv feem ntau, yog tias tsis muaj teeb meem. Txawm li cas los xij, li ntawm 1 ntawm 5 tus mob yuav rov qab los thiab xav tau kev kho mob ntxiv.

Teeb meem yuav suav nrog:

• Lub cev qhuav dej nrog electrolyte tsis txaus
• Perforation ntawm (qhov los ntawm) cov nyuv
• Tshuaj lom megacolon
• Kev Tuag

Hu rau koj tus kws kho mob yog tias koj muaj cov tsos mob li nram no:

• Ib qho quav ntshav (tshwj xeeb yog tom qab siv tshuaj tua kab mob)
• Tsib lossis ntau ntu kev mob raws plab hauv ib hnub rau ntau dua 1 txog 2 hnub
• Mob plab heev
• Cov cim ntawm lub cev qhuav dej

Cov neeg uas tau mob pseudomembranous mob plab yuav tsum qhia lawv cov kws kho mob ua ntej siv tshuaj tua kab mob ntxiv. Nws tseem ceeb heev uas yuav tau ntxuav tes kom zoo, tiv thaiv kom tsis txhob kis tus kab mob mus rau lwm tus neeg. Cawv cawv tsis ib txwm ua hauj lwm C difficile.

Cov kab mob tua kab mob sib kis; Colitis - pseudomembranous; Necrotizing mob plab; C difficile - pseudomembranous

• Lub plab zom mov
• Digestive system plab hnyuv siab raum

Gerding DN, Johnson S. Clostridial kis mob. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 280.

Gerding DN, Hluas VB. Donskey CJ. Clostridiodes difficile (yav tas los Clostridium difficle) mob. Hauv: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, thiab Bennett's Cov Ntsiab Cai thiab Kev Coj Ua ntawm Kab Mob KisCov. 9le ed. Philadelphia, PA: Elsevier; 2020: chap 243.

Kelly CP, Khanna S. Cov kab mob ua kom raws plab thiab clostridioides sib txawv kis tau tus mob. Hauv: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger thiab Fordtran's Gastrointestinal thiab Kab Mob SiabCov. 11th ed. Philadelphia, PA: Elsevier; 2021: chap 112.

McDonald LC, Gerding DN, Johnson S, li al. Cov chaw txhaj tshuaj rau cov kab mob rau cov neeg laus thiab menyuam yaus: 2017 hloov kho los ntawm Koom Haum Kab Mob Sib kis hauv tebchaws Meskas (IDSA) thiab Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv ntawm America (SHEA). Clin Kab Mob Tsis ZooCov. 2018; 66 (7): 987-994. PMID: 29562266 pubmed.ncbi.nlm.nih.gov/29562266/.