Vim i trng cp v mn tnh

Vim i trng cp do nhiu nguyn nhn khc nhau gy ra do vi khun do k sinh vt. Trong
phm vi bi ny chng ti xin trnh by nhm bnh hay gp Vit Nam l vim i trng cp do
l trc trng Shigella v do l amip.

Vim i trng mn tnh (VTMT) bao gm mt nhm bnh mn tnh i trng, v c chung
mt s cc triu chng gn ging nhau nn trc y c gi di tn chung l VTMT. Ngoi
nhng triu chng i trng, VTMT cn c cc biu hin bnh l cc c quan khc nh
xng khp, mt, gan mt, ty, thn Triu chng chung ca cc bnh VTMT bao gm: au
bng di cc mc khc nhau t au bng m n au bng d di, y hi, chng bng,
ri lon i tin nh a lng, to bn, khi n thc n l, n m l i lng, phn sng, phn c
nhy hoc mu. Bnh nhn c th st hoc khng st, c th gy st hoc vn bnh thng.

Viem dai trang cap tinh va man tinh

Hnh nh i trng

Vim i trng do l amip (Entamoeba Hystolyca)

Hu ht nhim trng dng mang mm bnh khng c triu chng, mt s bnh nhn c a chy
nh ko di, hoc gy triu chng l cp.

Vim i trng cp do amip c cc triu chng sau: au bng bn phi, bn tri hoc au khp
bng, mt rn, au rt hu mn, phn c mu, i lng vi s lng phn khng nhiu nhng i
nhiu ln, i lng nhiu ln c th gy mt nc, try tim mch nh hng ti tnh mng bnh
nhn. Khi b vim i trng cp do amip c th gy p xe gan- phi, do amip chui qua ch nim
mc i trng b tn thng vo tnh mch ca gy p xe gan- phi.

Nhng bin chng c th gp: Thng rut gy vim phc mc, y l bin chng nng nu
khng c iu tr kp thi dn ti t vong, bin chng chy mu, i khi phi truyn mu.

chn on vim i trng cp do amip cn hi k tin s c bnh l khng, c triu chng

au qun bng, mt rn a mu.

Soi i trng Sigma v trc trng: c cc lot ging nh hnh khuy o. Trn lot c cc cht
nhy bm, xt nghim c th thy amip n hng cu (loi amip gy bnh) cht nhy.

Xt nghim phn: Soi phn tm amip n hng cu, chp X-quang i trng c th thy ch tht
hoc hnh nh khi u amip.

Vim i trng do l trc trng (Shigella)

Vim i trng cp do Shigella c th c cc triu chng t nh ti nng: C th a lng nh, nu

nng c cc biu hin au qun bng, mt rn, a mu, st v cc du hiu nhim trng, nhim
c nh st cao mt mi, hc hc, ri lon nc, in gii dn n try tim mch.

Ngoi cc biu hin ng tiu ho, vim i trng cp do l trc trng cn c cc triu chng
ngoi ng tiu ho nh vim kt mc, vim m o, vim phi, vim khp, vim mng no,
nhim trng huyt

Bin chng ca bnh: Thng i trng, suy dinh dng, cha vim i trng bng thuc nam
vim lot i trng.

chn on nguyn nhn vim i trng cp do l trc trng th cn cy phn v soi phn ti
tm vi khun l l quan trng v cn thit nht.

Soi trc trng: Pht hin hnh vim xung huyt, hoc xut huyt, km theo nhng vt lot nng,
trn lot c nhy, c th tm thy vi khun l trong nhng cht nhy ny.

chn on xc nh v chn on nguyn nhn ca bnh vim i trng cp do l amip v l

trc trng quan trng nht l phi soi phn v cy phn tm vi khun gy bnh.

Cc th bnh

Trong nhm bnh VTMT c mt s cc bin chng ging nhau nh: hp i trng, tc rut
chy mu v c bit trong bnh vim lot i trc trng chy mu (VLTTCM) hoc bnh
Crohn cn bin chng ung th i trng.

Bnh VLTTCM

C ch sinh bnh cha r, ngy nay c coi l bnh t min, nguyn nhn do mi trng, do
nhim khun. Bnh din bin tng t, tn thng ngy cng lan rng, triu chng ging nh
bnh VTMT. Khi mi mc bnh, bnh nhn khng gy st, khi bnh nng c th gy st. Ngoi
cc triu chng i trng, cn c cc triu chng khc nh sng au cc khp, vim ct sng
dnh khp, vim khp cng chu, vim mng b o, vim mng mt

Cc bin chng ca VLTTCM l: Bn tc rut, thng rut chy mu hoc ung th.

Bnh Crohn: Gp mi la tui t tr nh cho ti ngi ln, c bit tui t 20 n 40.

au bng, a lng, c th chn n, gy st. Ngoi cc triu chng ng tiu ha, cn c cc triu
chng cc c quan khc nh vim a r thn kinh lm gim cc phn x, gim cm gic ngoi
bin, vim x ng mt, vim ty, tng nguy c si thn, vim mng b o, vim mng mt,
vim ct sng dnh khp, vim khp cng chn. Cc bin chng ca bnh Crohn l bn tc rut,
tc rut, chy mu v ung th.

Lao i trng: lao ng tiu ha thng gp rut non nhng c th lao i trng nht l manh
trng. Cc triu chng ca bnh lao i trng: au bng, st, ri lon i tin, i ngoi lc lng
lc to.

Cc bin chng ca bnh lao rut: bn tc rut, tc rut, thng rut, gy vim phc mc c th
gy t vong.

Vim i trng mn tnh do amip: sau mt giai on vim i trng cp tnh, hay bn cp do
amip, bnh tr thnh mn tnh vi tng t tin trin khng tm thy amip n hng cu (loi
amip gy bnh), thm ch cn amip trong i trng, nhng do vch rut b x chai do qu trnh
vim nhim lm tn thng h thn kinh thc vt trong lng i trng lm cho chc nng ca i
trng khng cn bnh thng na. Cc triu chng bao gm: au bng lin tc hay tng cn km
theo y bng, a lng, km n, st cn.

Vim i trng collagen: c cc triu chng trn nhng khng bao gi a mu.

Chn on xc nh nhm bnh VTMT

nhng ngi c tin s bnh l amip c cc triu chng au bng, y bng, chng bng, ri
lon v i tin v tnh cht phn c nhy, c mu, phn sng. Ngi bnh thng c st nhn,
gy st.

Chp X-quang i trng c tht thuc cn quang: c th thy hnh nh hp rut, lot hoc khi u.

Xt nghim phn: tm hng cu, bch cu, h thng vi khun trong phn, nm, amip. Ly phn
tm nm, vi khun lao.

chn on xc nh v chn on nguyn nhn cc bnh vim i trng mn, quan trng nht
l phi soi i trc trng, kt hp vi sinh thit tm nhng tn thng c hiu cho tng loi
bnh vim i trng mn.

Hnh nh soi ca bnh vim lot i trc trng mn tnh: nim mc ph n, sung huyt, d chy
mu, c th thy nhng lot nh nh hnh bm mng tay, hnh nh gi polyp. Khi sinh thit
lm xt nghim m bnh hc thy nim mc ph n sung huyt v xut huyt, thy t bo vim

rt c hiu cho bnh VLTTCM, l t bo vim mt nhn lympho Plasmocyte, thy tn

thng c cc p-xe nh y tuyn.

Hnh nh ni soi i trc trng ca bnh Crohn: thy hnh nh lot xen ln t chc lnh v lot
to thnh hnh nh lt . Hnh nh tn thng rt c bit: thnh rut c cc t chc ht cu
to bi cc t bo mt nhn lympho plasmocyte lin bo v cc t bo khng l.

Hnh nh ni soi ca lao i trng: tn thng thng thy on cui ca i trng (manh
trng) v on cui ca rut non (hi trng): thy hnh nh lot, gi polyp. Khi sinh thit lm xt
nghim t bo thy c tn thng c hiu ca lao.

Hnh nh ni soi ca vim i trng mn tnh do amip: soi trc trng thy nim mc trc trng
mt tnh cht nhn bng, ph n, xung huyt. Sinh thit lm xt nghim t bo thy t bo vim
khng c hiu, rt him khi tm thy amip trong nim mc trc trng.

Hnh nh ni soi trong vim i trng do bnh Collagene: soi i trc trng ch thynim mc
mt tnh cht nhn bng, xung huyt v xut tit. Xt nghim t bo khi sinh thit thy c nhiu
si collagene di lp nim mc.

Cn chn on phn bit cc bnh vim i trng mn tnh vi cc bnh i trng no?

Trc tin l cn phn bit vi bnh ung th i trng v bnh ung th i trng cng c cc triu
chng au bng, a mu, y bng do cn phi c soi i trng, sinh thit tn thng
pht hin ung th i trng cng sm cng tt. iu tr ung th i trng sm kt qu s tt hn
nhiu so vi ung th giai on mun.

Bnh i trng c nng: Cn gi l hi chng rut kch thch, l mt bnh ph bin, lnh tnh,
yu t thn kinh, tm l l nhng nguyn nhn thun li cho hi chng ny. Trong hi chng

rut kch thch, cng c cc triu chng: y hi, trng bng, ri lon i tin, lc a lng, lc
to bn hoc xen k gia a lng v to bn, phn c nhy. Tuy nhin khng c mt tn thng
no nim mc i trng.

Ri lon vi khun ng rut: trong ng rut c hai h thng vi khun: h thng vi khun
phn gii cht m (protein) gi l vi khun ln men thi, v h thng vi khun phn gii cht
ng gi l vi khun ln men chua. H thng vi khun phn gii cht ng d b tn cng bi
cc yu t nh: khi b nhim nhiu vi khun gy bnh, ru, stress, cy thuc cha bnh i
trng lm dng khng sinh lm cho s cn bng gia hai h thng vi khun trn b ph v to c
hi cho cc vi khun gy bnh pht trin mnh gy nn tiu chy. chn on chnh xc cc
bnh vim i trng mn tnh v nguyn nhn cn hi k tin s bnh, cc triu chng au bng,
y bng trng hi, thm khm xem c khi u hay khng v c bit l soi phn, cy phn, soi
i trc trng kt hp vi sinh thit pht hin nhng tn thng c hiu ca mi bnh.