Esiane ayaresa tebea horow bi, titiriw ɔhaw ahorow a ɛfa dwensɔtwaa kɛse no ho nti, ɛho hia sɛ wɔyɛ oprehyɛn na wɔayi saa ɔfã no afi hɔ. Afei, wobubue ketewaa bi wɔ yafunu no were mu na ama nwura atumi afi nipadua no mu. Enti, wɔboaboa nsu no ano wɔ kotoku bi a wɔde abata saa bue yi ho mu. Sɛ wɔde bag yi bɛtra ase a, ebetumi ayɛ nea ɛnyɛ dɛ kakra ama nnipa binom. Ebetumi ayɛ te sɛ akwanside bere a wo ne afoforo bɔ, wohyɛ ntade, na woreyɛ da biara da nnwuma no. Enti sɛ ɔkwan bi wɔ hɔ a yɛbɛfa so aboaboa nwura ano wɔ nipadua no mu a yenni akyi kotoku yi na yɛayiyi mu bere biara a yɛpɛ nso ɛ? Ɛno ano aduru ne Kock kotoku a yɛreka ho asɛm nnɛ no.
Sɛ yɛbɛka no tiawa a, dɛn ne Kock kotoku (K-kotoku) yi?
Fa no sɛ, sɛ́ anka wobɛma bag bi asɛn wo nipadua akyi no, sɛ wubetumi ayɛ kotoku ketewaa bi a ebetumi aboaboa nwura ano na wode asie wo nipadua mu nso ɛ? Ɛno ne nea Kock kotoku no yɛ.
Sɛ wotwa colectomy wie a, wɔde wo dwensɔtwaa ketewaa no awiei, ileum, ba wo yafunu no ani na wobue ketewaa bi. Wɔfrɛ eyi sɛ ileostomy. Wɔfrɛ saa bue yi stoma. Wɔtaa yɛ eyi denam akyi kotoku bi a wɔde bata stoma no ho so.
Nanso wɔ Kock kotoku nhyehyɛe no mu no, oduruyɛfo a ɔyɛ oprehyɛn no de w’ankasa dwensɔtwaa ketewaa no fã bi yɛ kotoku ketewaa bi wɔ wo nipadua mu . Saa kotoku yi bata baabi a wobue (stoma) a ɛwɔ wo yafunu mu no ho tẽẽ. Enti wunhia kotoku a ɛwɔ akyi na wode aboaboa wo nsu ase. Sɛ ɛho hia a, wobetumi de afiri ketewaa bi (catheter) afa saa bue yi mu na wɔayi nwura a aboaboa ano wɔ kotoku no mu no afi hɔ.
Eyi te sɛ "internal scrotum" a ɛwɔ nipadua no mu a yebetumi ayi mu bere biara. Wɔde oduruyɛfo a ɔyɛ oprehyɛn Nils Kock din too so.
Dɛn ne mfaso horow a ɛwɔ Kock kotoku mu?
Saa kwan yi na wɔde di dwuma titiriw ma nnipa a ɛsɛ sɛ wɔde `ileostomy` a ɛtra hɔ daa tra ase nanso wɔmpɛ sɛ wɔde abɔnten so nsu kotoku bedi dwuma. Mfaso kɛse a ɛwɔ eyi so ne sɛ wotumi di nsu a ɛkɔ nsu mu no so.
Wɔ ileostomy a ɛfata mu no, nsu betumi aboaboa ano wɔ kotoku no mu bere biara. Yɛrentumi nni so. Nanso wɔfrɛ ileostomy a wɔde Kock kotoku yɛ no continence ileostomy. Ɛno kyerɛ sɛ "wotumi di so." Wɔ eyi mu no, nsu a wɔde gu mu no boaboa ano wɔ kotoku a ɛwɔ mu no mu, sen sɛ ɛbɛtwetwe, enti wowɔ ahofadi sɛ wobɛpopa bere biara a wopɛ.
- Nsɛm foforo: Mfiase no wɔyɛɛ Kock kotoku no sɛ kotoku a ɛwɔ mu a wɔde boaboa nsu ano ma ayarefo a woyii wɔn akisikuru. Wɔda so ara de saa kwan no di dwuma nnɛ, nanso seesei wɔayɛ akwan foforo pii.
Ɔkwan bɛn so na wɔyɛ oprehyɛn yi?
Wo oprehyɛn ho ɔbenfo no betumi ayɛ Kock kotoku no bere koro no ara mu ne wo ileostomy no, anaasɛ wobetumi ayɛ no wɔ oprehyɛn a ɛyɛ soronko mu akyiri yi. Eyi kyerɛ sɛ sɛ woayɛ ileostomy dedaw a, wubetumi akɔ so adan akɔ Kock kotoku mu akyiri yi.
Sɛ yɛbɛka no tiawa a, wɔyɛ oprehyɛn no sɛnea edidi so yi:
1. Pouch no a wobɛbɔ: Oduruyɛfo no bɛfa w'ankasa wo dwensɔtwaa ketewa no awiei bɛyɛ nsateakwaa 18 na wabobɔw no ayɛ no "U". Afei, wobebue dwensɔtwaa no wɔ saa mpopaho yi mfinimfini na wɔapam anoano no abom. Eyi bɛma wɔayɛ kotoku no.
2. Valve no Yɛ: Eyi ne ɔfã a ɛho hia sen biara. Sɛ wɔde dwensɔtwaa a aka wɔ kotoku no awiei no di dwuma a, wɔyɛ valve soronko (`one-way valve`). Ɛte sɛ ɔpon a ebue kɔ baabi biako pɛ. Sɛ wɔde nwura hyɛ mu a, saa valve yi to mu ara kwa. Saa kwan yi so no, nsu, nsu, ne mframa ntu mfi mu.
3. Nkitahodi: Awiei koraa no, awiei a ɛne valve no bata bue (`stoma`) a wɔayɛ wɔ wo yafunu mu no ho. Oduruyɛfo no bɛhwɛ sɛ biribiara reyɛ adwuma yiye na nsu biara nni mu.
Dɛn na ɛba wɔ oprehyɛn no akyi? Bere tenten ahe na egye na obi ho atɔ no?
Wɔ oprehyɛn no akyi no, ebehia sɛ wotra ayaresabea hɔ bɛyɛ nnansa kosi anum. Saa bere yi mu no, wɔde nsukorade ahorow bɛka wo nipadua ho na aboa wo ma wo ho atɔ wo ntɛm.
- `IV` tube a wɔde ma saline
- `IV aduannuru` ma aduannuru
- Nsuo a ɛkɔ kuru mu a ɛyi nwura fi kuru no mu
- Nsuo a wɔde fa nsuo mu
- `Ɛyaw pɔmpɛ` a wɔde siw ɛyaw ano
Mma ɛnhaw wo wɔ saa nneɛma yi ho, ne nyinaa yɛ bere tiaa mu de.
Wobegyaw catheter a wɔde ahyɛ wo stoma mu no wɔ nea ɛwɔ hɔ adapɛn pii. Eyi bɛma nwura no akɔ kotoku a wɔayɛ no foforo no mu kosi sɛ kuru no bɛsa. Ɔyarehwɛfo bi bɛkyerɛ wo sɛnea wobɛhwɛ catheter no so.
Sɛ wokɔ fie kɔhome adapɛn kakraa bi wie a, wo duruyɛfo no beyi saa afiri yi afi hɔ. Afei, ɔyarehwɛfo bi bɛkyerɛ wo sɛnea w’ankasa wode afiri a wɔde fa nsu mu (catheter) a wɔde di dwuma daa bedi dwuma de aprapra kotoku no mu.
Mfiase no, ebia ebehia sɛ wopopa wo dwonku bɛyɛ mpɛn 8 da biara. Nanso mma ɛnhaw wo, wɔ asram kakraa a edi hɔ no mu no, kotoku foforo a ɛwɔ wo nipadua mu yi bɛyɛ kɛse nkakrankakra. Ɛno akyi no, ebia ɛho behia sɛ wopopa mu mpɛn 2-4 pɛ da biara.
Mfaso ne nsɛnnennen a ebetumi aba wɔ Kock kotoku mu
Te sɛ aduruyɛ mu adeyɛ biara no, mfaso ne asiane nyinaa wɔ so. Momma yɛnhwɛ wɔn.
| Mfasoɔ | Nsɛnnennen a Ebetumi Aba |
|---|---|
| Ɛho nhia sɛ wode kotoku a ɛwɔ akyi di dwuma: Ɛho nhia sɛ wohyɛ anaasɛ wobɛhwɛ abɔnten so ileostomy bag so. | Valve mu nsɛnnennen: Ɛtɔ mmere bi a, valve no betumi ayɛ mmerɛw na ama nsu a ɛwɔ nsu mu no akɔ. Anaasɛ ebia valve no besiw na wɔrentumi mfa tube no nhyɛ mu. Sɛ obi dwensɔtwaa no siw koraa a, ɛyɛ ade a egye ntɛmpɛ. Sɛ eyi ba a, ɛsɛ sɛ wokɔ ETU (Emergency Treatment Unit) ntɛm ara. |
| Ahofadi ne kokoamsɛm pii: Wobetumi de ade ketewaa bi te sɛ gauze akata stoma no so. Eyi renhu mfi abɔnten. | Fistulas: Nneɛma a ɛmfata betumi afi kotoku no mu akɔ honam ani anaa akwaa afoforo mu. Eyi betumi de ɛyaw ne ɔyare mmoawa aba. |
| Sɛnea Wotumi Di So: Wubetumi ayi wo dwonku mu bere biara ne baabiara a wopɛ, a wo nsu a ɛretu da mũ no nyinaa. | Pouchetis: Ɔfe anaa ɔyare mmoawa a ɛba kotoku no mu. Eyi yɛ tebea a ɛtaa ba. Mpɛn pii no, wobetumi de nnuru a ekum ɔyare mmoawa asa no ntɛm. |
| Dae a ahotɔ wom: Ɛnyɛ den koraa sɛ wobɛda anadwo. Ɛho renhia sɛ wosɔre anadwo fã ansa na wo bag mu ada mpan. | Ntrɛwmu a ɛbue (Stricture/stenosis): Akuru betumi ama stoma no ayɛ teateaa na ama ayɛ den sɛ wɔde tube no bɛhyɛ mu. |
| Parastomal hernia: Dwensɔtwaa no fã bi fi adi fa stoma no mu. Eyi nso betumi de akwanside aba. |
Sɛ saa nsɛnnennen yi ba a, mmere bi wɔ hɔ a ebia ɛho behia sɛ wɔyɛ oprehyɛn foforo (`revision surgery`) de siesie. Wɔ Kock kotoku ho, titiriw esiane valve haw nti, oprehyɛn a ɛte saa a wɔsan yɛ no dodow no boro akwan afoforo so kakra (bɛyɛ 30%). Nanso wo duruyɛfo no bɛkyerɛkyerɛ eyinom nyinaa mu akyerɛ wo yiye.
Nsonsonoe bɛn na ɛwɔ Kock kotoku ne J-kotoku ntam?
Ɛwom sɛ eyinom abien nyinaa yɛ kotoku ahorow a wɔhyehyɛ wɔ nipadua no mu de, nanso ɔkwan a wɔfa so yɛ adwuma no yɛ soronko koraa.
- Kock Pouch (K-pouch): Wɔde `ileostomy`, a ɛyɛ bue (`stoma`) a ɛwɔ yafunu no mu na ɛbɔ eyi. Wɔnam nsukorabea (`catheter`) a wɔde fa ɔkwan a wɔabue wɔ yafunu no mu no mu na ɛma nsu no mu da hɔ.
- J-Pouch: Eyi yɛ ɔkwan foforo a wɔfa so yɛ ileostomy. Ɛha yi, wɔyɛ kotoku bi fi dwensɔtwaa ketewa no awiei na wɔde bata akyi berɛmo (anal canal) no ho tẽẽ. Eyi ma ɛho nhia sɛ wɔde stoma (yafunu no bue). Ɔyarefo no betumi akɔ tiafi na wahohoro ne ho sɛnea ɛsɛ.
Mpɛn pii no, ayarefo a wɔpɛ sɛ woyi wɔn akyi berɛmo ne wɔn akyi berɛmo nyinaa paw J-pouch kwan no. Nanso, sɛ J-kotoku betumi ayɛ yiye a, ɛsɛ sɛ ntini a ɛwɔ akyi berɛmo no mu no yɛ adwuma yiye. Wɔn a wontumi nnya J-kotoku esiane biribi nti, anaasɛ wɔn a wɔanya J-kotoku a adi nkogu no, Kock kotoku yɛ ɔkwan pa a wobetumi afa so.
So wopɛ sɛ woyɛ nsakrae wɔ w’aduan mu?
Yiw, aduan a ɛkari pɛ na ahoɔden wom a wubedi no ho hia yiye na ama wo ho atɔ wo ntɛmntɛm. Sɛ wo nsu mu yɛ duru dodo anaasɛ ɛyɛ nsu dodo a, wubetumi ayɛ nsakrae nketenkete wɔ w’aduan mu. Ebetumi aboa kɛse sɛ wobɛhwehwɛ afotu afi aduan ho ɔbenfo hɔ. Wo duruyɛfo betumi de wo akɔ obi a ɔfata nkyɛn.
Nkrasɛm a Wɔde Kɔ Fie
- Kock kotoku yɛ ɔkwan pa a wobetumi afa so ama wɔn a wɔmpɛ sɛ wɔde abɔnten ileostomy bag bɛtra ase.
- Eyi bɛboa wo ma woadi wo dwensɔtwaa so na ama woanya ahofadi ne awerɛkyekye kɛse bere a wo ne afoforo bɔ no.
- Nanso, sɛnea ɛte wɔ oprehyɛn nyinaa mu no, asiane ne nsɛnnennen wɔ hɔ, titiriw no, ntini a ɛwɔ nipadua no mu no ho haw ahorow.
- Ansa na wubesi gyinae sɛ ebia ɔkwan yi fata wo no, ɛho hia yiye sɛ wo ne wo duruyɛfo kasa na wote mfaso ne ɔhaw ahorow no nyinaa ase pefee.
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