Sɛ wo duruyɛfo ka kyerɛ wo sɛ ɛsɛ sɛ woyɛ wo dwonku oprehyɛn a, ɛyɛ ade a ɛfata sɛ wobɛte ehu ne dadwen pii nka. Sɛ wote din te sɛ "proctocolectomy" a, ebetumi ayɛ te sɛ nea ɛyɛ den kɛse mpo. Nanso mma ɛnhaw wo. Eyi yɛ oprehyɛn a egye nkwa a ebetumi aboa wo ma woatra ase yiye denam wo mprempren sɛnkyerɛnne ahorow a ɛbɛma woayi afi hɔ no so. Yɛbɛka biribiara ho asɛm wɔ ɔkwan a ɛnyɛ den so a wubetumi ate ase.
Dɛn ankasa ne Proctocolectomy?
Sɛ yɛbɛka no tiawa a, proctocolectomy yɛ oprehyɛn a wɔde yi wo dwensɔtwaa ne wo dwensɔtwaa no fã a etwa to no.
Momma yɛnkyerɛkyerɛ eyi mu kakra. Dwensɔtwaa kɛse no yɛ yɛn aduan mu nhyehyɛe no fã tenten bi a ɛte sɛ nsukorade. Ɛwɔ afã atitiriw abiɛsa:
1. Colon: Eyi ne ɔfã a ɛsõ sen biara. Ɛtwe nsu a efi nwura a aka wɔ aduan a yedi mu no mu na ɛdan no yɛ ade a ɛyɛ den, a wɔfrɛ no nsu a ɛyɛ nwura.
2. Rectum (anus no fã a etwa to): Eyi ne fã tiawa a ɛwɔ akyi berɛmo no akyi. Ɛhɔ na wɔde nsukorade sie bere tiaa bi ansa na wɔatu no.
3. Anus: Ɔkwan a nsuo fa mu fi nipadua no mu.
Enti, wɔ proctocolectomy mu no, woyi akyi berɛmo ne akyi berɛmo no nyinaa, anaa ne fã bi. "Procto" kyerɛ sɛ akyi berɛmo. "Colectomy" kyerɛ sɛ wobeyi akyi berɛmo no afi hɔ.
Dɛn nti na ɛsɛ sɛ wɔyɛ wo oprehyɛn a ɛte sɛɛ?
Nneɛma pii nti na wobetumi ayɛ oprehyɛn kɛse a ɛte saa. Nea enti titiriw ne sɛ yare a ɛwɔ dwensɔtwaa mu no mma saa nipadua no fã no ntumi nyɛ adwuma yiye anaasɛ yare no de nkwa to asiane mu.
| Aduruyɛ mu tebea | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Nyarewa a Ɛma Ɔyare a Ɛyɛ Ɔhyew | Sɛ dwensɔtwaa no mu kɔ so pira na ɛyɛ hyew esiane tebea horow te sɛ Ulcerative Colitis ne Crohn’s disease , a, ebia ɛho behia sɛ wɔyɛ oprehyɛn sɛ wontumi mfa nnuru nni tebea no so a. |
| Kokoram a ɛwɔ akyi berɛmo mu ne tebea horow a ɛba ansa na kokoram aba | Sɛnea ɛbɛyɛ a wobesiw kokoram nkwammoaa a ɛwɔ akyi berɛmo mu no trɛw anaasɛ wɔ tebea horow te sɛ Familial Adenomatous Polyposis (FAP) , a ɛyɛ awosu mu tebea a ɛma polyps ɔhaha pii a ɛda adi sɛ ɛbɛdan kokoram ba no mu. |
| Nneɛma afoforo nti | Nsɛnnennen te sɛ dwensɔtwaa mu ntini a ewu esiane mogya a ɛyera (ischemia), akisikuru a emu yɛ den, dwensɔtwaa mu opira a emu yɛ den, anaa diverticulitis . |
Woyɛ dɛn yi wo ho fi wo ho bere a wɔayɛ wo oprehyɛn awie no?
Eyi ne asɛmmisa kɛse a nnipa pii wɔ. Sɛ woyi akyi berɛmo ne akyi berɛmo no fi hɔ a, ɔkwan a ɛfata a nsuo fa so tom no yera. Afei wobɛyɛ dɛn de wo ho ahyɛ wo ho? Eyi ho mmuae gyina proctocolectomy ko a woayɛ so. Wo duruyɛfo no begyina w’ayaresa tebea so akyerɛ ɔkwan a ɛfata sen biara.
Akwan atitiriw pii wɔ hɔ:
1. Ileostomy nhyehyɛe a wɔyɛ
Nea ɛka eyi ho ne sɛ wode wo dwensɔtwaa ketewaa no fã a etwa to a wɔfrɛ no ileum no bɛka ɔkwan ketewaa bi a wɔabue (stoma) a wɔayɛ wɔ wo yafunu honam ani no ho. Afei wɔde ostomy bag bi bata baabi a wɔabue no ho de boaboa nsu ano. Eyi betumi ayɛ nea ɛbɛtra hɔ daa anaasɛ bere tiaa mu de . Wɔyɛ bere tiaa mu de kosi sɛ wo nipadua no bɛsa. Wobetumi asesa eyi akyiri yi denam oprehyɛn foforo so.
2. Ileoanal Pouch (adebɔ a wɔde yɛ kotoku a ɛwɔ mu) .
Eyi yɛ adeyɛ a ɛyɛ anigye yiye. Wɔsan frɛ no Restorative Proctocolectomy. Wɔfa wo dwensɔtwaa ketewa (ileum) no fã bi na wɔde yɛ kotoku ketewaa bi. Fa no sɛ wo nipadua no fã foforo a ebetumi akura wo nsu mu bere tiaa bi, te sɛ wo akyi berɛmo no ara pɛ. Afei, wɔsan de kotoku no bata wo akyi berɛmo no ho. Sɛ woyɛ saa adeyɛ yi wie a, wubetumi akɔ tiafi na woahohoro wo ho sɛnea ɛsɛ wɔ bere tiaa bi akyi. Wɔfrɛ ɔkwan a wɔtaa fa so yɛ eyi no J-pouch .
3. Subtotal Proctocolectomy (wɔnsɛe ɔfã bi) .
Wɔ eyi mu no, wogyaw dwensɔtwaa kɛse no fã bi wɔ akyi. Sɛ ɛbɛyɛ yiye a, wobetumi asan de dwensɔtwaa no fã a aka no abata akyi berɛmo no anaa akyi berɛmo no fã a aka no ho (anastomosis). Nanso ɛtɔ mmere bi a, ebia ɛho behia sɛ wobue yafunu no mu bere tiaa bi na wɔde nsu kotoku (colostomy) hyɛ mu kosi sɛ baabi a wɔde nkitahodi no ayɛ no bɛsa.
Nea ɛho hia sen biara ne sɛ wo duruyɛfo no ne wo besusuw akwan yi mu nea eye ma wo ho. Enti, wo ne wo duruyɛfo nsusuw nsɛmmisa anaa dadwen biara a wowɔ ho.
Nea ɛkɔ so ansa na wɔayɛ oprehyɛn, bere a wɔreyɛ oprehyɛn, ne bere a wɔreyɛ no oprehyɛn akyi
Ansa na wɔreyɛ no oprehyɛn
Sɛ ɛnyɛ oprehyɛn a wɔyɛ no ntɛm a, wubenya bere de asiesie wo ho.
- Adapɛn kakraa bi ansa na: Wo duruyɛfo bɛkyerɛkyerɛ oprehyɛn no mu akyerɛ wo, asiane ahorow a ɛwom, ne akwan horow a wubetumi afa so.
- Adapɛn abien ansa na ɛno reba: Sɛ worenom nnuru a ɛma mogya tu a, wɔbɛka akyerɛ wo sɛ gyae anaasɛ tew so. Wɔbɛtu wo fo sɛ di aduan a ahoɔdennuru pii wom na nom nsu pii.
- Nnɔnhwerew 24 ansa na: Wɔbɛma wo bowel prep na ama wo dwensɔtwaa ho atew koraa. Wɔbɛka akyerɛ wo nso sɛ di nsu nkutoo ma da no. Ebia wɔbɛma wo nnuru a ekum ɔyare mmoawa nso de asiw ɔyare mmoawa ano bere a wɔayɛ wo oprehyɛn awie no.
Bere a wɔreyɛ oprehyɛn no
Wɔde aduru a wɔde kum wo bɛda, enti worente biribiara nka. Wobetumi afa akwan atitiriw abien so ayɛ oprehyɛn no:
- Open Surgery: Ɔkwan a wɔfa so yɛ no, a wɔyɛ no denam yafunu no mu ntwitwiridii kɛse so.
- Laparoscopic Surgery: Wɔsan frɛ no "keyhole" oprehyɛn, wɔyɛ eyi denam ntwitwiridii nketenkete kakraa bi a wɔyɛ wɔ yafunu no mu na wɔde mfoninitwa afiri ne nnwinnade a ɛyɛ mmerɛw fa mu so. Saa kwan yi ma ne ho tɔ no ntɛmntɛm na ɛyaw sua.
Afei oduruyɛfo a ɔyɛ oprehyɛn no de ahwɛyiye yi dwensɔtwaa no fã a yare no na ɔyɛ oprehyɛn a ɛho hia (ileostomy, kotoku, anaa re-connection) sɛnea yɛadi kan aka ho asɛm no.
Wɔ oprehyɛn akyi
Ɛho behia sɛ wotra ayaresabea hɔ bɛyɛ dapɛn biako. Saa bere yi mu no, wɔde nkakrankakra bɛdan wo afi nnuan a ɛyɛ nsu so akɔ nnuan a ɛyɛ den so. Sɛ wowɔ ostomy (bag) a, ɔyarehwɛfo a wɔatete no titiriw (WOCN - Wound Ostomy Continence Nurse) bɛkyerɛ wo sɛnea wode bedi dwuma na ama wo honam ani atew.
Dɛn ne nsɛnnennen a ebetumi aba?
Sɛnea ɛte wɔ oprehyɛn biara ho no, asiane ne nsɛnnennen bi wɔ hɔ a ebetumi aba, nanso mpɛn pii no eyinom yɛ bere tiaa mu de.
| Nsɛnnennen no su | Nkyerɛmu |
|---|---|
| Nsɛnnennen a ɛtaa ba wɔ oprehyɛn mu | Nneyɛe a ɛba bere a wɔde aduru a ɛma obi dwensɔ, mogya a ɛba nipadua no mu, ɔyare mmoawa, dwensɔtwaa mu akwanside, ne nea ɛkeka ho. |
| Nsɛnnennen a ɛfa ostomy (bag) ho . | Wora mu nyarewa a atwa stoma no ho ahyia, a ɛkɔhyɛ stoma no mu anaasɛ ɛpuepue.Tebea bi a wɔfrɛ no phantom rectum nso betumi aba. Eyi ne atenka a ɛne sɛ ɛsɛ sɛ wɔtow ne ho gu ɛmfa ho sɛ woyi akyi berɛmo no. Eyi so bɛtew bere a bere kɔ so no. |
| Nsɛnnennen a ɛfa Ileoanal Pouch (kotoku a ɛwɔ mu) ho . | Pouchetis , anastomotic leak, ne nsu a ɛtwetwe ntɛm. Eyinom mu pii yɛ nea wotumi sa. |
Dɛn ne tebea horow a egye ntɛmpɛ a ɛhwehwɛ sɛ wokɔ oduruyɛfo nkyɛn?
Sɛ wosan kɔ fie wɔ oprehyɛn akyi a, sɛ wowɔ sɛnkyerɛnne a edidi so yi mu biara a, frɛ wo duruyɛfo ntɛm ara anaa kɔ ayaresabea no Emergency Treatment Unit (ETU) .
- Akisikuru, yafunu mu yaw, akisikuru, ne akisikuru (eyinom betumi ayɛ sɛnkyerɛnne a ɛkyerɛ sɛ dwensɔtwaa no asiw).
- Yafunu mu yaw a emu yɛ den, atiridiinini, akisikuru a ɛsen fi baabi a wɔatwa no (eyinom yɛ ɔyare mmoawa ho sɛnkyerɛnne).
Mma wo werɛ mmfi sɛ, sɛ wote biribi a ɛyɛ soronko nka a, mmu w’ani ngu so. Ɛyɛ nea asiane biara nni ho sɛ wobɛhwehwɛ aduruyɛ mu afotu.
Nkrasɛm a Wɔde Kɔ Fie
- Ɛwom sɛ proctocolectomy yɛ oprehyɛn kɛse de, nanso ebetumi asa tebea horow a ɛde wo nkwa to asiane mu na ama woanya asetra a ahotɔ wom.
- Akwan ahorow wɔ hɔ a wɔfa so yi wɔn ho gu bere a wɔayɛ wɔn oprehyɛn awie no. Ɛsɛ sɛ nnipa binom de ostomy bag tra ase, bere a afoforo wɔ akwan foforo a wobetumi afa so a ɛma wotumi yi wɔn ho gu sɛnea ɛsɛ. Wo duruyɛfo na obesi nea eye ma wo ho gyinae.
- Egye bere ansa na asa. Wubetumi asan akɔ asetra a ɛfata mu wɔ asram kakraa bi mu. Ɛho hia paa sɛ wunya abotare na wudi wo duruyɛfo akwankyerɛ akyi wɔ saa bere yi mu.
- Fa ahofadi ne wo duruyɛfo susuw wo suro, w’adwenem naayɛ, ne nsɛmmisa nyinaa ho. Ɛbɛma woanya adwene mu ahoɔden kɛse.
- Ɛwom sɛ ostomy bag a wode bɛtra ase no betumi ayɛ asɛnnennen mfiase no de, nanso sɛ wode yɛ wo su pɛ a, wubetumi akɔ so ayɛ adwuma sɛnea ɛsɛ. Mfiri ne akwan pii wɔ hɔ nnɛ a ɛbɛboa wɔ eyi mu.
💬 Comments (0)
Wɔnnya nyɛɛ nsɛm biara. Fa wo nsɛm no ka ho wɔ ha nea edi kan.
Fa wo nsɛm no ka ho