So woanya yafunu mu yaw na wo ho nyɛ wo dɛ nna pii ni? Ebia wo duruyɛfo aka akyerɛ wo sɛ wowɔ dwensɔtwaa mu yare a ɛma obi ho hyehye no (IBD) te sɛ Crohn yare. Sɛ wunya saa tebea yi kyɛ a, wo dwensɔtwaa mu mmeae bi fi ase teateaa nkakrankakra. Ɛte sɛ nsu paipu a akɔhyɛ mfinimfini. Enti, yɛfrɛ saa oprehyɛn titiriw yi a wɔde trɛw mmeae a ɛyɛ teateaa yi mu `Strictureplasty`. Ɛnnɛ, yɛbɛka biribiara ho asɛm wɔ nsɛm a ɛnyɛ den mu.
Dɛn ankasa ne Strictureplasty?
Sɛ yɛbɛka no tiawa a, strictureplasty yɛ oprehyɛn a ɛma wo dwensɔtwaa mu baabi a ɛyɛ teateaa anaasɛ esiw (a wɔfrɛ no stricture) trɛw. Mpɛn pii no, eyi fi ɔfe a enni sabea, a efi dwensɔtwaa mu nyarewa a ɛma obi ho hyehye no (IBD) te sɛ Crohn yare ne Ulcerative Colitis. Saa ɔfe yi ma akuru ba dwensɔtwaa no afasu so, na ɛma ɛyɛ den na ɛyɛ teateaa.
Saa strictures ahorow yi taa ba wɔ:
- Dwonku ketewa no fã a ɛwɔ fam (ileum) .
- Ɛfa valve a ɛka dwensɔtwaa ketewa ne dwensɔtwaa kɛse (`ileocecal valve`) bom ho.
Nanso, saa tebea yi betumi aba wɔ akyi berɛmo, akyi berɛmo, ne akyi berɛmo mu nso. Oprehyɛn yi botae titiriw ne sɛ ɛbɛtrɛw dwensɔtwaa no fã a ayɛ teateaa no mu na ama aduan no asan akɔ sɛnea ɛsɛ, a wɔrenyi dwensɔtwaa no fã biara mfi hɔ.
Dɛn nti na wuhia oprehyɛn yi?
Sɛ wo dwensɔtwaa no fã bi yɛ teateaa saa a, aduan ntumi nkɔ fam yiye. Eyi betumi de sɛnkyerɛnne ahorow bi a ɛnyɛ dɛ koraa na ɛyɛ yaw aba.
| Nsɛnkyerɛnne a ɛkyerɛ | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Yafunu mu yaw a emu yɛ den ne akisikuru | Ɛyaw yi ba efisɛ dwensɔtwaa no twetwe bere a ɛbɔ mmɔden sɛ ɛde aduan bɛfa baabi a asiw no mu no. |
| Yafunu a ɛho ayɛ kurukuruwa ne yafunu a ɛyɛ mmerɛw | Yafunu no hohoro efisɛ aduan ne mframa ntumi nkɔ fam yiye na ɛkyere baabi biako. |
| Akisikuru ne ɔfe | Sɛ akwanside no mu yɛ den a, ebia aduan rentumi nkɔ fam na ebetumi asan aba soro. |
| Ayamtim | Nsu a wɔbɛtow agu no bɛyɛ den esiane sɛnea wɔyam brɛoo nti. |
| Aduan ho akɔnnɔ a ɛyera na ne mu duru so tew | Esiane ɛyaw ne ahometew nti, ɔpɛ a ɔwɔ sɛ obedidi no yera, na nipadua no ntumi nnye aduannuru no yiye. |
| Ɔbrɛ ne mogya a ɛtɔ kɔ nipadua mu | Mpɛn pii no, akuru ba wɔ mmeae a ayɛ teateaa yi. Saa akuru yi mogya tu nkakrankakra, na bere kɔ so no, mogya a ɛtɔ kɔ nipadua no mu. Saa tebea yi gyae bere a wɔayɛ no oprehyɛn akyi. |
Ade a ɛho hia sen biara: Sɛ saa teateaa yi kɔ so yɛ kɛse a, dwensɔtwaa no betumi asiw koraa (intestinal obstruction). Eyi yɛ tebea a asiane wom kɛse na ɛde nkwa mpo to asiane mu. Enti, sɛ wowɔ sɛnkyerɛnne bi a, ɛho hia sɛ wokɔ oduruyɛfo nkyɛn ntɛm ara.
Hena na oprehyɛn yi fata kɛse na ɛmfata mma no?
Strictureplasty oprehyɛn nyɛ obiara dea. Wo duruyɛfo begyina wo tebea so asi gyinae a eye sen biara.
| Wɔn a wɔfata sɛ wɔyɛ wɔn oprehyɛn | Nsɛm a ɛba bere a wɔnkamfo oprehyɛn nkyerɛ |
|---|---|
| Sɛ teateaa pii wɔ mmeae bi wɔ dwensɔtwaa no fã tenten bi ho a. | Sɛ dwensɔtwaa no fã tiawa bi mu teateaa mpɛn pii a, bɛn ho. |
| Sɛ woadi kan ayɛ wo dwensɔtwaa a wɔatwa a. | Sɛ opira, ɔfe, fistula, anaa onyin a ɛnteɛ wɔ beae a ɛyɛ teateaa no a. |
| Sɛ wowɔ dwensɔtwaa tiaa mu yare a. | Teateaa no bɛn beae bi a wɔadi kan ayɛ no oprehyɛn (anastomosis). |
| Sɛ ɛyɛ teateaa nkutoo a, ɛnyɛ ɔfe anaa opira wɔ beae a ɛyɛ teateaa no. | Sɛ wowɔ dwensɔtwaa a wɔatoto mu a. |
| Sɛ wotaa hu Crohn yare no ho sɛnkyerɛnne a. | Sɛ worehu amane wɔ aduan pa a wonnya nni a emu yɛ den ho a. |
Ɔkwan bɛn so na wusiesie wo ho ansa na wɔayɛ wo oprehyɛn?
Esiane sɛ eyi yɛ oprehyɛn a wɔayɛ ho nhyehyɛe nti, wo duruyɛfo no bedi kan ayɛ nhwehwɛmu pii.
- Mfoniniyɛ mu Sɔhwɛ: Wɔbɛyɛ sɔhwɛ te sɛ CT scan anaa Magnetic Resonance Enterography (MRE) de ahu baabi pɔtee a ɛyɛ teateaa no wɔ wo dwensɔtwaa mu ne bere tenten a ɛware.
- Mogya mu Nhwehwɛmu: Wɔbɛyɛ mogya mu nhwehwɛmu de ahwɛ aduannuru a wowɔ. Sɛ wunni aduan pa a, wobetumi ama wo aduannuru a wɔde ma wo denam ntini (`IV`) so nna kakraa bi ansa na wɔayɛ wo oprehyɛn. Eyi bɛboa wo ma wo ho atɔ wo ntɛmntɛm wɔ oprehyɛn akyi.
- Stoma (Ostomy bag): Wɔ tebea horow bi mu no, wɔ oprehyɛn akyi no, ebia ɛho behia sɛ wɔyɛ bere tiaa mu bue (`stoma`) wɔ yafunu no honam ani na ama nsu atumi afa mu, na ebia ɛho behia sɛ wɔde bag (`ostomy bag`) bata ho kosi sɛ dwensɔtwaa no bɛsa. Mma eyi nhaw wo. Sɛ eyi ho hia a, wo duruyɛfo bɛkyerɛkyerɛ mu yiye akyerɛ wo ansa na wɔayɛ oprehyɛn no.
Ɔkwan bɛn so na wɔyɛ oprehyɛn no?
Strictureplasty yɛ oprehyɛn kɛse a wɔyɛ wɔ aduru a wɔde kum nipadua no nyinaa mu. Ɛho behia sɛ wotra ayaresabea hɔ nna kakraa bi. Ansa na wobefi oprehyɛn no ase no, wɔbɛma wo aduru a wɔde kum nipadua no nyinaa, enti worente ɛyaw biara anaasɛ worenkae oprehyɛn no.
Bere a wɔreyɛ oprehyɛn no, oduruyɛfo a ɔyɛ oprehyɛn no twa dwensɔtwaa no fã a ayɛ teateaa no na ɔpam bue. Fa no sɛ woretwitwa afiri bi a asiw no tenten, atetew nea wɔatwa no ano abien no mu, na woapam abom. Sɛ dwensɔtwaa no trɛw a, aduan tumi fa mu ntɛmntɛm bio. Sɛ wowɔ strictures pii a, mpɛn pii no wubetumi asa ne nyinaa wɔ oprehyɛn biako mu.
Strictureplasty ahorow pii wɔ hɔ a egyina sɛnea wɔayɛ no teateaa no tenten so:
Heineke-Mikulicz a Wɔde Yɛ Nneɛma a Wɔde Yɛ Nneɛma a Ɛyɛ Den
Eyi ne ɔkwan a wɔtaa fa so yɛ adwuma. Wɔyɛ no ma ntwitwiridii a ɛyɛ tiaa sen sɛntimita 10 (bɛyɛ nsateakwaa 4).
Finney anaa Jaboulay Strictureplasty a wɔde yɛ aduru
Wɔde eyinom yɛ teateaa a ne tenten yɛ sɛntimita 10-20 (bɛyɛ nsateakwaa 8). Wɔ oprehyɛn yi mu no, wɔbobɔ dwensɔtwaa no ma ɛyɛ ‘U’.
Michelassi Nneɛma a Wɔde Yɛ Nneɛma a Ɛyɛ Katee
Eyi yɛ ɔkwan titiriw a wɔfa so yɛ strictures a ne tenten boro sɛntimita 20. Wɔ saa adeyɛ yi mu no, wɔbobɔ dwensɔtwaa no fã a ayɛ teateaa no mu abien, wɔde afã abien no bom, wɔtwa tenten, na wɔpam abien no bom.
Bere tenten ahe na egye na obi ho atɔ no wɔ oprehyɛn akyi?
Eyi yɛ oprehyɛn kɛse, enti ebegye bere kakra ansa na ne ho atɔ no. Ebia ebehia sɛ wotra ayaresabea hɔ bɛyɛ dapɛn biako . Sɛ nsɛnnennen bi wɔ hɔ a, ebia ebehia sɛ wotra hɔ kyɛ.
- Ɛyaw: Ebia wobɛte yafunu mu yaw bi wɔ nna kakraa a edi kan wɔ oprehyɛn no akyi. Oduruyɛfo no bɛma wo nnuru a wɔde kum ɛyaw ama eyi.
- Anohyeto ahorow: Worentumi nyɛ nneɛma te sɛ nneɛma a emu yɛ duru a wobɛma so anaa karka adapɛn kakraa bi.
- Hwɛ yiye wɔ ɔyare mmoawa ho: Ɛsɛ sɛ wohwɛ yiye kɛse wɔ ɔyare mmoawa a wubenya wɔ oprehyɛn akyi no ho. Sɛ wowɔ sɛnkyerɛnne ahorow te sɛ ɛyaw a emu yɛ den, atiridiinini, kɔkɔɔ anaa ɔfe wɔ baabi a wɔreyɛ oprehyɛn no, anaasɛ nsu a ɛyɛ soronko a efi kuru no mu ba a, ɛsɛ sɛ wobɔ wo duruyɛfo amanneɛ ntɛm ara .
- Aduane: Ɛgyina wo tebea so no, wo duruyɛfoɔ anaa aduane ho ɔbenfoɔ bɛkamfo aduane soronko bi akyerɛ (`GI soft diet`).
- IBD Ayaresa: Ade a ɛho hia sɛ yɛkae ne sɛ oprehyɛn yi trɛw nea ɛyɛ teateaa no mu nkutoo. Ɛnsa IBD a ɛwɔ ase (te sɛ Crohn de no) no yare. Enti, ɛho behia sɛ wokɔ so nom nnuru afoforo ma wo tebea no.
Nsonsonoe bɛn na ɛwɔ `Strictureplasty` ne `Bowel Resection` ntam?
Eyi yɛ asɛm a nnipa pii bisa. Nsonsonoe kɛse da oprehyɛn abien yi ntam.
| Su a ɛwɔ hɔ | Strictureplasty (a wɔtrɛw mu) . | Nkwammoaa a Wɔtwa |
|---|---|---|
| Nea ɛsɛ sɛ wɔyɛ | Wɔtrɛw dwensɔtwaa no fã a ayɛ teateaa no mu . | Wotwa dwensɔtwaa no fã a ayɛ teateaa no na wɔde afã abien a aka no bom. |
| Mfaso titiriw | Wɔkora dwensɔtwaa no tenten nyinaa so, na ɛtew asiane a ɛwɔ hɔ sɛ obi benya `Short Bowel Syndrome` (aduannuru a wɔtwetwe mu haw) so . | Ebia asiane a ɛwɔ hɔ sɛ ɔhaw bi bɛsan aba wɔ beae koro no ara so atew kakra. |
| Asiane a ɛbɛba daakye | Hokwan kɛse wɔ hɔ sɛ daakye ɛho behia sɛ wɔyɛ oprehyɛn bio. | Hokwan a ɛba fam sɛ ebehia sɛ wɔsan yɛ oprehyɛn daakye. |
Nnuruyɛfo taa di kan sɔ strictureplasty hwɛ, efisɛ dwensɔtwaa no tenten a wɔbɛkora so ho hia yiye ma aduannuru.
Nkrasɛm a Wɔde Kɔ Fie
- Strictureplasty yɛ oprehyɛn a wɔyɛ de trɛw dwensɔtwaa no mmeae a ɛyɛ teateaa esiane nyarewa te sɛ Crohn de nti. Ɛnhwehwɛ sɛ wotwitwa dwensɔtwaa no afã horow.
- Saa oprehyɛn yi betumi ayi sɛnkyerɛnne te sɛ yafunu mu yaw ne yafunu a ɛho ayɛ fĩ afi hɔ, na atew asiane a ɛwɔ hɔ sɛ dwensɔtwaa no besiw koraa no so.
- Oprehyɛn yi mfata obiara. Wo duruyɛfo no begyina wo tebea no so akyerɛ ayaresa a ɛfata sen biara.
- Eyi yɛ oprehyɛn kɛse, enti egye bere ansa na asa. Asiane ahorow te sɛ ɔyare mmoawa ne mogya a ɛbɛtɔ obi wɔ hɔ.
- Saa oprehyɛn yi bɛsa nea ɛyɛ teateaa no nkutoo. Ɛsɛ sɛ wɔsa yare a ɛde ba (IBD) no.
- Sɛ wowɔ nsɛmmisa bi fa eyi ho a, nsuro sɛ wo ne wo duruyɛfo bɛkasa na woasiesie biribiara.
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