Zonse zokhudza chithandizo cha kutsekeka kwa ndulu (Biliary Drainage) mwachidule

Kodi maso ndi khungu lanu zimaoneka zachikasu? Kapena muli ndi kuyabwa kosalekeza thupi lanu lonse? Izi nthawi zina zimakhala zizindikiro zomwe zimachitika pamene njira zonyamulira madzi otchedwa 'bile' kuchokera ku chiwindi chathu zatsekedwa. Madzi otchedwa 'bile' ndi ofunikira kwambiri pa ntchito yogaya chakudya m'thupi lathu. Chifukwa chake ngati njira iyi ya bile yatsekedwa, imatha kubwerera m'chiwindi ndikuyambitsa mavuto ambiri. Lero, tikulankhula za chithandizo chapadera chomwe madokotala amachita pazochitika zotere. Chimatchedwa Biliary Drainage.

Mwachidule, kodi Biliary Drain iyi ndi chiyani?

Chitoliro chotulutsira madzi m'mimba ndi chubu chopyapyala komanso chosinthasintha. Chubuchi chimagwiritsidwa ntchito kuletsa kutsekeka kwa ndulu komwe kumalumikiza chiwindi chathu ndi matumbo ang'onoang'ono ndikuchotsa ndulu m'thupi kapena kuibwezeretsa kumatumbo ang'onoang'ono.

Tangoganizirani chidutswa cha zinyalala chomwe chaikidwa pakati pa chitoliro cha madzi. Kenako madziwo amadzaza pamalo amodzi, kuthamanga kwa magazi kumawonjezeka, ndipo chitolirocho chimatha kuwonongeka, sichoncho? Umu ndi momwe njira zotulutsira ndulu zimatsekekera. Ndudu zimasonkhana m'chiwindi. Malinga ndi madokotala timatcha vutoli kuti cholestasis . Izi zikachitika, vuto la jaundice, lomwe limakhala lachikasu m'maso ndi pakhungu, limachitika, monga tafotokozera kale. Pamodzi ndi izi, pakhoza kukhala kuyabwa kwakukulu mthupi lonse.

Choncho, chomwe chimachitika ndi ndulu iyi ndikupewa kutsekeka kwake ndikupanga njira yoti ndulu ibwererenso. Nthawi zina, ndulu iyi imasonkhanitsidwa m'thumba kunja kwa thupi.

Kodi njira zoyikira machubu izi ndi ziti? (Mitundu ya Machubu Oyeretsera Biliary)

Pali njira ziwiri zazikulu zochizira matendawa. Kutengera ndi matenda anu, dokotala wanu adzasankha njira yoyenera kwa inu.

1. Kutulutsa madzi m'chiwindi kudzera m'chiwindi (PTBD)

Izi zimaphatikizapo kulowetsa chubu chopyapyala (catheter) kudzera pakhungu kumbali yakumanja ya mimba yanu, kudzera m'chiwindi chanu, ndi mu duct yanu ya bile. Izi zimachitika pogwiritsa ntchito fluoroscopy, njira yapadera ya X-ray. Chubucho chimayikidwa mutapeza malo enieni omwe adatsekeka. Kenako, mbali ina ya chubuchi imalumikizidwa ndi thumba kunja kwa thupi. Kenako nduluyo imasonkhanitsidwa m'thumba limenelo.

2. Kutulutsa Madzi Ochokera M'mimba (EBD)

Chomwe chimachitika apa ndichakuti chubu chopyapyala chokhala ndi kamera yolumikizidwa, yotchedwa endoscope , chimalowetsedwa kudzera pakamwa panu ndikutsika mu chitoliro chanu cha chakudya mpaka potseguka pa duct ya bile (koyambira kwa matumbo ang'onoang'ono). Kenako, chubu china chopyapyala chimadutsa mu endoscope ndikulowetsedwa mu duct ya bile yotsekedwa kuti itulutse ndulu.

Njira iyi ingathenso kuchitika m'njira zosiyanasiyana.

• Madzi Otulutsa M'mphuno Opangidwa ndi Endoscopic (ENBD):Apa, ndowe zimayenda kudzera mu chubu chomwe chimayikidwa kudzera mu mphuno ndikusonkhana m'thumba kunja kwa thupi.
• Kuika stent mkati mwa thupi: Izi zimaphatikizapo kuyika chubu chaching'ono chonga stent mkati mwa malo otsekeka ndikulola ndulu kudutsamo. Izi zimathandiza ndulu kuyenda mwachindunji m'matumbo ang'onoang'ono, m'malo motuluka m'thupi. Iyi ndiyo njira yodziwika kwambiri.

N’chifukwa chiyani munthu angafune kuyika chitoliro chotere?

Pali zifukwa zambiri zomwe njira yotulutsira ndulu ingatsekere kapena kutsekeka. Chithandizochi chikufunika chifukwa cha vuto lotchedwa cholestasis lomwe limachitika izi zikachitika. Tiyeni tiwone zomwe zimayambitsa.

Kodi muyenera kukonzekera bwanji musanalandire chithandizo?

Ndikofunikira kwambiri kutsatira malangizo a dokotala wanu musanalandire chithandizochi. Kawirikawiri, muyenera kusamala ndi zinthu izi.

• Muyenera kusiya kudya, kumwa, ndi kusuta fodya osachepera maola 6 musanayambe kulandira chithandizo . Mungaloledwe kumwa madzi pang'ono, koma dokotala wanu adzakuuzani zomwe mungachite.
• Uzani dokotala wanu za ziwengo zilizonse zomwe muli nazo kale, makamaka mankhwala oletsa ululu, utoto wosiyana womwe umagwiritsidwa ntchito mu X-ray, pulasitiki, kapena zitsulo.
• Uzani dokotala wanu za mankhwala ndi mavitamini onse omwe mukumwa panopa .
• Ngati mukumwa mankhwala omwe amaletsa magazi kuundana (monga mankhwala oletsa magazi kuundana monga aspirin ndi warfarin), lankhulani ndi dokotala wanu ngati muyenera kuwasiya musanalandire chithandizo komanso momwe mungachitire zimenezi.
• Ngati muli ndi pakati kapena mungakhale ndi pakati, onetsetsani kuti mwatidziwitsa.
• Popeza simudzatha kuyendetsa galimoto mutalandira chithandizo chifukwa cha mankhwala oletsa ululu, ndikofunikira kukonza kuti wina akuyendetseni kunyumba pasadakhale.

Kodi chimachitika ndi chiyani panthawi ya chithandizo?

Pakhoza kukhala kusiyana pang'ono pa zomwe zimachitika kutengera njira yomwe mukuchita, koma dokotala adzakufotokozerani zonse pasadakhale.

Momwe njira ya percutaneous (PTBD) imachitikira

1. Choyamba, dokotala adzatsuka khungu la pamimba panu ndi mankhwala opha tizilombo toyambitsa matenda ndikuchotsa dzanzi pamalopo.

2. Kenako, singano yopyapyala imalowetsedwa kudzera pakhungu mu duct ya ndulu m'chiwindi.

3. Utoto wapadera wotchedwa contrast umayikidwa kuti uwonetse bwino njira ya ndulu pa X-ray.

4. Pambuyo popeza malo enieni omwe ndulu yatsekeka, chubu chotulutsira ndulu chimalowetsedwamo ndipo ndulu imaloledwa kutuluka.

5. Malekezero akunja a chubucho amachotsedwa pakhungu la m'mimba ndikulumikizidwa ku thumba. Ndowe zimasonkhana m'thumba limenelo. Thumba ili liyenera kuchotsedwa kangapo patsiku.

Momwe njira ya endoscopic (EBD) imachitikira

1. Mudzagonekedwa tulo tofa nato kapena kugona tulo tofa nato.

2. Musanalowetse endoscope kudzera pakamwa, thirakiti la mankhwala limayikidwa pakhosi kuti pakhosi pakhale dzanzi.

3. Kenako dokotalayo amalowetsa endoscope kudzera pakamwa, amaidutsa pa chitoliro chopezera chakudya, kenako n’kulowa m’mimba mwaing’ono.

4. Kuchokera pamenepo, chubu china choonda (catheter) chimalowetsedwa kudzera mu endoscope mu duct yotsekedwa ya ndulu.

5. Chotsekekacho chimachotsedwa ndipo ndulu imaloledwa kutuluka. Ngati stent ikuyikidwa mkati, izi zimachitika panthawiyi. Ngati chubu chikuchotsedwa, chubucho chimachotsedwa m'mphuno ndikulumikizidwa ku thumba.

Kodi pali zoopsa zilizonse zomwe zingachitike?

Monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, pali zoopsa ndi zovuta zomwe zingachitike. Dokotala wanu adzakudziwitsani zonsezi.

Kodi mumasamalira bwanji chitolirocho mukafika kunyumba?

Ngati muli ndi chubu ndi thumba loika kunja kwa thupi lanu, namwino adzakupatsani malangizo atsatanetsatane a momwe mungasamalire. Tsatirani malangizowo mosamala.

• Imwani zakumwa zokhala ndi ma electrolyte zofanana ndi kuchuluka kwa ndulu yomwe imayikidwa mu thumba. Dokotala wanu adzakuuzani zomwe muyenera kumwa komanso kuchuluka kwa zomwe muyenera kumwa.
• Pumulani mokwanira mukatha kulandira chithandizo. Ndi bwino kukhala ndi munthu woti akuthandizeni usiku woyamba.
• Musagone ndi kulemera kwanu kumbali yomwe chubu chili . Mwanjira imeneyi, mwayi woti chubucho chizungulire ndi wochepa.
• Nthawi zambiri mukhoza kuyambiranso ntchito zanu zachizolowezi patatha maola 24, koma musanyamule chilichonse cholemera kuposa 5 kg .
• Imwani mankhwala onse omwe dokotala wakupatsani monga momwe mwalangizidwira .
• Mukhoza kusamba patatha maola 48. Komabe, pewani kusambira m'madziwe, m'nyanja, kapena m'mitsinje mpaka chubucho chitakhala pamalo ake.

Kodi muyenera kupita kwa dokotala nthawi yomweyo liti?

Ngati mukukumana ndi zizindikiro zotsatirazi, zikhoza kukhala chizindikiro cha matenda. Choncho imbani dokotala wanu nthawi yomweyo kapena pitani ku Dipatimenti Yodzidzimutsa ya chipatala chapafupi (ETU) .

• Ngati ululu, kutupa, kapena kufiira pamalo omwe payipi yaikidwapo zikuwonjezeka .
• Ngati mafinya kapena madzi ena akutuluka kuchokera pamalo a chubu.
• Ngati mukumva malungo .

Samalaninso zinthu izi:

• Ngati khungu kapena maso anu akuyamba chikasu kapena kuoneka ngati akuipiraipira .
• Ngati mtundu kapena fungo la ndowe zomwe zasonkhanitsidwa m'thumba lasintha mwadzidzidzi .
• Ngati chitolirocho chikuoneka kuti chikutuluka pamalo pomwe chinayikidwa.
• Ngati muli ndi vuto la m'mimba kapena ngati ululu wanu womwe mukukumana nawo ukukulirakulira.
• Ngati kusanza kukupitirira.
• Ngati m'mimba simukutuluka madzi kapena mpweya sutuluka .

Ndizachilendo kumva mantha pang'ono mukamva za mtundu uwu wa chithandizo. Koma kumbukirani, izi zimathandiza thupi lanu kuchotsa kusasangalala ndikubwezeretsa thanzi lanu. Lankhulani ndi dokotala wanu za mafunso kapena nkhawa zilizonse zomwe mungakhale nazo. Iye adzakufotokozerani zonse.