Kodi maso kapena khungu lanu likusintha kukhala lachikasu, ndipo mukuvutika ndi kuyabwa kwakukulu komanso kosapiririka? Izi ndi zizindikiro za zomwe nthawi zambiri timazitcha kuti jaundice. Izi nthawi zambiri zimachitika pamene njira zotulutsira ndulu—machubu omwe amanyamula ndulu kuchokera ku chiwindi chanu kuti athandize kugaya chakudya—atsekedwa. Kutsekeka kumeneku kukachitika, ndulu imasonkhana m'chiwindi, zomwe zimapangitsa kuti khungu lanu likhale lachikasu komanso kuyabwa kosalekeza. Pazochitika zotere, madokotala amagwiritsa ntchito njira yapadera yotchedwa biliary drainage. Mwachidule, izi zimaphatikizapo kuyika chubu chaching'ono mu njira yotulutsira ndulu kuti ndulu ibwererenso momasuka. Tiyeni tikambirane zonse zomwe muyenera kudziwa za njirayi.
Kodi Kutulutsa Madzi a Biliary ndi Chiyani, Ndipo Mitundu Yake Ndi Yotani?
Kutulutsa madzi m'mimba mwa nyongolotsi ndi njira yomwe imagwiritsa ntchito chubu chopyapyala komanso chosinthasintha (catheter) kuti ipewe kutsekeka kwa nyongolotsi yanu, zomwe zimalola nyongolotsi kutuluka kuchokera m'chiwindi kupita m'matumbo ang'onoang'ono. Taganizirani izi ngati kupanga njira yodutsa payipi yamadzi yotsekedwa.
Izi zimachitika makamaka m'njira ziwiri. Dokotala wanu adzasankha njira yoyenera kwambiri pa vuto lanu.
| Mtundu wa Ndondomeko | Kufotokozera Kosavuta |
|---|---|
| Kutulutsa Madzi a M'mimba Ochokera M'chiwindi (PTBD) | Mu njira imeneyi, dokotala amaika chubu kudzera pakhungu lanu ndikuchilowetsa mwachindunji m'chiwindi kuti chifike mu duct ya ndulu. Pogwiritsa ntchito njira yapadera ya X-ray (fluoroscopy), dokotalayo amatsogolera chubucho pamalo oyenera. Kenako ndulu imatuluka kudzera mu chubucho kupita mu thumba laling'ono lakunja. |
| Kutulutsa Madzi Ochokera M'mimba (EBD) | Pa njirayi, chubu chopyapyala, chokhala ndi kamera (endoscope) chimadutsa pakamwa panu ndikutsika m'mimba mwanu kuti chifike mu duct ya ndulu. Akafika kumeneko, dokotalayo amagwiritsa ntchito endoscope kuchotsa kutsekeka kapena kuyika chubu chaching'ono (stent) kuti ndulu ibwerere m'matumbo mwachibadwa. |
Kodi Kusuta N'chiyani?
Nthawi zina, makamaka ngati kutsekekako kuli kosatha (monga chifukwa cha chotupa), dokotala wanu angaike chubu chaching'ono, chonga maukonde chotchedwa stent kuti ndulu isamatseguke kosatha. Izi nthawi zambiri zimachitika patatha masiku angapo chubu choyamba chotulutsira madzi chitayidwa.
N’chifukwa Chiyani Njirayi Ndi Yofunika?
Chifukwa chachikulu cha njirayi ndi kutsekeka kapena kuchepa (`stricture`) mu duct ya bile, zomwe zimapangitsa kuti bile iunjikane mu chiwindi (`cholestasis`). Monga momwe ngalande yotsekeka mu sinki yanu yakukhitchini imalepheretsera kuyenda bwino kwa magazi.
Zomwe zimayambitsa kutsekeka kwa njira za bile ndi izi:
- Miyala ya ndulu (choledocholithiasis).
- Khansa ya kapamba kapena khansa ya kapamba .
- Khansa ya duct ya bile (`Cholangiocarcinoma`).
- Khansa ya chiwindi kapena khansa ya ndulu .
- Kutupa kwa ma lymph nodes pafupi ndi chiwindi kapenakhansa ya kapamba.
- Matenda ena a parasitic .
- Kuvulala kwa ndulu komwe kudachitika kale ndi opaleshoni.
- Kutupa kosatha kwa ndulu, monga Primary Sclerosing Cholangitis.
Chofunika kwambiri, ngati muli ndi zizindikiro izi, chonde pitani kwa dokotala nthawi yomweyo kuti mudziwe chomwe chikuyambitsa vutoli. Musayese kudzichiza nokha.
Kodi Muyenera Kukonzekera Bwanji?
Dokotala wanu adzakupatsani malangizo enieni, omwe muyenera kutsatira mosamala.
1. Chakudya ndi Zakumwa: Mwina mungafunike kusiya kudya, kumwa, ndi kusuta fodya maola osachepera 6 musanachite opaleshoniyi. Dokotala wanu adzakulangizani ngati mungathe kumwa madzi pang'ono.
2. Matenda a ziwengo: Uzani dokotala wanu za ziwengo zilizonse, makamaka mankhwala oletsa ululu, utoto wosiyana womwe umagwiritsidwa ntchito pojambula X-ray, kapena pulasitiki/zitsulo.
3. Mankhwala: Uzani dokotala wanu za mankhwala onse omwe mukumwa panopa, kuphatikizapo mavitamini. Ngati mukumwa mankhwala ochepetsa magazi monga aspirin kapena warfarin, funsani dokotala wanu nthawi yoti musiye kumwa mankhwalawa musanachite opaleshoni.
4. Mimba: Ngati muli ndi pakati kapena mukuganiza kuti muli ndi pakati, muyenera kudziwitsa gulu lanu lachipatala.
5. Mayendedwe: Popeza mudzalandira mankhwala oletsa ululu, simudzatha kuyendetsa galimoto. Chonde konzani kuti wina akutengereni kunyumba.
Kodi Chimachitika N'chiyani Panthawi ya Ndondomekoyi?
Masitepewo amasiyana malinga ndi ngati muli ndi PTBD kapena EBD, koma dziwani kuti gulu lanu lachipatala lidzakufotokozerani zonse pasadakhale.
Momwe PTBD Imagwirira Ntchito:
- Khungu la pamimba panu lidzayeretsedwa ndi kuchotsedwa mano.
- Dokotala adzalowetsa singano yopyapyala pakhungu mu duct ya ndulu yomwe ili mkati mwa chiwindi.
- Utoto wosiyana umayikidwa kuti mitsempha iwonekere pa X-ray.
- Mukapeza chotsekacho, chubu chotulutsira madzi chimayikidwa kuti ndulu ituluke.
- Malekezero akunja a chubucho adzalumikizidwa ku thumba lakunja lomwe limasonkhanitsa ndulu. (Muyenera kutulutsa madzi m'thumbali nthawi ndi nthawi).
Momwe EBD Imagwirira Ntchito:
- Mudzapatsidwa mankhwala oletsa ululu am'deralo kapena onse kuti mukhale omasuka.
- Endoscope imadutsa pakamwa panu ndikutsikira m'dera la duct.
- Dokotala amagwiritsa ntchito zida zomwe zimadutsa mu endoscope kuti apewe kutsekeka kwa khungu.
- Kutengera ndi momwe zinthu zilili, amatha kuyika stent kuti duct isamatseguke mkati.
Zoopsa ndi Chisamaliro Pambuyo pa Kubadwa
Monga momwe zimakhalira ndi njira iliyonse yachipatala, pali zoopsa zomwe zingachitike.
- Mavuto Omwe Angakhalepo:
- Chubucho chingatuluke, kupotoka, kapena kutsekeka.
- Kusasangalala kapena kupweteka.
- Matenda (dokotala wanu adzakupatsani mankhwala opha tizilombo kuti apewe izi).
- Kutuluka magazi.
- Kusalinganika kwa ma electrolyte.
- Kawirikawiri, mavuto a m'mapapo monga pneumothorax.
Dokotala wanu adzakambirana nanu zoopsa izi ndikukupatsani malangizo a zomwe mungachite ngati pakhala vuto lililonse.
Kudzisamalira Kunyumba:
Ngati muli ndi chubu chakunja ndi thumba, ogwira ntchito yosamalira ana adzakuphunzitsani momwe mungawasamalire.
- Pewani kupanikizika pamalo olowera, chifukwa izi zitha kupotoza chubu.
- Ngati mwalangizidwa, tsukani chubucho ndi saline tsiku lililonse monga mwalangizidwira.
- Sungani madzi okwanira m'thupi ndi zakumwa zokhala ndi ma electrolyte ambiri ngati dokotala wanu akulangizani kuti muchepetse kutayika kwa madzi m'thupi.
- Mungathe kusamba maola 48 mutatha kuchita opaleshoniyi, koma musasambe m'madziwe, m'nyanja, kapena m'nyanja pamene chubu chilipo.
- Pewani kunyamula zinthu zolemera mpaka dokotala atakuchotsani.
Kodi Muyenera Kupeza Chithandizo Chachipatala Chadzidzidzi Liti?
Ngati mukukumana ndi chilichonse mwa zotsatirazi, funsani dokotala wanu nthawi yomweyo kapena pitani ku dipatimenti yapafupi yothandiza anthu mwadzidzidzi.
- Malungo kapena kuzizira.
- Kuwonjezeka kwa ululu, kutupa, kapena kufiira pamalo omwe ali ndi chubu.
- Mafinya kapena kutuluka kwachilendo kwa madzi kuchokera pamalopo.
- Ululu watsopano kapena woipa kwambiri m'mimba.
- Kubwerezabwereza kwa khungu lachikasu kapena maso.
- Kusanza kosalekeza.
- Ngati chubucho chikuoneka kuti chikutuluka kapena chamasuka.
- Ngati simungathe kutulutsa ndowe kapena mpweya.
Kutulutsa madzi m'mimba ndi njira yabwino kwambiri yothandizira kutsekeka kwa ndulu. Gulu lanu lachipatala lidzakuthandizani kusankha njira yabwino kwambiri yothanirana ndi thanzi lanu. Khalani omasuka kuwafunsa mafunso aliwonse omwe mungakhale nawo.
Mfundo Zofunika Kwambiri
- Kutulutsa madzi m'mimba ndi njira yochepetsera kutsekeka kwa ndulu kuti ndulu iyende bwino.
- Zizindikiro nthawi zambiri zimaphatikizapo jaundice (kutuluka kwachikasu kwa khungu/maso), kuyabwa, ndi mkodzo wakuda.
- Njirayi imachitika pogwiritsa ntchito PTBD (yochokera pakhungu) kapena EBD (endoscopic).
- Kutsatira malangizo asanayambe njira yochizira matenda okhudza kusala kudya ndi mankhwala n'kofunika kwambiri.
- Funani chithandizo chadzidzidzi ngati mukumva malungo, kupweteka kwambiri, kapena kutuluka madzi pamalopo mutachita opaleshoni.
Kutulutsa madzi m'mimba, njira zotsekeka za ndulu, jaundice, PTBD, EBD, matenda a chiwindi, miyala ya ndulu, nkhani yachipatala ya Nirogi Lanka
