Kutulutsa madzi m'mimba: Chifukwa chiyani ndipo kumachitika bwanji?

Kodi maso ndi khungu lanu likusintha kukhala lachikasu ndipo thupi lanu lonse likuyabwa mosapiririka? Izi ndi zizindikiro za zomwe tonse timazidziwa kuti jaundice. Nthawi zambiri, chifukwa cha izi ndi kutsekeka kwa ndulu, komwe ndi madzi ochokera m'chiwindi chathu ndipo kumathandiza kugaya chakudya. Izi zikatsekeka, madziwo amabwerera m'chiwindi, zomwe zimapangitsa kuti chikasu ndi kuyabwa ziwonekere. Chifukwa chake, njira yapadera yothandizira yomwe madokotala amagwiritsa ntchito pazochitika zotere imatchedwa Biliary Drainage. Mwachidule, izi zimaphatikizapo kuyika chubu chaching'ono mu ndulu yotsekeka ndikulola ndulu kutuluka. Tiyeni tikambirane izi mwatsatanetsatane lero.

Kodi njira yotulutsira madzi m'mimba (Biliary Drainage) ndi chiyani? Kodi pali mitundu ina iliyonse?

Kutulutsa madzi m'mimba mwa ndulu ndi njira yomwe imagwiritsa ntchito chubu chofewa komanso chosinthasintha (catheter) kuti ndulu iyende kudzera mu duct ya ndulu yotsekedwa, yomwe imayenda kuchokera pachiwindi kupita kumatumbo ang'onoang'ono. Zili ngati kupanga njira yatsopano ya njira yotsekedwa yamadzi. Izi zimachitika m'njira ziwiri zazikulu. Dokotala wanu adzasankha njira yoyenera kwa inu kutengera momwe mulili.

Kodi malo oika stent ndi chiyani?

Nthawi zina, makamaka ngati kutsekekako kuli kosatha (mwachitsanzo, chifukwa cha khansa), dokotala wanu angaike chubu chaching'ono chonga mesh, chotchedwa stent, mkati mwa ndulu yanu kuti chikhale chotseguka. Izi nthawi zambiri zimachitika patatha masiku angapo chubu choyamba chitayikidwa.

N’chifukwa chiyani munthu angafunikire chithandizo chamtunduwu?

Chifukwa chachikulu chomwe chikufunika chithandizochi ndi kutsekeka kapena kuchepa kwa njira yotulutsira bile (`stricture`). Izi zimapangitsa kuti madzi a bile azisonkhana m'chiwindi (`cholestasis`). Tangoganizirani, chinthu ngati pamene payipi yotulutsira madzi m'nyumba mwathu yatsekeka, madzi amasonkhana pano. Pakhoza kukhala zifukwa zingapo zomwe njira yotulutsira bile imatsekeka:

• Miyala mu ndulu kapena ndulu (choledocholithiasis).
• Khansa ya kapamba kapena khansa ya kapamba.
• Khansa ya ndulu (Cholangiocarcinoma).
• Khansa ya chiwindi kapena khansa ya ndulu .
• Kutupa kwa ma lymph nodes pafupi ndi chiwindi kapena kapamba chifukwa cha khansa.
• Matenda ena a parasitic .
• Kuwonongeka kwa ducts ya ndulu panthawi ya opaleshoni ina.
• Matenda otupa a ndulu omwe amakhalapo kwa nthawi yayitali, monga `primary sclerosing cholangitis`.

Kodi mumakonzekera bwanji musanalandire chithandizo?

Pali zinthu zingapo zomwe muyenera kuchita musanalandire chithandizochi. Dokotala wanu adzakupatsani malangizo omveka bwino okhudza izi. Ndikofunikira kwambiri kutsatira malangizo amenewo molondola. 1. Chakudya ndi Zakumwa: Muyenera kusiya kudya, kumwa, ndi kusuta fodya osachepera maola 6 musanalandire chithandizo. Dokotala wanu angakuuzeni nthawi yomwe mungamwe madzi, monga madzi. 2. Ziwengo: Onetsetsani kuti mwauza dokotala wanu za ziwengo zilizonse zomwe muli nazo, makamaka mankhwala oletsa ululu, utoto wosiyana womwe umagwiritsidwa ntchito mu X-ray, kapena pulasitiki kapena zitsulo. 3. Mankhwala:Uzani dokotala wanu za mankhwala onse omwe mukumwa panopa (kuphatikizapo mavitamini). Makamaka ngati mukumwa mankhwala ochepetsa magazi (anticoagulants) monga aspirin ndi warfarin, funsani ngati muyenera kusiya kuwamwa komanso nthawi yake. 4. Mimba: Onetsetsani kuti mwauza dokotala wanu ngati muli ndi pakati kapena mungakhale ndi pakati. 5. Kuyendetsa Galimoto: Simungathe kuyendetsa galimoto mukatha kulandira chithandizo chifukwa mudzakhala pansi pa mankhwala oletsa kupweteka. Choncho konzani kubweretsa munthu wina kuti akutengereni kunyumba.

Kodi chimachitika ndi chiyani panthawi ya chithandizo?

Njira zochitira izi zimasiyana pang'ono kutengera njira yomwe mukuchitidwa (PTBD kapena EBD). Koma musadandaule, dokotala wanu adzakufotokozerani zonse pasadakhale.

Momwe njira ya percutaneous (PTBD) imachitikira:

• Choyamba, khungu la m'mimba mwanu limatsukidwa ndipo malowo amakhala opanda mphamvu.
• Dokotalayo amaika singano yaying'ono kudzera pakhungu kupita mu duct ya ndulu m'chiwindi.
• Madzi apadera (utoto wosiyana) amabayidwa kuti X-ray iwonekere.
• Akangodziwa bwino malo enieni omwe atsekeka, chubu chotulutsira madzi chimayikidwa m'dera limenelo ndipo madzi a ndulu amaloledwa kutuluka.
• Mbali ina ya chubu ichi imatuluka pakhungu lanu ndipo imalumikizidwa ndi thumba lakunja. Madzi a ndulu amasonkhana m'thumba ili. (Thumba ili liyenera kuchotsedwa kangapo patsiku.)

Momwe njira ya endoscopic (EBD) imachitikira:

• Mu izi, mudzapatsidwa mankhwala oletsa ululu kapena mankhwala oletsa ululu pang'ono, kotero simudzamva chilichonse.
• Pakhosi panu pakugunda.
• Dokotala amaika chubu chokhala ndi kamera (endoscope) kudzera pakamwa, n’kuchiyika pa chitoliro chodyera, n’kuchitsogolera komwe kuli ndulu.
• Kenako, chubu china (catheter) chimadutsa mu chubu chimenecho ndikudutsa mu duct yotsekedwa kuti ndulu iyende.
• Ngati chiphuphu chachotsedwa kunja, chubu chimalowetsedwa kudzera m'mphuno ndikulumikizidwa ku thumba. Ngati chachotsedwa mkati, stent imayikidwa mkati.

Zoopsa ndi chisamaliro pambuyo pa chithandizo

Monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, pali zoopsa ndi zovuta zomwe zingachitike.

• Mavuto omwe angakhalepo:
• Kumasula, kupotoza, kapena kutsekeka kwa chubu cholowetsedwa mwangozi.
• Ululu kapena kusasangalala.
• Matenda (dokotala adzakupatsani mankhwala opha tizilombo kuti apewe izi).
• Kutuluka magazi.
• Kusintha kwa kapangidwe ka ma electrolyte m'thupi (`Kusakhazikika kwa ma electrolyte`).
• Nthawi zambiri, mavuto a m'mapapo (`Pneumothorax`) amatha kuchitika.

Dokotala adzakufotokozerani momveka bwino zoopsazi ndikukupatsani malangizo a zomwe mungachite ngati pakhala vuto lililonse.

Kodi mungadzisamalire bwanji kunyumba?

Ngati muli ndi chubu ndi thumba loika kunja kwa thupi lanu, ogwira ntchito yosamalira ana adzakuphunzitsani momwe mungasamalire.

• Musagone ndi kulemera kwanu kumbali yomwe chubu chili. Izi zingayambitse kuti chubucho chizungulire.
• Ngati dokotala wanu akulangizani kuti mutsuke chubucho ndi madzi amchere pang'ono tsiku lililonse, chitani zimenezo.
• Imwani zakumwa zokhala ndi ma electrolyte kuti zigwirizane ndi kuchuluka kwa madzi omwe akutuluka m'thumba. Funsani dokotala wanu zomwe mumwe ndi kuchuluka kwa zomwe mumwe.
• Mukhoza kusamba maola 48 mutalandira chithandizo. Komabe, musapite kukasambira m'madziwe kapena m'nyanja/m'mtsinje pamene chubu chilipo.
• Pewani kunyamula zolemera mpaka dokotala wanu atakuuzani kuti muchite zimenezo.

Kodi muyenera kufunafuna chithandizo chamankhwala nthawi yomweyo liti?

Ngati mukukumana ndi zizindikiro zotsatirazi, imbani dokotala wanu nthawi yomweyo, kapena pitani ku Dipatimenti Yodzidzimutsa (ETU) ya chipatala chapafupi.

• Malungo .
• Ngati pali kupweteka kowonjezereka, kutupa, kapena kufiira pamalo omwe payikidwa chubu.
• Ngati mafinya kapena madzi ena akutuluka kuchokera pamalo a chubu.
• Ngati kupweteka m'mimba kukuwonjezeka kapena kubwereranso.
• Ngati khungu kapena maso asintha kukhala achikasu kachiwiri.
• Ngati mukusanza.
• Ngati chitoliro chikuwoneka kuti chikutuluka.
• Ngati ndowe sizituluka kapena mpweya sutuluka.

Kutuluka kwa ndulu m'mimba ndi njira yothandiza kwambiri yochizira kutsekeka kwa ndulu. Gulu lanu lachipatala lidzakuthandizani kusankha njira yabwino kwambiri yochizira matenda anu. Khalani omasuka kuwafunsa mafunso kapena nkhawa zilizonse zomwe mungakhale nazo. Kutulutsa madzi m'mimba, Kutsekeka kwa ndulu, Jaundice, PTBD, EBD, Matenda a Chiwindi, Miyala ya m'ndulu, Nkhani yachipatala ya Sinhala