Kodi mukufuna kudula kwakukulu kuti muchotse zotupa m'mimba? Tiyeni tikambirane za Endoscopic Submucosal Dissection

Kodi dokotala wanu wakuuzani kuti muli ndi minofu yaying'ono yosazolowereka, chotupa, kapena polyp m'thupi lanu, kutanthauza m'mimba mwanu kapena m'mero? Tikamva zimenezo, mantha omwe amabwera m'maganizo mwathu ndi akuti, "O, kodi ndiyenera kuchita opaleshoni yayikulu tsopano?" Koma ndi sayansi ya zamankhwala yapita patsogolo masiku ano, palibe chifukwa chochita opaleshoni yomwe imayambitsa kucheka kwakukulu pa chilichonse. Ndicho chifukwa chake tikambirana za njira yabwino kwambiri yothandizira yomwe ingayambitse kuwonongeka kochepa kwa thupi ndikuchira mwachangu.

Mwachidule, kodi Endoscopic Submucosal Dissection ndi chiyani?

Ngakhale dzinali lingamveke ngati lovuta pang'ono, njira imeneyi ndi yosavuta. Endoscopic Submucosal Dissection , kapena ESD mwachidule, ndi njira yosavulaza yomwe imachotsa minofu yolakwika, zotupa za maselo zomwe zingakhale khansa, kapena zotupa zazing'ono mkati mwa matumbo anu.

Tangoganizirani izi zikuchitika ndi dokotala wa matenda a m'mimba. Amagwiritsa ntchito chubu chachitali komanso chosinthasintha chokhala ndi kamera kumapeto kwake. Timachitcha kuti endoscope.

• Ngati vuto lili m'mimba mwanu (monga m'mero, m'mimba), endoscope iyi imayikidwa kudzera pakamwa panu.
• Ngati vuto lili m'matumbo anu apansi (matumbo akulu, rectum), limalowetsedwa kudzera mu anus.

Izi zimachitika pogwiritsa ntchito chipangizo chaching'ono chochitira opaleshoni chomwe chimayikidwa mu chubu ndipo, motsogozedwa ndi kamera, chimagwiritsidwa ntchito kudula mosamala ndikuchotsa minofu yolakwika. Gawo labwino kwambiri ndilakuti, zonsezi zimachitika mkati mwa thupi. Popeza palibe mabala akunja, mutha kuchira mwachangu, kupweteka pang'ono, komanso kupewa zipsera.

Kodi ESD imagwiritsidwa ntchito pa matenda amtundu wanji?

Mankhwala a ESD nthawi zambiri amagwiritsidwa ntchito pochotsa khansa yomwe imayamba msanga kapena yoyambirira m'mimba. Tiyeni tiwone zomwe zili.

Kodi kusiyana pakati pa ESD ndi EMR ndi kotani?

Mwina munamvapo za njira ina yofanana, yotchedwa Endoscopic Mucosal Resection (EMR) . Ngakhale njira zonse ziwiri sizimavulaza kwambiri, pali kusiyana pang'ono.

Khoma la dongosolo lathu logaya chakudya limapangidwa ndi zigawo zingapo. Nembanemba yopyapyala yamkati imatchedwa mucosa.

• Njira ya EMR: Izi zimachotsa makamaka zotupa zomwe zili mkati mwa chotupa chotchedwa mucosa. Izi zimaphatikizapo kubaya madzi pansi pa chotupacho, kuchikweza, ndikuchidula ndi chinthu chonga lupu yachitsulo.
• Njira ya ESD: Iyi ndi njira yapamwamba pang'ono kuposa EMR. Imatha kuchotsa zotupa zomwe zili mu mucosa, komanso zotupa zomwe zafalikira mpaka pansi pake. Ubwino waukulu wa izi ndikuti minofu yosazolowereka, ngakhale itakhala yayikulu bwanji, imatha kuchotsedwa m'chidutswa chimodzi . Kenako zimakhala zosavuta kuzitumiza ku labotale ndikutsimikizira molondola ngati khansa yachotsedwa kwathunthu.

Kodi ndiyenera kukonzekera bwanji ndisanalandire chithandizochi?

Dokotala wanu adzakupatsani malangizo omveka bwino musanalandire chithandizochi. Ndikofunikira kwambiri kuwatsatira bwino.

• Ngati mukulandira chithandizo cha m'mimba chapamwamba: (m'mimba, m'mimba) muyenera kusiya kudya ndi kumwa kwa maola angapo musanalandire chithandizo. Izi zikutanthauza kuti m'mimba mwanu muyenera kukhala opanda kanthu.
• Ngati mukulandira chithandizo cha matenda a m'mimba: (matumbo akulu), mudzapemphedwa kuti mukonzekere "matumbo." Izi zimaphatikizapo kutulutsa madzi onse m'matumbo anu akuluakulu mwa kumwa madzi apadera ( mankhwala otseketsa ). Izi zimathandiza dokotala kuona mkati bwino pogwiritsa ntchito endoscope.

Kodi chimachitika ndi chiyani panthawi ya chithandizo?

Simudzamva kupweteka kulikonse panthawi ya chithandizochi. Izi zili choncho chifukwa mudzapatsidwa mankhwala oletsa ululu. Mungagone mokwanira (General Anesthesia), kapena mungapatsidwe mtundu wa mankhwala oletsa ululu omwe amakupangitsani kumva tulo komanso kumasuka (Monitored Anesthesia Care).

Pa nthawi ya chithandizo, dokotala wanu adzatsatira njira izi:

1. Endoscope imayikidwa kudzera pakamwa kapena m'matumbo.

2. Pogwiritsa ntchito kamera, endoscope imatumizidwa komwe kuli minofu yolakwika.

3. Pogwiritsa ntchito chipangizo chodutsa mu endoscope, chizindikiro chimapangidwa mozungulira chotupacho kuti chichotsedwe.

4. Kenako, madzi apadera amalowetsedwa mu nembanemba yomwe ili pansi pa chotupacho. Izi zimapangitsa kuti pakhale mthunzi pansi pa chotupacho, ndikuchikweza kuchokera ku minofu yathanzi yozungulira. Izi zimapangitsa kuti zikhale zosavuta kuchilekanitsa ndikuchidula.

5. Pomaliza, pogwiritsa ntchito chipangizo chapadera monga mpeni wamagetsi wothamanga kwambiri, chotupacho chimadulidwa mosamala pamzere wolembedwa ndikuchotsedwa.

Njira yonseyi nthawi zambiri imatenga pakati pa ola limodzi ndi atatu , kutengera kukula ndi malo a minofu yomwe yachotsedwa.

Kodi chimachitika ndi chiyani mukalandira chithandizo?

Pambuyo poti chithandizo chatha, minofu yochotsedwayo imatumizidwa ku labotale komwe katswiri wa matenda amaifufuza kuti awone ngati ili ndi maselo a khansa komanso ngati yachotsedwa kwathunthu.

Mudzatengedwera ku chipinda chochiritsira odwala kwa kanthawi kochepa mutalandira chithandizo. Mukamaliza kulandira chithandizo cha mankhwala oletsa ululu, mutha kupita kunyumba tsiku lomwelo, kapena mungafunike kugona kuchipatala usiku wonse. Muyenera kutsagana ndi munthu wina kunyumba , chifukwa zingatenge maola 24 kuti mankhwala oletsa ululu athetsedwe.

Kodi pali zotsatirapo zake ndi zoopsa zake?

Monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, pali zotsatirapo zazing'ono komanso zoopsa zochepa kwambiri.

Zotsatirapo zazing'ono zomwe zingakhalepo

Izi nthawi zambiri zimazimiririka kwathunthu mkati mwa tsiku limodzi kapena awiri.

• Kudzaza mimba
• Kuwawa kwam'mimba
• Mpweya ndi ululu womwe umayambitsa
• Kusanza kapena kusanza
• Kupweteka pakhosi (ngati endoscope idalowetsedwa kudzera pakamwa)

Ndizachilendo kukhala ndi magazi ochepa kwambiri mu ndowe zanu, koma ayenera kusiya mkati mwa maola 24.

Zovuta zachilendo

Kuthekera kwa izi kuchitika n'kochepa kwambiri, koma ndikofunikira kudziwa za izo.

• Kutuluka magazi: Kutuluka magazi kuchokera pamalo pomwe minofu yachotsedwa.
• Kuboola kwa m'mimba: Kuboola kwa khoma la njira ya m'mimba pogwiritsa ntchito endoscope kapena chida.
• Zilonda: Makamaka pochiza m'mero, zilonda zomwe zimachitika panthawi yochira zingayambitse kuchepa kwa m'mero ​​(esophageal strictures).

Kodi ubwino wa njira iyi ndi wotani?

Njira ya ESD ili ndi ubwino wambiri poyerekeza ndi opaleshoni yotseguka.

• Kupweteka kochepa: Kupweteka kochepa kwambiri chifukwa palibe mabala.
• Kuchira mwachangu: Mutha kubwerera ku moyo wabwinobwino ndikugwira ntchito mwachangu.
• Palibe zipsera: Palibe zipsera zomwe zimaonekera kunja kwa thupi.
• Mavuto ochepa: Pali chiopsezo chochepa cha mavuto kuposa opaleshoni yotseguka.
• Kusunga ziwalo: Njirayi ingapewe zinthu monga kuchotsa gawo la m'mimba kapena matumbo lomwe likanachitidwa pa opaleshoni yayikulu.

Kodi muyenera kupita kwa dokotala nthawi yomweyo liti?

Mukapita kunyumba mutalandira chithandizo, ngati mukukumana ndi zizindikiro zilizonse zochenjeza, ndikofunikira kwambiri kuyimbira dokotala wanu kapena kupita ku chipatala chapafupi cha Emergency Department (ETU) mwachangu .

Zimatenga nthawi yayitali bwanji kuti munthu achire?

Anthu ambiri amatha kubwerera kuntchito patatha masiku asanu. Komabe, ngati mugwira ntchito yovuta kwambiri, monga kunyamula zinthu zolemera, dokotala wanu angakulangizeni kuti mupumule kwakanthawi. Pakhoza kukhala kusintha pang'ono m'matumbo kwa pafupifupi sabata imodzi mutalandira chithandizo.

Nthawi zambiri mudzaonananso ndi dokotala wanu pakatha milungu iwiri. Panthawiyo, adzakufotokozerani zotsatira za lipoti la labu ndikusankha ngati pakufunika chithandizo china kapena ayi.

ESD ndi mankhwala opambana kwambiri. Kafukufuku wina wasonyeza kuti chiopsezo cha khansa kubwereranso pamalo omwewo mwa anthu omwe adalandira chithandizochi ndi chotsika kufika pa 1%.