Kodi njira ya Hartmann ndi yotani? Tiyeni tiphunzire mwachidule.

Bwanji ngati muli ndi matenda aakulu, kutsekeka, kapena khansa m'matumbo mwanu ndipo mukufunika opaleshoni yaikulu? Nthawi zina, madokotala amafunika kuchita opaleshoni yopulumutsa moyo mwachangu kwambiri. Njira imodzi yapadera yomwe imagwiritsidwa ntchito pazochitika zotere imatchedwa Hartmann's Procedure. Dzinalo lingamveke ngati loopsa pang'ono, koma tiyeni tikambirane momveka bwino zomwe zimachitikadi, chifukwa chake zimachitika, ndi zomwe zimachitika pambuyo pa opaleshoni.

Mwachidule, kodi njira ya Hartmann iyi ndi yotani?

Njira ya Hartmann ndi opaleshoni yomwe imachitidwa pa matumbo athu akuluakulu (colon). Makamaka, imaphatikizapo kudula ndikuchotsa gawo lodwala la matumbo athu akuluakulu, makamaka gawo lomaliza lomwe ndowe zimatuluka, lomwe ndi sigmoid colon, ndipo nthawi zina gawo lapamwamba la rectum.

Tsopano taganizirani kuti mutachotsa gawo la m'mimba lomwe ladwala, magawo awiri otsala athanzi ayenera kulumikizidwanso. Komabe, ndi zoopsa kwambiri kulumikizanso magawo awiriwa nthawi imodzi pamene pali matenda oopsa, kutupa, kapena mavuto ena. Kuchita zimenezi kungayambitse matenda kufalikiranso, zomwe zingakhale vuto lalikulu.

Ndicho chifukwa chake madokotala akupatsa nthawi magawo awiri otsala a matumbo kuti achire.

1. Mapeto a matumbo olumikizidwa ndi anus (chitsa cha rectal) amasokedwa kwakanthawi.

2. Mapeto abwino a matumbo akuluakulu, omwe ali pamwamba, amamangiriridwa ku kabowo kakang'ono (stoma) komwe kamapangidwa pakhoma la m'mimba.

Apa ndi pomwe ndowe imatuluka kudzera m'bowo latsopanoli m'mimba. Izi zimatchedwa colostomy . Kuti chopondachi chitengedwe, thumba lapadera (colostomy bag) limamangiriridwa kunja kwa bowolo.

Izi zingamveke ngati kusintha kwakukulu, koma kumbukirani, nthawi zambiri izi zimakhala yankho la kanthawi kochepa . Matumbo akachira bwino (pafupifupi miyezi 6-12), opaleshoni ina ikhoza kuchitidwa kuti agwirizanenso magawo awiri a matumbo omwe adatsekedwa, ndikutseka colostomy.

N’chifukwa chiyani mukufunikira opaleshoni iyi?

Pali zifukwa zingapo zazikulu zochitira opaleshoni ya Hartmann. Pali zifukwa zosiyanasiyana zochotsera gawo la m'mimba ndi kuika colostomy.

N’chifukwa chiyani gawo la m’mimba limachotsedwa?

• Kutsekeka: Ngati pali chotsekeka kwinakwake m'matumbo chomwe chimalepheretsa chopondapo kuyenda.
• Kubowoka: Ngati dzenje lapangika pakhoma la m'mimba ndipo chopondapo chikutuluka m'mimba, izi zitha kufalitsa matenda m'mimba yonse (peritonitis).
• Matenda osalamulirika kapena matenda: Matenda ena (monga diverticulitis yovuta) kapena matenda monga khansa angafunike kuchotsedwa kwa gawo lodwala kuti apewe kufalikira kwina.

N’chifukwa chiyani opaleshoni ya colostomy imachitidwa?

Monga tafotokozera pamwambapa, opaleshoni ikachitika mwadzidzidzi, thupi la wodwalayo limafooka ndipo chiopsezo cha matenda chimakhala chachikulu kwambiri. Pazochitika zotere, kulumikiza magawo awiri a matumbo (anastomosis) kumakhala koopsa kwambiri. Chifukwa chake, cholinga choyamba cha madokotala ndikupulumutsa moyo wa wodwalayo. Colostomy imapatsa matumbo nthawi yoti achire, kenako imalola opaleshoni yoyenera komanso yosakhala yoopsa, kuti abwezeretsenso moyo wabwinobwino.

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Momwe opaleshoni imachitikira ndi momwe imachitikira

Opaleshoni iyi ingachitike m'njira ziwiri zazikulu:

1. Opaleshoni Yotseguka: Opaleshoni imachitika potsegula m'mimba kudzera m'chibowo chachikulu cha m'mimba. Njirayi imagwiritsidwa ntchito nthawi zambiri pazochitika zadzidzidzi komanso zovuta.

2. Opaleshoni ya Laparoscopic: Opaleshoni imachitika kudzera m'mabala ang'onoang'ono angapo m'mimba, pogwiritsa ntchito kamera ndi zida zapadera. Ngakhale kuti kuchira kumachitika mwachangu, njira iyi si yoyenera odwala onse.

Musanachite opaleshoni

Ngati mukukonzekera opaleshoni, mudzapemphedwa kuti musale kudya kwa maola 6-12. Mungapatsidwenso madzi apadera (kukonzekera matumbo) kuti muyeretse matumbo anu. Mukalowa m'chipatala, mudzalowetsedwa mumtsempha womwe uli m'dzanja lanu ndipo mudzapatsidwa madzi ndi mankhwala.

Pa nthawi ya opaleshoni

Opaleshoniyi imachitidwa pansi pa mankhwala oletsa ululu. Dokotalayo amachotsa matumbo omwe ali ndi matendawa, kutseka kumapeto kwa rectum, ndikulumikiza mbali inayo ku mimba.Stoma imalumikizidwa pa khomo. Pomaliza, thumba la colostomy limalumikizidwa ndipo mabala a opaleshoni amakokedwa. Ntchito yonseyi ingatenge maola awiri kapena anayi.

Pambuyo pa opaleshoni

Pambuyo pa opaleshoni, choyamba mudzatengedwera ku chipinda chochiritsira kenako mudzasamutsidwira ku chipinda chothandizira odwala matenda anu akakhazikika. Muyenera kukhala m'chipatala kwa masiku pafupifupi 7-10.

• M'masiku oyambirira, mankhwala ochepetsa ululu, maantibayotiki, ndi madzi adzaperekedwa kudzera mu saline.
• Zingatenge masiku angapo kuti matumbo agwirenso ntchito.
• Choyamba, amapatsidwa chakudya chamadzimadzi ndipo pang'onopang'ono amapatsidwa chakudya cholimba.
• Namwino wophunzitsidwa bwino adzakuphunzitsani inu ndi banja lanu momwe mungayeretsere ndikusintha thumba la colostomy, komanso momwe mungasamalire stoma (chisamaliro cha stoma).

Kodi zoopsa ndi zotsatirapo zake zingakhale zotani?

Monga momwe zimakhalira ndi opaleshoni iliyonse, pali zoopsa zina zomwe zimachitika, koma zimaonedwa kuti ndi njira yotetezeka.

• Zoopsa zomwe zingachitike: matenda a pabala, matenda a m'mapapo (chibayo), kutuluka magazi mkati, kutuluka kwa madzi m'matumbo, kuwonongeka kwa ziwalo zozungulira, kupangika kwa hernia.
• Zotsatirapo zomwe zingatheke:
• Ileus ya kanthawi kochepa: Zimatenga nthawi kuti matumbo ayambirenso kugwira ntchito pambuyo pa opaleshoni.
• Kutuluka kwa madzi m'matupi: Ngakhale ngati simukuchita chimbudzi, madzi ofanana ndi mamina nthawi zina angatuluke m'mbali yotsala ya rectum. Izi ndi zachilendo.
• Kulephera kugonana: Nthawi zambiri, opaleshoni imatha kuwononga mitsempha yomwe imakhudzidwa ndi ntchito yogonana. Lankhulani ndi dokotala wanu ngati muli ndi nkhawa iliyonse pankhaniyi.

Kuchira ndi kuchira

Zimatenga nthawi kuti munthu achire bwino.

• Masabata 4-6: Chepetsani kugwiritsa ntchito mankhwala ochepetsa ululu, bwererani ku zakudya zabwinobwino, ndipo pitirizani kuchita masewera olimbitsa thupi pang'ono.
• Miyezi 3-6: Kuzolowera moyo ndi thumba la colostomy, kumva kuti mwachira mokwanira mwakuthupi.

Kodi colostomy ingasinthidwe? (Kusintha)

Ili ndiye vuto lalikulu kwa anthu ambiri. Inde, nthawi zambiri limatha kusinthidwa.

Patatha miyezi 6-12 kuchokera pamene munachitidwa opaleshoni yoyamba, dokotala wanu adzawunikanso thanzi lanu. Ngati muli ndi thanzi labwino, matumbo anu achira bwino, ndipo mutha kupirira opaleshoni ina, mungasankhe kuchitidwa opaleshoni yobwezeretsa .

Komabe, ngati khansa yafalikira m'thupi lonse, ngati pali matenda oopsa m'thupi, kapena ngati wodwalayo ali wofooka kwambiri, dokotala sangalimbikitse opaleshoni ina. Mutha kukambirana momasuka ndi dokotala wanu za zonsezi.