Kodi mumamva chotupa pakhosi kapena pachifuwa mukamadya kapena kumwa? Kodi nthawi zina mumaopa kudya chifukwa zimamveka ngati chakudya chanu sichikutsika? Izi zitha kukhala chifukwa cha matenda osowa otchedwa Achalasia. Kukhala ndi vutoli sikophweka. N'kovuta kumeza chakudya, ndipo kusadya bwino kungayambitsenso kusowa zakudya m'thupi. Chifukwa chake lero tikambirana za opaleshoni yotchedwa Heller Myotomy, yomwe imachitidwa ngati chithandizo cha izi.
Kodi opaleshoni ya Heller Myotomy ndi chiyani?
Mwachidule, Heller Myotomy ndi opaleshoni yaying'ono yochizira Achalasia . Achalasia ndi vuto losowa lomwe limakhudza mmero, kapena chitoliro cha chakudya. Izi zimachitika pamene njira yotumizira chakudya ndi zakumwa kuchokera ku mmero kupita m'mimba sigwira ntchito bwino.
Mawu akuti "myotomy" amatanthauza kudula minofu. Mu Heller Myotomy, dokotala wa opaleshoni amadula pang'ono pang'ono m'mphepete mwa minofu pansi pa mmero, yotchedwa Lower Esophageal Sphincter (LES) . LES ndi minofu yokhuthala yomwe imakhala pakati pa gawo la pansi la mmero ndi gawo lapamwamba la mimba yanu. Ili ngati valavu.
Ngati muli ndi achalasia, minofu ya LES simatseguka kapena kutsekedwa bwino. Izi zimalepheretsa chakudya kudutsa kuchokera ku mmero kupita m'mimba. Opaleshoni ya Heller Myotomy imagwira ntchito pomasula minofu ya LES ndikuyitsegula.
Opaleshoni iyi nthawi zambiri imachitika limodzi ndi njira ina yotchedwa fundoplication . Izi zimaphatikizapo dokotala kutenga gawo la m'mimba mwanu ndikulikulunga mozungulira mmero mwanu. Izi zimachepetsa chiopsezo cha asidi m'mimba kubwerera mu mmero mwanu (reflux).
Chofunika kwambiri ndichakuti opaleshoni ya Heller Myotomy si mankhwala athunthu a Achalasia. Imapereka mpumulo kwa nthawi yayitali, komabe, kungakhale kofunikira kuti opaleshoniyi ibwerezedwe pakapita nthawi.
Kodi mumakonzekera bwanji musanachite opaleshoni?
Kuti atsimikizire kuti ndinu woyenera opaleshoni, dokotala wanu adzakulamulani kuti muyesedwe kangapo opaleshoni isanachitike. Mwachitsanzo, kuyezetsa magazi, X-ray pachifuwa, ndi ECG.
Opaleshoni isanachitike, dokotala wogonetsa anthu amene adzakugonetsani adzakulankhulani nanu. Adzakufunsani mafunso monga:
- Kodi mudachitapo opaleshoni yoletsa ululu kale ndipo munakumana bwanji ndi vutoli?
- Ndi zitsamba, mankhwala, kapena mavitamini ati omwe mumagwiritsa ntchito?
- Kodi mumagwiritsa ntchito fodya, mowa, kapena mankhwala ena osokoneza bongo?
Pali zinthu zingapo zomwe muyenera kuchita pokonzekera opaleshoni. Izi ziyenera kufotokozedwa ndi kutsimikiziridwa ndi dokotala wanu.
| Zoyenera kuchita | N’chifukwa chiyani zimenezo n’zofunika? |
|---|---|
| Kusiya kugwiritsa ntchito nikotini (mtundu uliwonse, kuphatikizapo ndudu ndi ndudu zamagetsi) | Nikotini imakhudza kuyenda kwa magazi m'thupi lanu, zomwe zingachedwetse kuchira kwa mabala pambuyo pa opaleshoni. |
| Kusala kudya. | Dokotala wanu angakuuzeni kuti musadye chilichonse kwa maola 6 kapena kuposerapo musanachite opaleshoni. Mutha kumwa zakumwa zoyera (monga madzi) kwa kanthawi musanachite opaleshoni. Koma onetsetsani kuti mwafunsa dokotala wanu za izi. |
| Kukonzekera kukhala kuchipatala. | Iyi ndi opaleshoni yaikulu, kotero muyenera kukhala m'chipatala kwa tsiku limodzi mutatha opaleshoni. Komanso, konzani kuti wina akutengereni kunyumba ndikukhala nanu kwa maola 24 oyambirira. |
| Kukonzekera kuchira. | Pambuyo pa opaleshoni, dokotala angakulembereni mankhwala ochepetsa ululu. Simungathe kuyendetsa galimoto mpaka mutamwa, choncho pezani wina woti akuthandizeni pa ntchito zimenezo. |
Kodi opaleshoniyi imachitidwa bwanji?
Tsopano tiyeni tiwone zomwe zimachitika mkati mwa opaleshoni. Nthawi zambiri, izi zimachitika pogwiritsa ntchito laparoscopically . Izi zikutanthauza kuti, pogwiritsa ntchito telescope. Apa, dokotalayo amagwiritsa ntchito chida chopyapyala chokhala ndi kamera yolumikizidwa kuti ayang'ane mkati mwa mmero wanu ndi zida zazing'ono kwambiri kuti achite opaleshoniyo.
- Choyamba, dokotala wogonetsa adzaika chingwe cha IV (monga chubu chomwe chimapereka saline) mumtsempha womwe uli m'dzanja lanu ndikukupatsani mankhwala oti akugonetseni. Simudzamva chilichonse panthawi ya opaleshoni.
- Kenako, dokotalayo adzakudulani ziwalo 5 zazing'ono kwambiri m'mimba mwanu (m'mimba).
- Kenako, m'mimba mwanu mumakhala mpweya wa carbon dioxide. Izi zimachitika kuti zikhale zosavuta kusuntha zida zochitira opaleshoni komanso kuti muwone bwino m'mero ndi pamwamba pa mimba.
- Tsopano dokotalayo akuika kamera ndi zida zazing'ono zopangira opaleshoni kudzera m'mabala amenewo.
- Pogwiritsa ntchito zida zimenezi, minofu yomwe ili pansi pa m'mero imadulidwa motalikirapo ndipo LES imatsegulidwa.
- Kenako, njira yotchedwa fundoplication imachitika. Izi zimaphatikizapo kutenga gawo la pamwamba pa mimba ndikulikulunga mozungulira m'mero. Izi zimaletsa asidi m'mimba kutuluka.
- Pomaliza, kamera ndi zida zimachotsedwa, ndipo mabala ang'onoang'ono amenewo amasokedwa.
Opaleshoni yonseyi nthawi zambiri imatenga pafupifupi maola awiri.
Kodi chimachitika ndi chiyani pambuyo pa opaleshoni?
Zomwe zimachitika mukachita opaleshoni zimatha kusiyana pang'ono malinga ndi munthu. Koma nthawi zambiri, mudzakhala m'chipatala usiku wonse. Panthawiyi, mudzapatsidwa madzi ndi zakudya kudzera mu IV line. Pambuyo pake, nthawi yochira imayamba.
Chofunika kwambiri ndichakuti mmero wanu ukhale wotupa mutachita opaleshoni. Zingatenge miyezi iwiri kuti kutupaku kuthe kwathunthu. Chifukwa chake muyenera kusintha zakudya zanu pang'onopang'ono.
Gulu lanu lachipatala lidzakufotokozerani izi, koma ndondomeko ya zakudya yachizolowezi ndi iyi.
| Nthawi | Chakudya chikupezeka |
|---|---|
| Tsiku loyamba ndi lachiwiri | Zakumwa zoyera. Mwachitsanzo: msuzi wa nkhuku/ng'ombe (wochepetsedwa), jeli, mapaketi a ayezi, madzi. |
| Kuyambira tsiku lachitatu mpaka tsiku lachisanu ndi chiwiri | Zakudya za mkaka. Mwachitsanzo: ayisikilimu, supu ya kirimu wokhuthala, phala monga Kirimu wa Tirigu kapena Kirimu wa Mpunga. |
| Kuyambira tsiku lachisanu ndi chitatu mpaka kukayezetsa kwa milungu iwiri | Zakudya zofewa. Dokotala wanu adzakuuzani nthawi yomwe mungayambe kuwonjezera zakudya zolimba. |
Kodi ubwino ndi zoopsa za opaleshoniyi ndi ziti?
Ubwino
Anthu ambiri omwe ali ndi achalasia amagwiritsa ntchito Heller Myotomy pamene njira zina zosagwiritsa ntchito opaleshoni sizikugwira ntchito. Ubwino waukulu wa njirayi ndikuti zizindikiro za achalasia zimatha pambuyo pa opaleshoni.
Kafukufuku waposachedwapa wasonyeza kuti pakati pa 87% ndi 92% ya anthu omwe adalandira chithandizochi zizindikiro zawo zatha. Komabe, monga tanenera kale, izi sizimachiritsa achalasia kwathunthu. Zizindikiro nthawi zina zimatha kubwereranso zaka 5-10 pambuyo pa opaleshoni.
Zoopsa
Monga momwe zimakhalira ndi opaleshoni iliyonse yayikulu, Heller Myotomy ili ndi zoopsa. Zoopsa zambiri zimaphatikizapo kutuluka magazi ambiri komanso matenda opatsirana. Kuphatikiza apo, zovuta zina zomwe zingachitike ndi izi:
- M'mero wa Barrett
- Matenda a m'mero
- GERD (matenda a reflux a m'mimba)
- Kuphulika kwa m'mero
Nthawi yoti mukaonane ndi dokotala
Ngati muli ndi zizindikiro zotsatirazi mutachita opaleshoni, imbani dokotala wanu nthawi yomweyo, kapena pitani ku Dipatimenti Yodzidzimutsa (ETU) ya chipatala chapafupi.
- Ngati malo ochitira opaleshoni ali ofiira komanso otupa.
- Ngati mafinya akuchokera pa bala la opaleshoni.
- Ngati simungathe ngakhale kumeza zakumwa.
- Ngati mankhwala ochepetsa ululu omwe dokotala wakupatsani sachepetsa ululu.
Kusiyana pakati pa opaleshoni ya Heller Myotomy ndi opaleshoni ya POEM
Mwina munamvapo za njira yotchedwa POEM. POEM ndi chidule cha Peroral Endoscopic Myotomy . Monga Heller Myotomy, iyi ndi njira yochiritsira matenda a Achalasia.
Kusiyana pakati pa awiriwa ndikuti mu opaleshoni ya POEM, palibe kudula m'mimba komwe kumachitika. M'malo mwake, dokotala wanu amaika endoscope (chubu chokhala ndi kamera yolumikizidwa) kudzera pakamwa panu ndikutsika m'mero. Kenako minofu ya LES imadulidwa kuchokera mkati. Mu opaleshoni ya Heller Myotomy, izi zimachitika kuchokera kunja kudzera m'kucheka pang'ono m'mimba mwanu.
Uthenga Wopita Nawo Kunyumba
- Heller Myotomy ndi opaleshoni yochitidwa pochiza achalasia, vuto lomwe limapangitsa kuti munthu azivutika kumeza.
- Izi nthawi zambiri zimachitika mwa laparoscopically kudzera m'mabala ang'onoang'ono m'mimba, komwe gawo la m'munsi mwa mmero limamasuka.
- Ngakhale opaleshoni iyi imapereka mpumulo kwa nthawi yayitali ku zizindikiro, si mankhwala athunthu a Achalasia.
- Mukachira pambuyo pa opaleshoni, muyenera kutsatira zakudya zapadera kwa milungu ingapo.
- Ndikofunikira kwambiri kutsatira malangizo a dokotala wanu monga momwe amaperekedwera musanachite opaleshoni komanso mutachita opaleshoni.
- Fufuzani thandizo lachipatala mwamsanga ngati mukuona zizindikiro zilizonse zochenjeza, monga kutupa, mafinya, kapena kulephera kumeza zakumwa pamalo ochitira opaleshoni.
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