Njira yokhala ndi moyo wabwinobwino mutachotsa m'matumbo akuluakulu: Dziwani za opaleshoni ya J-Pouch

Pali nthawi zina pamene m'mimba mwathu wonse ndi m'matumbo athu zimafunika kuchotsedwa chifukwa cha matenda enaake. Zimenezi zikachitika, funso lalikulu lomwe anthu ambiri amakhala nalo ndi lakuti, "Ndingachotse bwanji chimbudzi tsopano?" Nthawi zambiri, yankho la izi ndikuyika thumba pakhungu la mimba kuti ndowe zidutse. Koma lero, tikambirana za opaleshoni yapadera yomwe imapanga yankho mkati mwa thupi, popanda thumba lakunja lotere, ndipo imathandiza anthu kuchotsa chimbudzi mwachizolowezi kudzera mu anus. Imeneyo ndi opaleshoni ya J-Pouch.

Mwachidule, kodi J-Pouch iyi ndi chiyani?

Tangoganizani kuti matumbo anu akuluakulu, gawo lomaliza la rectum yanu, komwe kumakhala ndowe kwakanthawi, achotsedwa opaleshoni. Ndiye kuti sipadzakhala malo m'thupi lanu osonkhanitsira ndowe ndikusunga.

J-Pouch ndi thumba laling'ono lomwe dokotala wa opaleshoni amapanga mkati mwa thupi lanu pogwiritsa ntchito kumapeto kwa matumbo anu ang'onoang'ono . Kunena zoona, kumapeto kwa matumbo ang'onoang'ono amatchedwa "ileum." Chifukwa chake thumba ili limapangidwa kuchokera ku "ileum" iyi.

Chikwama ichi chimapangidwa popinda gawo la matumbo anu ang'onoang'ono kukhala mawonekedwe a chilembo "J" ndikuchisoka kuchokera mkati. Chimatchedwa J-Pouch chifukwa cha mawonekedwe a "J". Kenako chikwamacho chimalumikizidwa ku anus yanu. Tsopano, m'malo mwa rectum yanu yochotsedwa, J-Pouch imagwira ntchito ngati chosungira kwakanthawi chosonkhanitsira ndikusunga ndowe. Chifukwa chake mumamva kufunikira kochita chimbudzi mwachizolowezi, ndipo mutha kupita kuchimbudzi kukachita chimbudzi.

Kodi kusiyana pakati pa J-Pouch ndi Ileostomy ndi kotani?

Anthu ambiri amasokoneza awiriwa. Tiyeni tifotokoze bwino zimenezo.

• J-Pouch: Ichi ndi thumba lomwe limapangidwa mkati mwa thupi . Limalumikizidwa mwachindunji ku anus, kotero mutha kuchita chimbudzi mwachizolowezi . Palibe chomwe chikuwoneka kuchokera kunja, palibe thumba.
• Ileostomy: Izi zimaphatikizapo kubweretsa kumapeto kwa matumbo ang'onoang'ono pamwamba pa khungu la m'mimba, ndikupanga kabowo kakang'ono (stoma) kuti ndowe zidutse. Kenako ndoweyo imasonkhanitsidwa mu thumba lakunja lolumikizidwa ndi chobowocho. Chikwamacho chiyenera kuchotsedwa chikadzaza.

Mwachidule, ngati rectum yanu ili bwino, J-Pouch ndiye njira yabwino kwambiri yokhalira popanda thumba lakunja (permanent ileostomy).

Kodi opaleshoni iyi ndi yoyenera kwa ndani?

Opaleshoni ya J-Pouch imangoperekedwa kwa anthu omwe adachitidwa opaleshoni yonse ya proctocolectomy (opaleshoni yochotsa m'matumbo onse ndi m'matumbo). Komabe, si ya aliyense. Pali zinthu zingapo zomwe zingakuthandizeni kudziwa ngati ndinu woyenera kuchita opaleshoniyi.

• Minofu ndi mitsempha ya m'matumbo zomwe zimagwira ntchito bwino:Izi ndizofunikira kwambiri poletsa matumbo. Dokotala wanu adzayang'ana momwe zinthu zilili.
• Khalani ndi thanzi labwino kuti mupirire maopaleshoni angapo: Opaleshoni ya J-Pouch nthawi zambiri imachitika m'magawo awiri kapena atatu, kotero muyenera kukhala ndi thanzi labwino kuti mupirire.
• Matenda ena kapena mankhwala: Madokotala adzasamaliranso kwambiri ngati muli ndi matenda ena kapena mukumwa mankhwala ena.

Kodi opaleshoni ya J-Pouch imachitidwa bwanji?

Iyi si opaleshoni yochitidwa kamodzi kokha. Nthawi zambiri imachitika m'magawo awiri kapena atatu . Tiyeni tiwone njira zimenezo.

1. Gawo 1: Gawo loyamba ndikuchotsa m'matumbo ndi m'matumbo omwe ali ndi matenda (kuchotsa kwathunthu kwa proctocolectomy). J-Pouch ikhoza kupangidwa panthawi ya opaleshoniyi kapena pambuyo pake pa opaleshoni ina.

2. Kupanga thumba: Dokotala wa opaleshoni amatenga zingwe ziwiri za m'mimba mwanu, pafupifupi mainchesi 1.5, ndikuzipinda pakati kuti apange "U." Kenako, mkati mwa gawo lopindidwa mumatsegulidwa ndipo m'mbali ziwirizo zimasokedwa pamodzi kuti apange thumba.

3. Kulumikiza thumba: Thumba ili limatsitsidwa kuchokera m'mimba ndikulumikizidwa ku anus. Dzina lachipatala la kulumikizana uku ndi ``ileal pouch-anal anastomosis`` kapena ``(IPAA)```.

4. Kupanga Ileostomy Yakanthawi: J-Pouch yatsopanoyo imafunika nthawi kuti ichiritse. Choncho, kuti chopondacho chisadutse mkati mwake panthawiyo, matumbo ang'onoang'ono amadulidwa pamwamba pa J-Pouch ndipo ileostomy yanthawi yochepa imapangidwa pamwamba pa khungu la mimba (`(ileostomy yanthawi yochepa)`). Chifukwa chake, kwa miyezi pafupifupi 2-3, choponda chanu chidzatuluka m'thumba lakanthawi ili. Panthawiyi, J-Pouch yatsopanoyo idzachira bwino.

5. Kuyang'ana thumba: Pambuyo pa miyezi 2-3, mayeso apadera amachitidwa kuti aone ngati thumbalo lachira bwino komanso ngati pali mabowo kapena kutuluka madzi. Izi zimatchedwa ``pouchogram''. Mu izi, madzi apadera amadzazidwa mu thumba kudzera mu chubu chomwe chimayikidwa kudzera mu anus ndipo X-ray imatengedwa.

6. Gawo Lomaliza: Chikwamacho chikachira bwino ndipo palibe vuto, dokotala wanu adzakonza nthawi yoti muchitidwe opaleshoni yomaliza. Izi zikuphatikizapo kuchotsa ileostomy ya kanthawi kochepa ndikutseka mpata m'mimba mwanu. Kuyenda kwa matumbo anu tsopano kwatha! Chimbudzi chanu chidzayamba kudutsa bwino kudzera mu J-Pouch yanu yatsopano.

Kodi mungayembekezere chiyani mutachita opaleshoni?

Pambuyo pa opaleshoni, thupi lanu lidzatenga nthawi kuti lizolowere dongosolo latsopanoli. Izi ndi zachilendo, choncho musadandaule nazo.

Poyamba, J-Pouch ndi yaying'ono kwambiri. Chifukwa chake imatha kusunga ndowe zochepa kwambiri. Izi zikutanthauza kuti muyenera kupita kuchimbudzi pafupipafupi patsiku . Mwina nthawi zoposa 10 patsiku. Mungafunike kudzuka kangapo usiku. Koma musadandaule, pakapita nthawi thumbalo lidzatambasuka pang'onopang'ono ndikukulira , ndipo kuchuluka kwa nthawi zomwe muyenera kupita kuchimbudzi kudzachepa pang'onopang'ono. Nthawi zambiri, lidzawongoleredwa mpaka pakati pa nthawi 5-10 patsiku.

Komanso, minofu ya m'matumbo mwanu ikhoza kukhala yofooka pang'ono chifukwa sinagwiritsidwe ntchito opaleshoni isanachitike. Muyenera kuiphunzitsanso kuti ilamulire mayendedwe anu a m'mimba. Dokotala wanu adzakuphunzitsani masewera olimbitsa thupi, monga masewera olimbitsa thupi a Kegel, kuti akuthandizeni pa izi.

Kodi zoopsa ndi zovuta za opaleshoni iyi ndi ziti?

Monga opaleshoni iliyonse, pali zoopsa zina zomwe zimakhudzidwa, ndipo ndikofunikira kuzidziwa.

Kodi mungathe kukhala moyo wabwinobwino ndi J-Pouch?

Inde, n'zothekadi! Ndipotu, anthu ambiri amanena kuti moyo wawo wasintha kwambiri atachitidwa opaleshoniyi. Chifukwa chakuti salinso ndi matenda aakulu omwe anali nawo kale, ndipo safunikanso kusunga thumba lakunja.

Koma muyenera kuzolowera kusintha pang'ono pang'ono:

• Kuchuluka kwa nthawi yopita kuchimbudzi: Muyenera kupita kuchimbudzi kangapo patsiku kuposa kale.
• Kapangidwe ka chopondapo: Popeza matumbo akulu sakuyamwanso madzi, chopondapo chanu chidzakhala chamadzimadzi ambiri kuposa kale.
• Imwani madzi ambiri: Popeza thupi lanu likutaya madzi ambiri, ndikofunikira kumwa madzi ambiri tsiku lonse kuti mupewe kutaya madzi m'thupi. Ngakhale zinthu monga madzi akumwa zingakhale zofunikira pachiyambi.

Kodi ndiyenera kusintha zakudya zanga nditachita opaleshoni?

Palibe zakudya zenizeni kwa munthu amene ali ndi J-Pouch. Komabe, kudya zakudya zoyenera komanso zopatsa thanzi kungathandize kuchira msanga komanso kuchepetsa ululu. Nazi malangizo angapo:

• Yambani pang'onopang'ono: Mukayambanso kudya zakudya zolimba mutachita opaleshoni, yambani kudya zakudya zochepa zomwe zimakhala zosavuta kugaya, zokometsera pang'ono, komanso mafuta ochepa. Pang'onopang'ono onjezerani zakudya zatsopano muzakudya zanu.
• Imwani madzi ambiri: Izi ndizofunikira kwambiri. Yesetsani kumwa malita osachepera 2-3 a madzi patsiku. Zinthu monga supu zoyera, phala, ndi madzi a zipatso nazonso ndi zabwino.
• Chepetsani kutsegula m'mimba: Ngati ndowe zanu zikuoneka kuti zili ndi madzi ambiri, idyani zakudya zambiri zokhala ndi sitachi monga nthochi, mbatata, mpunga, ndi buledi kuti zithandize kuzikhuthala pang'ono. Chepetsani shuga, caffeine, zakudya zamafuta, ndi mowa, chifukwa zimatha kukulitsa kutsegula m'mimba.
• Zakudya zomwe zimaletsa kutupa: Idyani zakudya zomwe zimathandiza kupewa kutupa m'thumba. Zakudya monga zakudya za ku Mediterranean, zomwe zimaphatikizapo zinthu monga mafuta a azitona, nsomba, ndiwo zamasamba, zipatso, ndi mtedza, zapezeka kuti ndi zabwino kwambiri pa izi.

Opaleshoni ya J-Pouch ndi gawo lalikulu m'moyo wanu. Ndizachibadwa kukhala ndi mantha komanso kusatsimikiza za izi. Chifukwa chake, musanapange chisankho, fufuzani ndikufunsa dokotala wanu mafunso onse omwe mukufuna. Mukasankha kupita paulendowu, banja lanu ndi anzanu adzakhala gwero lalikulu la mphamvu. Ndi thandizo lawo, mutha kuthana ndi vutoli.