Chifukwa cha matenda ena, makamaka mavuto a m'matumbo akuluakulu, opaleshoni imafunika kuti achotse gawolo. Kenako, pamakhala kabowo kakang'ono pakhungu la mimba kuti zinyalala zituluke m'thupi. Chifukwa chake, ndowe zimasonkhanitsidwa m'thumba lomwe limalumikizidwa ndi kabowo aka. Kukhala ndi thumba ili kungakhale kovuta kwa anthu ena. Zingamveke ngati cholepheretsa kucheza, kuvala zovala, komanso kuchita ntchito za tsiku ndi tsiku. Nanga bwanji ngati pali njira yosonkhanitsira zinyalala mkati mwa thupi popanda thumba lakunja ili ndikulitulutsa nthawi iliyonse yomwe tikufuna? Yankho la funsoli ndi thumba la Kock lomwe tikukamba lero.
Mwachidule, kodi thumba la Kock (K-pouch) ili ndi chiyani?
Tangoganizirani, m'malo mokhala ndi thumba lopachikidwa kunja kwa thupi lanu, bwanji ngati mutapanga thumba laling'ono lomwe lingasonkhanitse ndikusunga zinyalala mkati mwa thupi lanu? Ndicho chimene thumba la Kock lili.
Pambuyo pa opaleshoni ya colectomy, kumapeto kwa matumbo anu ang'onoang'ono, ileum, kumabweretsedwa pamwamba pa khungu m'mimba mwanu ndipo kabowo kakang'ono kamapangidwa. Izi zimatchedwa ileostomy. Kabowo aka kamatchedwa stoma. Izi nthawi zambiri zimachitika pomangirira thumba lakunja ku stoma.
Koma mu opaleshoni ya thumba la Kock, dokotalayo amagwiritsa ntchito gawo la matumbo anu ang'onoang'ono kuti apange thumba laling'ono mkati mwa thupi lanu . Thumba ili limalumikizidwa mwachindunji ndi khomo (stoma) m'mimba mwanu. Chifukwa chake simukusowa thumba lakunja kuti mutenge ndowe zanu. Mukafuna, chubu chaching'ono (catheter) chikhoza kulowetsedwa kudzera m'bokosili ndipo zinyalala zomwe zasonkhanitsidwa m'thumbalo zitha kuchotsedwa.
Izi zili ngati "mkati mwa thumba la m'mimba" lomwe tingathe kutulutsa nthawi iliyonse. Dzina lake limatengera dzina la dokotala wa opaleshoni Nils Kock.
Kodi thumba la Kock limagwiritsidwa ntchito bwanji?
Njirayi imagwiritsidwa ntchito makamaka kwa anthu omwe ali ndi vuto la `ileostomy` koma sakufuna kugwiritsa ntchito thumba lakunja la ndowe. Ubwino waukulu wa izi ndikuti amatha kulamulira kuyenda kwa ndowe.
Mu opaleshoni yachibadwa ya ileostomy, ndowe zimatha kusonkhana m'thumba nthawi iliyonse. Sitingathe kuzilamulira. Koma opaleshoni ya ileostomy yokhala ndi thumba la Kock imatchedwa continence ileostomy. Izi zikutanthauza "kulamulira." Pankhaniyi, ndowe imasonkhana m'thumba lomwe lili mkati, m'malo motuluka, kotero muli ndi ufulu wotulutsa nthawi iliyonse yomwe mukufuna.
- Zambiri Zowonjezera: Thumba la Kock poyamba linapangidwa ngati thumba lamkati loti litenge mkodzo wa odwala omwe anachotsedwa chikhodzodzo chawo. Njira imeneyi ikugwiritsidwabe ntchito mpaka pano, koma njira zambiri zatsopano zapangidwa.
Kodi opaleshoni iyi imachitidwa bwanji?
Dokotala wanu akhoza kupanga thumba la Kock nthawi yomweyo ndi ileostomy yanu, kapena angachite opaleshoni ina mtsogolo. Izi zikutanthauza kuti ngati muli kale ndi ileostomy, mutha kusintha kupita ku thumba la Kock mtsogolo.
Mwachidule, opaleshoniyi imachitika motere:
1. Kupanga thumba: Dokotala adzatenga pafupifupi mainchesi 18 kuchokera kumapeto kwa matumbo anu ang'onoang'ono ndikulipinda kukhala mawonekedwe a "U". Kenako, matumbo adzatsegulidwa pakati pa thumba ili ndipo m'mbali mwake mudzasokedwa pamodzi. Izi zipanga thumba.
2. Kupanga Valavu: Iyi ndi gawo lofunika kwambiri. Pogwiritsa ntchito matumbo otsala kumapeto kwa thumba, valavu yapadera (`valavu yolowera imodzi`) imapangidwa. Ili ngati chitseko chomwe chimatseguka mbali imodzi yokha. Zinyalala zikadzadza mkati, valavu iyi imatseka yokha. Mwanjira imeneyi, ndowe, madzi, ndi mpweya sizituluka.
3. Kulumikizana: Pomaliza, mapeto a valavu amalumikizidwa ku malo otseguka (`stoma`) omwe amapangidwa m'mimba mwanu. Dokotala adzafufuza kuti atsimikizire kuti chilichonse chikugwira ntchito bwino ndipo palibe kutuluka madzi.
Kodi chimachitika ndi chiyani pambuyo pa opaleshoni? Zimatenga nthawi yayitali bwanji kuti munthu achire?
Pambuyo pa opaleshoni, muyenera kukhala m'chipatala kwa masiku atatu kapena asanu. Panthawiyi, machubu osiyanasiyana adzalumikizidwa ku thupi lanu kuti akuthandizeni kuchira mwachangu.
- Chubu cha `IV` choperekera saline
- `Zakudya za IV` za zakudya
- Mapaipi otulutsa zinyalala pabala
- Katheta wa mkodzo
- `Pampu yoletsa ululu`
Musadandaule ndi zinthu izi, zonse ndi zakanthawi.
Katheta yomwe imayikidwa mu stoma yanu idzasiyidwa pamalo pake kwa milungu ingapo. Izi zithandiza kuti zinyalala zituluke m'thumba latsopanolo mpaka bala litachira. Namwino adzakuphunzitsani momwe mungasamalire kathetayo.
Mukapita kunyumba ndi kupuma kwa milungu ingapo, dokotala wanu adzachotsa chubu ichi. Kenako, namwino adzakuphunzitsani momwe mungatulutsire madzi m'thumba lanu pogwiritsa ntchito chubu wamba (catheter).
Poyamba, mungafunike kutulutsa madzi m'chikhodzodzo chanu pafupifupi kasanu ndi kawiri patsiku. Koma musadandaule, m'miyezi ingapo ikubwerayi, thumba latsopanoli lomwe lili m'thupi lanu lidzakula pang'onopang'ono. Pambuyo pake, mungafunike kutulutsa madziwo kawiri kapena kanayi patsiku.
Ubwino ndi zovuta zomwe zingachitike pa thumba la Kock
Monga njira ina iliyonse yachipatala, pali ubwino ndi zoopsa zake. Tiyeni tiwone.
| Ubwino | Mavuto Omwe Angakhalepo |
|---|---|
| Palibe chifukwa chogwiritsa ntchito thumba lakunja: Simukuyenera kuvala kapena kusamalira thumba lakunja la ileostomy. | Mavuto a valavu: Nthawi zina valavu imatha kumasuka ndikupangitsa kuti ndowe zituluke. Kapena valavu ikhoza kutsekeka ndipo chubu sichingathe kuyikidwa. Kutsekeka kwathunthu kwa matumbo ndi vuto ladzidzidzi. Ngati izi zitachitika, muyenera kupita ku ETU (Emergency Treatment Unit) nthawi yomweyo. |
| Ufulu wochulukirapo komanso chinsinsi: Stoma ikhoza kuphimbidwa ndi chinthu chaching'ono, monga gauze pad. Izi sizidzawoneka kuchokera kunja. | Fistula: Ma ngalande osayenera amatha kupangidwa kuchokera m'thumba kupita ku khungu kapena ziwalo zina. Izi zingayambitse ululu ndi matenda. |
| Kulamulira: Mutha kutulutsa madzi m'chikhodzodzo chanu nthawi iliyonse komanso kulikonse komwe mukufuna, popanda kutuluka ndowe tsiku lonse. | Pouchitis: Kutupa kapena matenda a thumba. Ili ndi vuto lofala. Nthawi zambiri limatha kuchiritsidwa mwachangu ndi maantibayotiki. |
| Kugona bwino: N'kosavuta kugona usiku. Simudzafunika kudzuka pakati pa usiku kuti mutulutse zinthu zonse m'thumba lanu. | Kuchepa kwa potseguka (Stricture/stenosis): Kutupa kungapangitse kuti stoma ikhale yopapatiza komanso kupangitsa kuti zikhale zovuta kulowetsa chubu. |
| Hernia ya m'mimba: Mbali ina ya m'mimba imatuluka kudzera mu stoma. Izi zingayambitsenso kutsekeka. |
Ngati mavutowa achitika, nthawi zina pangafunike opaleshoni ina (`revision surgery`) kuti ikonzedwe. Pankhani ya thumba la Kock, makamaka chifukwa cha mavuto a valavu, kuchuluka kwa opaleshoni yokonzanso koteroko kumakhala kokwera pang'ono kuposa njira zina (pafupifupi 30%). Koma dokotala wanu adzakufotokozerani zonsezi bwino.
Kodi kusiyana pakati pa thumba la Kock ndi thumba la J ndi kotani?
Ngakhale kuti zonsezi ndi mitundu ya matumba opangidwa mkati mwa thupi, momwe amagwirira ntchito ndi osiyana kwambiri.
- Kock Pouch (K-pouch): Ichi chimapangidwa ndi `ileostomy`, yomwe ndi mpata (`stoma`) m'mimba. Chimbudzi chimatulutsidwa kudzera mu chubu (`catheter`) chomwe chimayikidwa kudzera m'mpata m'mimba.
- J-Pouch: Iyi ndi njira ina m'malo mwa ileostomy. Apa, thumba limapangidwa kuchokera kumapeto kwa matumbo ang'onoang'ono ndikulumikizidwa mwachindunji ku anus (njira ya anal). Izi zimachotsa kufunikira kwa stoma (kutseguka kwa m'mimba). Wodwalayo amatha kupita kuchimbudzi ndikuchita chimbudzi mwachizolowezi.
Nthawi zambiri, odwala omwe akufuna kuchotsedwa m'matumbo ndi m'matumbo amasankha njira ya J-pouch. Komabe, kuti J-pouch igwire bwino ntchito, minofu ya m'matumbo iyenera kugwira ntchito bwino. Kwa iwo omwe sangakhale ndi J-pouch pazifukwa zina, kapena kwa iwo omwe ali ndi J-pouch yomwe yalephera, thumba la Kock ndi njira yabwino kwambiri.
Kodi mukufuna kusintha zakudya zanu?
Inde, kudya zakudya zopatsa thanzi komanso zopatsa thanzi n'kofunika kwambiri kuti muchiritse msanga. Ngati ndowe zanu ndi zokhuthala kwambiri kapena zamadzimadzi kwambiri, mutha kusintha pang'ono zakudya zanu. Zingakhale zothandiza kwambiri kufunsa upangiri kwa katswiri wazakudya. Dokotala wanu angakutumizireni kwa munthu woyenera.
Uthenga Wopita Nawo Kunyumba
- Chikwama cha Kock ndi njira yabwino kwambiri kwa iwo omwe sakufuna kukhala ndi thumba lakunja la ileostomy.
- Izi zidzakuthandizani kulamulira mayendedwe anu a m'mimba ndikukupatsani ufulu ndi chitonthozo chochulukirapo mukamacheza.
- Komabe, monga momwe zimakhalira ndi opaleshoni zonse, pali zoopsa ndi zovuta zina, makamaka mavuto a valavu.
- Musanasankhe ngati njira iyi ndi yoyenera kwa inu, ndikofunikira kwambiri kulankhula ndi dokotala wanu ndikumvetsetsa bwino zabwino ndi zoyipa zonse.
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