Ngati matumbo anu akuluakulu akuyenera kuchotsedwa opaleshoni chifukwa cha matenda, muyenera kukhala ndi thumba lakunja (stoma) lolumikizidwa ku dzenje lapadera (stoma) lopangidwa pakhungu la mimba yanu kuti zinyalala (ndowe) zituluke m'thupi lanu. Kukhala ndi thumba lakunja ili tsiku ndi tsiku kungakhale kovuta komanso kovutitsa kwa anthu ena. Koma kodi mukudziwa kuti pali njira ina yoposa iyi? Lero tikulankhula za thumba lapadera (thumba) lomwe limapangidwa mkati mwa thupi.
Kodi thumba la Kock ndi chiyani?
Mwachidule, Kock Pouch ndi thumba laling'ono lomwe dokotala wa opaleshoni amapanga mkati mwa thupi lanu, pogwiritsa ntchito gawo la matumbo anu ang'onoang'ono. Ndi njira ina m'malo mwa thumba lakunja la ileostomy.
Mu opaleshoni yachilendo ya ileostomy, mapeto a matumbo ang'onoang'ono amafika pamwamba pa khungu m'mimba, zomwe zimapangitsa kuti stoma iwoneke. Popeza ndowe nthawi zonse zimatuluka kudzera m'bowo ili, thumba lakunja liyenera kuvalidwa nthawi zonse kuti litengedwe.
Koma mu Kock Pouch, popeza thumba ili lili mkati mwa thupi, ndowe sizimatuluka nthawi imodzi. M'malo mwake, zimasonkhana mkati mwa thumba. Mutha kutulutsa madzi m'thumba ili kangapo patsiku, nthawi iliyonse yomwe mukufuna, poika chubu chaching'ono (catheter) kudzera mu `stoma`. Izi zimatchedwanso "Continence Ileostomy" . Izi zikutanthauza kuti mutha kuwongolera njira yodutsa ndowe. Njirayi idayambitsidwa koyamba ndi dokotala wa opaleshoni dzina lake Nils Kock. Ichi ndichifukwa chake imatchedwa Kock Pouch.
Tangoganizirani mpumulo umene ungakhalepo kukhala ndi ulamuliro pa momwe mumatayira zinyalala zanu nthawi iliyonse, popanda kunyamula thumba lakunja. Umenewo ndiye ubwino waukulu wa Kock Pouch.
Kodi opaleshoni ya Kock Pouch imachitidwa bwanji?
Opaleshoni iyi ndi yovuta pang'ono. Dokotala wanu adzachita motere:
- Choyamba, tengani mainchesi 18 kuchokera kumapeto kwa matumbo anu ang'onoang'ono (ileum) ndikupinda kuti akhale mawonekedwe a "U".
- Chachiwiri, gawo lopindidwa limatsegulidwa pakati ndipo m'mbali mwake mumalumikizidwa ndikusokedwa pamodzi. Izi zimapangitsa thumba. Gawo laling'ono la matumbo limasiyidwa kumapeto.
- Chachitatu komanso chofunika kwambiri, pogwiritsa ntchito matumbo otsala, valavu yolowera mbali imodzi imapangidwa pafupi ndi pakamwa pa thumba. Izi ndizofunikira kwambiri chifukwa ndi valavu iyi yomwe imaletsa zinyalala kapena mpweya kutuluka mu stoma thumba likadzaza.
- Pomaliza, mapeto a valavu amalumikizidwa mkati mwa stoma yomwe imapangidwa m'mimba. Pamapeto pa opaleshoni, madokotala amafufuza kuti atsimikizire kuti valavuyo ikugwira ntchito bwino.
Kodi chimachitika ndi chiyani pambuyo pa opaleshoni? Zimatenga nthawi yayitali bwanji kuti munthu achire?
Mukamaliza opaleshoni, mudzakhala m'chipatala kwa masiku atatu kapena asanu. Panthawiyi, machubu osiyanasiyana adzaikidwa kuti akuthandizeni kuchira mwachangu.
- Mzere wa IV (chubu cholowetsedwa mumtsempha) kuti upereke saline
- Mapaipi otayira mabala
- Chubu cha mankhwala ochepetsa ululu (Pampu yopatsira ululu)
- Katheta wa mkodzo
Muyenera kusunga catheter pamalo ake kwa milungu ingapo. Izi zithandiza kuti madzi omwe ali mu thumba latsopanolo atuluke ndikulola bala kuchira bwino. Namwino adzakuwonetsani momwe mungasamalire catheter kunyumba.
Patatha milungu ingapo mutapita kunyumba, dokotala adzachotsa chubucho. Pambuyo pake, namwino adzakuphunzitsani momwe mungatulutsire madzi m'thumba ndi catheter wamba, yomwe mudzagwiritse ntchito kuyambira pano.
Poyamba, mungafunike kutulutsa madzi m'thumba pafupifupi kasanu ndi kawiri patsiku. Koma musadandaule. Pakatha miyezi ingapo, thumbalo litakula pang'ono ndipo likuchira bwino, mungafunike kutulutsa madzi kawiri kapena kanayi patsiku.
| Ubwino wa Kock Pouch | Mavuto Omwe Angakhalepo |
|---|---|
| Palibe chifukwa chovalira thumba la maluwa panja. | Mavuto a mavavu: Nthawi zina valavu imatha kutayikira ndikutulutsa zinyalala. Izi zingafunike opaleshoni ina kuti ikonzedwe. |
| Stoma ikhoza kuphimbidwa ndi gauze kuti isawonekere kuchokera kunja. | Fistula: Kulumikizana kosazolowereka (monga ngalande) pakati pa chikhodzodzo, khungu, kapena chiwalo china. |
| Ali ndi ulamuliro wochita chimbudzi nthawi iliyonse akafuna. | Pouchitis: Kutupa kwa thumba komwe kumachitika chifukwa cha matenda. Nthawi zambiri kumatha kuchiritsidwa ndi maantibayotiki. |
| Kugona usiku n'kosavuta, ndipo simuyenera kudzuka kuti mutulutse zinthu zonse m'thumba. | Kuchepa kwa pobowola (Stricture/Stenosis): Minofu ya zipsera imatha kufinya stoma, zomwe zimapangitsa kuti zikhale zovuta kulowetsa chubucho. |
| Moyo wabwino komanso kudzidalira kumawonjezeka. | Hernia ya m'mimba: Hernia yomwe mbali ya m'mimba imatuluka kudzera mu stoma. Iyeneranso kukonzedwa ndi opaleshoni. |
Tiyeni tidziwenso za vuto lalikulu.
Ngati valavu yamasuka ndipo kutsegula kwa thumba latsekedwa ndipo chubu sichingathe kulowetsedwa, ndi vuto ladzidzidzi. Zikatero, muyenera kupita ku chipatala cha Emergency Treatment Unit (ETU) nthawi yomweyo. Komanso, ngati muyenera kuchitidwa opaleshoni mobwerezabwereza chifukwa cha mavuto otere, pali chiopsezo chakuti matumbo ang'onoang'ono akhale afupikitsa ndikuyamba kusowa zakudya zokwanira (Short Bowel Syndrome).
Kodi kusiyana pakati pa Kock Pouch ndi J-Pouch ndi kotani?
Mwina munamvapo za J-Pouch. Ngakhale kuti zonsezi ndi mitundu ya matumba amkati, zimagwira ntchito mosiyana.
- J-Pouch: Izi zikutanthauza kuti muyenera kumangirira thumba ku ngalande yanu ya kumatako. Izi zikutanthauza kuti simukusowa stoma. Muthabe kuchita chimbudzi kudzera mu anus yanu monga mwachizolowezi. Anthu ambiri amakonda njira iyi. Komabe, anus yanu ndi minofu yozungulira iyenera kukhala ndi thanzi labwino.
- Kock Pouch: Kock Pouch ndi njira yabwino kwambiri kwa munthu amene sangathe kugwiritsa ntchito J-Pouch (mwachitsanzo, ngati anus nayonso yachotsedwa) kapena kwa munthu amene wakhala ndi J-Pouch koma yalephera.
Kodi ndiyenera kusintha zakudya zanga pambuyo pa opaleshoni iyi?
Inde, kudya zakudya zopatsa thanzi komanso zopatsa thanzi n'kofunika kwambiri kuti muchiritse msanga. Kale, mwina munali ndi zakudya zochepa chifukwa cha matenda anu. Tsopano mutha kukulitsa pang'onopang'ono zakudyazo.
Ngati ndowe zanu ndi zokhuthala kwambiri kapena zamadzimadzi kwambiri, mutha kukonza izi mwa kusintha zakudya zanu. Ndikoyenera kufunsa upangiri wa katswiri wa zakudya pankhaniyi. Dokotala wanu akhoza kukutumizirani kwa dokotala wina.
Uthenga Wopita Nawo Kunyumba
- Chikwama cha Kock ndi njira yabwino kwambiri yopangira opaleshoni ya ileostomy yakunja. Chingakuthandizeni kwambiri kukhala ndi moyo wabwino komanso thanzi labwino la maganizo.
- Ichi ndi thumba lamkati lomwe limapangidwa ndi opaleshoni kuchokera m'matumbo anu ang'onoang'ono. Lingakuthandizeni kulamulira mayendedwe anu a m'mimba.
- Monga momwe zimakhalira ndi opaleshoni zonse, pali chiopsezo cha zovuta, zomwe zingafunike opaleshoni yokonzanso kuti zikonzedwe.
- Njira yabwino yodziwira ngati njira imeneyi ndi yoyenera kwa inu komanso ubwino ndi kuipa kwake ndi kukambirana momasuka ndi dokotala wanu. Musaope kufunsa dokotala wanu mafunso aliwonse omwe mungakhale nawo.
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