Kodi mudamvapo za chiwalo chaching'ono koma chofunikira kwambiri chomwe chimagwira ntchito mwakachetechete mkati mwa matupi athu kuti chigaye chakudya chomwe mumadya ndikulamulira kuchuluka kwa shuga m'magazi? Chimenecho ndi kapamba, kapena monga momwe timachitchulira mu Chingerezi, kapamba. Nthawi zina, chifukwa cha matenda ena omwe amapezeka m'chiwalo chofunikirachi, gawo kapena lonse limayenera kuchotsedwa opaleshoni. Ndicho chomwe timachitcha kuti pancreatectomy. Ndizachibadwa kumva mantha pang'ono mukamva za opaleshoni yotereyi. Ichi ndichifukwa chake, lero tikambirana mwachidule, mwanjira yomwe mungamvetse.
Nchifukwa chiyani muyenera kuchita opaleshoni ya Pancreatectomy?
Madokotala nthawi zambiri amalangiza opaleshoni yayikulu ngati iyi pokhapokha ataganizira bwino komanso pokhapokha ngati pakufunikadi. Pali zifukwa ziwiri zazikulu zomwe zimapangitsa izi.
1. Ziphuphu: Ziphuphu zina zomwe zimapangidwa mu kapamba zimatha kukhala khansa. Izi zimakhala ndi chiopsezo chachikulu chofalikira (metastatic) ku ziwalo zina za thupi. Choncho njira yabwino yochepetsera chiopsezocho ndikuchotsa gawo la kapamba lomwe lili ndi chotupacho.
2. Pancreatitis: Apa ndi pamene kapamba amatupa. Izi zingayambitse ululu waukulu ndi mavuto ena. Nthawi zina, pamene vutoli lakula kwambiri moti silingathe kulithetsa, opaleshoni ingafunike.
Kuphatikiza apo, opaleshoniyi imagwiritsidwanso ntchito ngati yankho la matenda monga pancreatic cysts ndi zotupa zina zomwe zimapanga mahomoni (pancreatic neuroendocrine tumors).
Kodi mitundu ya opaleshoni ya pancreatectomy ndi iti?
Pancreas yathu imapangidwa ngati nsomba. Ili ndi " mutu " waukulu, "thupi" lapakati, ndi "mchira" woonda. Chifukwa chake, kutengera komwe matendawa ali, gawo lomwe limachotsedwa limasiyana. Chifukwa chake, pali mitundu ingapo ya opaleshoni.
| Mtundu wa opaleshoni | Mwachidule, kodi chikuchitika n’chiyani? |
|---|---|
| Kuchotsa Pancreatectomy ya Distal | Mu izi, gawo la "mchira" wa kapamba, ndipo nthawi zina gawo la "thupi", limachotsedwa. Popeza gawoli lili pafupi kwambiri ndi kapamba, nthawi zambiri limachotsedwa limodzi ndi kapamba . |
| Kuchotsa Pancreatectomy Yapakati | Iyi ndi opaleshoni yovuta pang'ono komanso yosazolowereka. Imafuna kuchotsa " mutu " ndi "mchira" wokha ndikusiya "thupi" lapakati liri lonse . Izi zimathandiza kuti ntchito ya kapamba isawonongeke kwambiri. |
| Pancreatoduodenectomy (Njira ya Whipple) | Izi ndi zomwe anthu ambiri amazidziwa kuti ndi opaleshoni ya "Whipple". Pachifukwa ichi, " mutu " wa kapamba umachotsedwa. Nthawi yomweyo , gawo loyamba la matumbo ang'onoang'ono (duodenum), ndulu, ndi njira yolumikizira ndulu yomwe imalumikizidwa nayo imachotsedwanso . Kenako, kapamba wotsala, njira yolumikizira ndulu, ndi m'mimba zimalumikizidwanso ndi matumbo ang'onoang'ono. |
| Kuchotsa Pancreatectomy Yonse | Monga momwe dzinalo likusonyezera, izi zimaphatikizapo kuchotsa kapamba wonse . Opaleshoni iyi imachitika pamene matendawa afalikira m'chiwalo chonse kapena ngati palibe minofu yathanzi yomwe ingapulumutsidwe. Pamodzi ndi kapamba, imakhudzanso kuchotsa kapamba, ndulu, gawo loyamba la matumbo ang'onoang'ono, ndi gawo la m'mimba. |
Kodi n'zotheka kukhala ndi moyo wopanda kapamba?
Inde, mungathedi. Koma ndi kusintha kwina. Chifukwa chakuti mumataya ma enzyme ndi mahomoni opangidwa ndi kapamba, muyenera kuwagwiritsa ntchito kunja kwa thupi lanu lonse.
Mwachidule, muyenera kumwa ma enzyme omwe amathandiza kugaya chakudya (Pancreatic Enzyme Replacement Therapy - PERT) monga mapiritsi, ndi mahomoni a insulin omwe amalamulira shuga m'magazi (insulin) monga jakisoni.
Kodi ndidzakhala ndi matenda a shuga?
Vutoli ndi la anthu ambiri. Ngati gawo limodzi la kapamba lachotsedwa, gawo lotsalalo likhoza kupanga kapena kusapanga insulin yokwanira m'thupi. Zimatengera gawo lomwe lachotsedwa. Komabe, ngati kapamba wonse wachotsedwa (Total Pancreatectomy), mudzadwala matenda a shuga . Chifukwa maselo opanga insulin atha kwathunthu. Nthawi yomweyo, muyenera kuyamba kulandira chithandizo cha insulin.
Kodi chimachitika ndi chiyani opaleshoni isanachitike, panthawi komanso pambuyo pake?
Opaleshoni isanachitike...
Muyenera kukonzekera masiku angapo opaleshoni isanachitike.
- Mayeso:Muyenera kuyesedwa kangapo kuti muwone ngati muli ndi thanzi labwino, monga kuyezetsa magazi, X-ray pachifuwa, ndi EKG.
- Kusiya zizolowezi zoipa: Ngati ndinu chidakwa, muyenera kuuza dokotala wanu za vutoli. Mowa ukhoza kuyambitsa mavuto panthawi ya opaleshoni komanso pambuyo pake. Gulu lachipatala lidzakuthandizani kusiya zizolowezi zoipa.
- Mankhwala: Nthawi zina mudzapemphedwa kuti musiye kumwa mankhwala ochepetsa magazi masiku angapo opaleshoni isanachitike.
Pa nthawi ya opaleshoni...
Pa tsiku la opaleshoni, dokotala wogonetsa anthu ogonetsa adzakugonetsani tulo tofa nato ndi chingwe cha IV m'dzanja lanu. Choncho simudzamva kupweteka kulikonse. Opaleshoniyo ingatenge maola 4 mpaka 6. Dokotalayo adzachita opaleshoniyo kudzera mu kudula m'mimba mwanu (opaleshoni yotseguka) kapena kudula pang'ono pang'ono pogwiritsa ntchito kamera (opaleshoni ya laparoscopic kapena robotic).
Pambuyo pa opaleshoni...
Pambuyo pa opaleshoni, mudzasamutsidwira ku chipinda chosungiramo odwala ndipo thanzi lanu lidzayang'aniridwa bwino. Mudzakhala m'chipatala kwa masiku pafupifupi 7.
- Choyamba, amapatsidwa chakudya chamadzimadzi kenako pang'onopang'ono amapatsidwa chakudya chanthawi zonse.
- Mankhwala ochepetsa ululu amaperekedwa ngati pakufunika.
- Kuyambira tsiku lotsatira opaleshoni, mudzathandizidwa kudzuka pabedi ndikuyenda pang'ono mothandizidwa ndi anamwino. Izi ndizofunikira kwambiri kuti muchiritse mwachangu.
- Gulu lachipatala nthawi zonse limayang'ana kuchuluka kwa shuga m'magazi mwanu komanso momwe chakudya chanu chimagayidwira.
Kodi zoopsa ndi zovuta za opaleshoni iyi ndi ziti?
Monga opaleshoni ina iliyonse, pali zoopsa zina zomwe zimachitika. Koma madokotala amachita opaleshoniyi chifukwa ubwino wake ndi woposa zoopsa zake.
| Mtundu wa vuto | Kufotokozera |
|---|---|
| Zotsatira zoyipa za kanthawi kochepa (nthawi yochepa opaleshoni itatha) | |
| Kuchepetsa thupi | Ndizabwinobwino kuchepetsa makilogalamu pafupifupi 5-7 mutachita opaleshoni. Izi zimachitika chifukwa cha kusintha kwa zakudya komanso mphamvu ya thupi yochira. Pakapita nthawi, kulemera kumakhazikika. |
| Kutopa | Chifukwa thupi lanu likugwiritsa ntchito mphamvu zambiri kuti lidzichiritse lokha kuchokera mkati, mungamve kutopa kwambiri kuposa masiku onse. Ndizachibadwa kumva bwino tsiku lina kenako kutopa tsiku lotsatira. Pumulani mokwanira. |
| Mavuto a m'mimba | Nthawi zina, matumbo sagwira ntchito bwino (Paralytic ileus). Komanso, kutulutsidwa kwa chakudya m'mimba kungachedwe (Kuchedwa kutulutsa chakudya m'mimba). Izi ndi zakanthawi kochepa. |
| Mavuto a nthawi yayitali | |
| Matenda a shuga | Monga tafotokozera kale, kuchotsa kapamba konse kumabweretsa matenda a shuga. |
| Kulephera kwa Exocrine Pancreatic | Kusakwanira kupanga ma enzyme ofunikira kuti chakudya chigayidwe bwino. Izi zingayambitse zizindikiro monga kutupa ndi kutsegula m'mimba. Izi zimafuna kumwa mapiritsi a enzyme (PERT) . |
| Kuchepa kwa chitetezo chamthupi | Ngati ndulu yachotsedwa panthawi ya opaleshoni, mphamvu yolimbana ndi matenda ena idzachepa. Chifukwa chake, dokotala angakulangizeni kuti mulandire katemera wina. |
Kodi zimatenga nthawi yayitali bwanji kuti munthu achire? Ndipo ndiyenera kupita liti kwa dokotala?
Zingatenge milungu inayi mpaka isanu ndi itatu kuti munthu achire bwino akabwerera kunyumba, kutengera thanzi lanu komanso mtundu wa opaleshoniyo.
Ngati muli ndi zizindikiro zotsatirazi, imbani dokotala nthawi yomweyo:
- Ngati bala la opaleshoni latupa, lofiira, kapena likutuluka madzi ngati mafinya.
- Ngati kutentha kwa thupi kuli pamwamba pa madigiri 100 F (37.7 C).
- Ngati muli ndi kutsegula m'mimba kosalekeza kapena kudzimbidwa.
- Ngati ululu ukukulirakulira.
Uthenga Wopita Nawo Kunyumba
- Pancreatectomy ndi opaleshoni yaikulu yomwe imachotsa gawo lodwala kapena kapamba wonse. Imachitika pa matenda omwe angawononge moyo monga khansa.
- Pambuyo pa opaleshoni, n'zotheka kukhala ndi moyo wopanda kapamba, koma chithandizo cha moyo wonse monga mapiritsi a enzyme ochizira kugaya chakudya ndi insulin yoletsa matenda a shuga chingafunike.
- Ngakhale opaleshoni iyi ndi yoopsa pang'ono, gulu lachipatala lidzakupatsani chithandizo chabwino kwambiri komanso chithandizo chomwe mukufuna.
- Ngati muli ndi mafunso, mantha, kapena kukayikira pankhaniyi, chonde kambiranani ndi dokotala wanu mosazengereza.
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