Mwina inuyo kapena munthu amene mumamudziwa adauzidwa ndi dokotala kuti ayenera kuchitidwa opaleshoni yotchedwa 'proctocolectomy'. Ndizachilendo kumva mantha pang'ono komanso mantha mukamva mawu awa. Mwina muli ndi mafunso ambiri m'mutu mwanu, monga "Kodi opaleshoni iyi ndi chiyani? Nchifukwa chiyani ndikufunikira izi? Kodi moyo wanga udzakhala bwanji pambuyo pa izi?" Musadandaule. Tiyeni tikambirane zonsezi m'njira yosavuta, pang'onopang'ono, monga momwe mungalankhulire ndi mnzanu.
Mwachidule, kodi Proctocolectomy ndi chiyani?
Kuchotsa proctocolectomy ndi opaleshoni yomwe imachotsa gawo kapena matumbo onse akuluakulu (m'mimba) ndi rectum.
Tsopano tiyeni tifotokoze izi pang'ono. Thupi lathu la m'mimba lili ndi gawo lotchedwa matumbo akulu. Lili ndi magawo atatu: m'matumbo akulu, m'matumbo ang'onoang'ono, ndi m'matako. Taganizirani ngati chubu chachitali.
- M'mimba mwa mayi: Iyi ndi gawo lalikulu kwambiri la chubu ichi. Apa ndi pomwe zinyalala zomwe zimatsala titamaliza kugaya chakudya chomwe timadya zimayamwa ndikusintha kukhala cholimba, chotchedwa ndowe.
- Rectum: Iyi ndi gawo lalifupi la matumbo akuluakulu lomwe limasunga ndowe kwakanthawi lisanatuluke m'thupi.
- Mphuno: Iyi ndi malo otulukira ndowe m'thupi.
Mu opaleshoni ya proctocolectomy, "procto" imatanthauza rectum ndipo "colectomy" imatanthauza kuchotsa m'matumbo. Chifukwa chake , proctocolectomy ndi opaleshoni yomwe imachotsa m'matumbo ndi m'matumbo. Nthawi zina, ngati m'matumbo okha achotsedwa, imatchedwa colectomy. Ngati m'matumbo okha achotsedwa, imatchedwa proctectomy. Kodi mukumvetsa kusiyana kwake?
N’chifukwa chiyani muyenera kuchitidwa opaleshoni yamtunduwu?
Madokotala amalangiza opaleshoni yaikulu ngati imeneyi pokhapokha ngati pali chifukwa chachikulu. Opaleshoni imeneyi nthawi zambiri imachitika ngati vuto linalake m'matumbo kapena m'matumbo likulepheretsa matumbo kapena m'matumbo kugwira ntchito bwino, kapena ngati vutoli lili pachiwopsezo chachikulu.
Nazi zina mwa zifukwa zazikulu:
- Matenda Otupa M'matumbo (IBD): Izi ndi matenda omwe amayambitsa kutupa kwa nthawi yayitali ndi zilonda m'matumbo. Matenda a Ulcerative Colitis ndi Matenda a Crohn ndi zitsanzo zazikulu. Anthu ena amafunika kuchotsedwa ziwalo za m'matumbo awo zomwe zili ndi matenda pamene sizingathe kuthetsedwa ndi mankhwala.
- Khansa ya m'matumbo ndi matenda omwe asanafike khansa: Pamene maselo a khansa akukula m'matumbo kapena m'matumbo, kapena pamene ma polyps omwe angathe kukhala khansa akukula (matenda monga Familyal Adenomatous Polyposis ), chithandizo chabwino kwambiri ndikuchotsa kwathunthu malo omwe ali ndi matendawa.
- Zifukwa zina:
- Ischemia imachitika pamene magazi akupita m'matumbo atayika ndipo minofu imafa.
- Matenda ovuta a Diverticulitis .
- Kuvulala kwa m'mimba chifukwa cha ngozi yaikulu.
- Kudzimbidwa kwambiri komwe sikungathe kuchiritsidwa ndi mankhwala.
Chofunika kwambiri ndichakuti opaleshoniyi ikuchitika kuti mupulumutse moyo wanu ndikukupatsani moyo wabwino komanso womasuka.
Kodi mumatuluka bwanji ndowe mutatha opaleshoni?
Funso lalikulu kwambiri lomwe aliyense amafunsa ndi ili. Pambuyo poti m'mimba ndi m'matumbo mwachotsedwa, njira yotulutsira ndowe imachoka. Ndiye kodi mumatsuka bwanji ndowe?
Yankho la izi limadalira mtundu wa opaleshoni ya proctocolectomy yomwe mukuchitidwa. Dokotala wanu adzasankha mtundu wa opaleshoni yomwe ili yoyenera kwa inu kutengera matenda anu komanso chifukwa cha opaleshoniyo. Tiyeni tiwone mitundu yake.
Kodi mitundu ya opaleshoni ya proctocolectomy ndi iti?
Pali njira zingapo zochitira opaleshoni iyi. Dokotala wanu adzasankha njira yomwe ili yoyenera kwa inu.
| Mtundu wa opaleshoni | Kufotokozera kosavuta kwa zomwe zikuchitika |
|---|---|
| Proctocolectomy ndi Ileostomy (ndi ileostomy) | Mu njira imeneyi, m'mimba ndi m'matumbo zimachotsedwa kwathunthu. Kenako, gawo lomaliza la matumbo ang'onoang'ono, lotchedwa ileum , limatuluka kudzera pakhungu la mimba ndipo pamakhala dzenje (stoma). Chimbudzi chimatuluka kudzera m'dzenje ili. Chikwama chimamangiriridwa kunja kwake. Anthu ena amafunika kuvala izi kwamuyaya, pomwe ena kwa kanthawi kochepa. |
| Kuchotsa Proctocolectomy ndi Ileoanal Pouch (Opaleshoni yolowa m'malo) | Mu njira imeneyi, m'mimba ndi m'matumbo zimachotsedwanso, koma m'matumbo mumasiyidwa pamalo pake. Kenako, thumba lamkati limapangidwa kuchokera kumapeto kwa matumbo ang'onoang'ono (ileum). thumba ili, monga m'matumbo oyamba, limathandiza kusunga ndowe kwa kanthawi. Thumba ili limalumikizidwa ku m'matumbo (ileoanal anastomosis).Izi zimakupatsani mwayi wochita chimbudzi mwachizolowezi. Izi zitha kuchitika mu opaleshoni imodzi kapena ziwiri. |
| Kuchotsa Proctocolectomy Yonse (kuchotsa gawo) | Izi zimaphatikizapo kusiya gawo la m'matumbo kapena rectum. Mwachitsanzo, njira ya Hartmann imachotsa gawo lomaliza la m'matumbo (sigmoid colon) ndi rectum. Ngati izi zachitika, magawo otsala athanzi a m'matumbo amatha kulumikizidwanso (anastomosis) , kuti muzitha kuyenda bwino m'matumbo. Nthawi zina colostomy ya kanthawi (kutseguka kwa m'matumbo) ikhoza kuyikidwa mpaka bala litachira. |
Kodi muyenera kuchita chiyani musanachite opaleshoni?
Ngati si opaleshoni yadzidzidzi, mudzakhala ndi nthawi yokwanira yokonzekera.
- Masabata angapo pasadakhale: Lankhulani ndi dokotala wanu za opaleshoniyi, mitundu yake, zoopsa zake, ndi ubwino wake. Funsani mafunso aliwonse omwe muli nawo.
- Masabata awiri musanayambe kumwa mankhwala ochepetsa magazi, dokotala wanu adzakulangizani kuti musiye kapena kuchepetsa kumwa mankhwalawo. Komanso, yesetsani kusunga matumbo anu athanzi mwa kudya zakudya zambiri zokhala ndi ulusi wambiri komanso kumwa madzi ambiri panthawiyi.
- Maola 24 musanachite opaleshoni: Tsiku lisanafike opaleshoni, mudzapatsidwa mankhwala oyeretsera matumbo anu onse. Mudzaloledwa kumwa madzi oyera okha, monga madzi ndi supu, tsiku lomwelo. Mungapatsidwenso mankhwala opha tizilombo toyambitsa matenda kuti mupewe matenda mutachita opaleshoni.
Kodi chimachitika ndi chiyani panthawi ya opaleshoni?
Mukapita kuchipatala, mudzaikidwa chovala cha opaleshoni. Katheta ya IV idzaikidwa mumtsempha wanu ndipo mudzapatsidwa saline ndi mankhwala aliwonse ofunikira. Kenako mudzatengedwera ku chipinda chochitira opaleshoni.
Dokotala wogonetsa anthu adzakuikani pansi pa mankhwala oletsa ululu. Simudzamva chilichonse panthawi ya opaleshoni. Mudzalumikizidwa ndi makina (ventilator) kuti akuthandizeni kupuma.
Opaleshoni Yotseguka? Opaleshoni ya Laparoscopic?
Masiku ano, opaleshoni zambiri za proctocolectomy zimachitika pogwiritsa ntchito laparoscopically . Izi zikutanthauza kuti m'malo mopanga chotupa chachikulu m'mimba, opaleshoniyi imachitika kudzera m'mabowo ang'onoang'ono, momwe kamera ndi zida zazing'ono kwambiri zimayikidwa. Njirayi imalola kuti munthu achire mwachangu, achepetse ululu, komanso azipsera zazing'ono. Komabe, njira iyi si yoyenera aliyense. Pazochitika zovuta kapena zadzidzidzi, opaleshoni yachikhalidwe yotseguka imafunika.
Pa opaleshoni, dokotalayo amachotsa mosamala m'matumbo ndi m'matumbo omwe ali ndi matenda. Kenako, monga tafotokozera kale, ileostomy/colostomy imapangidwa kapena matumbo amalumikizidwanso (anastomosis).
Kodi chimachitika ndi chiyani pambuyo pa opaleshoni?
Pambuyo pa opaleshoni, muyenera kukhala m'chipatala kwa pafupifupi sabata imodzi. Panthawiyi, pang'onopang'ono mudzayamba kudya zakudya zamadzimadzi kenako pang'onopang'ono mudzayamba kudya zakudya zolimba.
Ngati muli ndi ostomy (ileostomy/colostomy), Wound Ostomy Continence Nurse (WOCN) adzakuthandizani. Adzakuphunzitsani zonse zomwe muyenera kudziwa zokhudza kugwiritsa ntchito thumba la ostomy ndi kusunga stoma yanu (yotseguka m'mimba mwanu) yoyera. Ngakhale kuti ndi ostomy yakanthawi, zimatenga miyezi ingapo musanakambirane ndi dokotala wanu za njira zotsatirazi (kuichotsa kapena kupanga thumba lamkati)
Kodi zoopsa ndi zovuta zomwe zimachitika chifukwa cha opaleshoniyi ndi ziti?
Monga momwe zimakhalira ndi opaleshoni iliyonse, pali zoopsa zina zomwe zimachitika, koma izi ndizosowa kwambiri.
| Mtundu wa vuto | Zinthu zotheka |
|---|---|
| Zoopsa zomwe zimachitika chifukwa cha opaleshoni | Kuyankha chifukwa cha mankhwala oletsa ululu, kuwonongeka kwa ziwalo zozungulira, kutuluka magazi kwambiri, ndi matenda. |
| Mavuto okhudzana ndi opaleshoni | - Kutsekeka kwa matumbo: Minofu ya zipsera chifukwa cha opaleshoni ingayambitse kutsekeka kwa matumbo. - Kuwonongeka kwa mitsempha: Opaleshoni ya kumatako ingawononge mitsempha yomwe imakhudzidwa ndi kugonana kapena kukodza. Izi nthawi zambiri zimachira pakapita nthawi. |
| Mavuto Okhudzana ndi Ostomy (Ileostomy/Colostomy) | - Ziwengo pakhungu: Khungu lozungulira stoma likhoza kufiira ndi kupweteka chifukwa chokhudza ndowe. - Kusintha kwa stoma: Stoma ikhoza kulowa mkati kuchokera pamlingo wa khungu (kubwerera m'mbuyo) kapena kutuluka kwambiri (kutsika). - Phantom Rectum: Ngakhale rectum itachotsedwa, anthu ena angakhalebe ndi chilakolako chofuna kuchita chimbudzi. Izi zidzachepa pakapita nthawi. |
| Mavuto Okhudzana ndi Thumba la Mkati | - Pouchitis: Kutupa kwa mkati mwa thumba latsopano. Izi zimachiritsidwa ndi maantibayotiki. - Kutuluka kwa madzi m'mimba: Kutuluka kwa madzi m'mimba. Uwu ndi matenda osowa koma oopsa. - Kuvuta kwakanthawi kolamulira mayendedwe a m'mimba: Poyamba, zingakhale zovuta kulamulira mayendedwe a m'mimba chifukwa cha minofu yofooka ya kumatako. Izi zidzasintha ndikuchita masewera olimbitsa thupi komanso nthawi. |
Kodi chisamaliro cha pambuyo pa opaleshoni chili bwanji?
Zingatenge miyezi ingapo kuti munthu achire bwino. Panthawiyi, ndikofunikira kwambiri kutsatira malangizo a dokotala wanu mosamala.
- Kusamalira mabala: Dokotala kapena namwino adzakuphunzitsani momwe mungatsukire bala ndikusintha bandeji.
- Kusamalira thumba la ostomy: Mudzaphunzira momwe mungatulutsire madzi mu thumba la ostomy kangapo patsiku ndikusunga khungu lozungulira stoma kukhala loyera.
- Chakudya: Mukafika kunyumba kuchokera kuchipatala, pang'onopang'ono muyambe kudya zakudya zolimba. M'malo modya chakudya chambiri nthawi imodzi, idyani pang'ono kangapo patsiku. Tafunani chakudya chanu bwino.
- Kuthira madzi m'thupi: Izi ndizofunikira kwambiri. Popeza gawo lalikulu la m'mimba mwanu lachotsedwa, thupi lanu lidzamwa madzi ochepa. Choncho ndikofunikira kumwa madzi ndi zakumwa zambiri tsiku lonse.
Nthawi yoti mukaonane ndi dokotala
Mukabwerera kunyumba kuchokera ku opaleshoni, ngati muli ndi zizindikiro zotsatirazi , imbani dokotala wanu nthawi yomweyo kapena pitani ku Dipatimenti Yothandiza Pangozi (ETU) ya chipatala chapafupi.
- Zizindikiro za kutsekeka kwa matumbo ndi monga kudzimbidwa, kupweteka m'mimba, kudzimbidwa, ndi nseru.
- Zizindikiro za matenda opatsirana monga kupweteka kwambiri m'mimba, kutupa, kutuluka mafinya pabala, ndi malungo.
Kuchotsa opaleshoni ya proctocolectomy ndi opaleshoni yaikulu. Koma ingakuthandizeni kupeza mpumulo ku vuto lanu la nthawi yayitali ndikukweza moyo wanu. Ndi ukadaulo wamakono, matumba a ostomy amatha kupangidwa osawoneka komanso omasuka kwambiri. Lankhulani ndi dokotala wanu za zomwe mungasankhe ndikupanga chisankho chomwe chili chabwino kwa inu.
Uthenga Wopita Nawo Kunyumba
- Kuchotsa proctocolectomy ndi opaleshoni yopulumutsa moyo yomwe imachotsa m'matumbo ndi m'matumbo. Nthawi zambiri imachitidwa pa matenda aakulu monga IBD ndi khansa.
- Njira yochotsera matumbo pambuyo pa opaleshoni imasiyana. Pali njira zina monga ileostomy (thumba lakunja) kapena thumba lamkati (thumba lamkati).
- Kambiranani momasuka ndi dokotala wanu za mtundu wa opaleshoni yoyenera kwa inu ndipo mafunso anu onse ayankhe.
- Zimatenga nthawi kuti munthu achire pambuyo pa opaleshoni. Panthawiyi, tsatirani malangizo a dokotala mosamala, makamaka okhudza chakudya ndi madzi omwe amamwa.
- Ngakhale kukhala ndi ostomy kungawoneke kovuta poyamba, ndi maphunziro ndi chithandizo choyenera, kungakhale gawo la moyo wabwinobwino.
- Ngati mukukumana ndi zizindikiro zachilendo (kupweteka kwambiri, kutentha thupi, nseru) mutachita opaleshoni, funsani upangiri wa dokotala nthawi yomweyo.
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