Dokotala wanu akakuuzani kuti muyenera kuchitidwa opaleshoni ya m'matumbo, ndi zachilendo kumva mantha ndi nkhawa zambiri. Mukamva dzina loti "proctocolectomy," zingawoneke zovuta kwambiri. Koma musadandaule. Iyi ndi opaleshoni yopulumutsa moyo yomwe ingakuthandizeni kukhala ndi moyo wabwino pochepetsa zizindikiro zomwe muli nazo panopa. Tikambirana chilichonse m'njira yosavuta yomwe mungamvetse.
Kodi Proctocolectomy ndi chiyani kwenikweni?
Mwachidule, proctocolectomy ndi opaleshoni yochotsa m'matumbo anu ndi gawo lomaliza la rectum yanu.
Tiyeni tifotokoze bwino izi. Matumbo akuluakulu ndi gawo lalitali longa chubu cha m'mimba mwathu. Lili ndi magawo atatu akuluakulu:
1. M'mimba mwa mayi: Iyi ndi gawo lalikulu kwambiri. Imayamwa madzi kuchokera ku zinyalala zomwe zatsala kuchokera ku chakudya chomwe timadya ndipo imasanduka mawonekedwe olimba, otchedwa ndowe.
2. Rectum (gawo lomaliza la anus): Iyi ndi gawo lalifupi pambuyo pa m'matumbo. Ndi komwe ndowe zimasungidwa kwakanthawi musanatulutse.
3. Mphuno: Mpata womwe ndowe zimatulukira m'thupi.
Choncho, pochotsa proctocolectomy, m'matumbo ndi m'matumbo zimachotsedwa, kapena mbali yake. "Procto" amatanthauza rectum. "Colectomy" amatanthauza kuchotsa m'matumbo.
N’chifukwa chiyani muyenera kuchitidwa opaleshoni yamtunduwu?
Pali zifukwa zingapo zomwe opaleshoni yaikulu yotereyi ingachitikire. Chifukwa chachikulu ndi chakuti matenda omwe ali m'matumbo amalepheretsa gawo la thupi kugwira ntchito bwino kapena kuti matendawa ndi oopsa kwambiri.
| Matenda | Kufotokozera kosavuta |
|---|---|
| Matenda Otupa a M'mimba | Ngati mkati mwa matumbo mukuvulala nthawi zonse komanso kutupa chifukwa cha matenda monga Ulcerative Colitis ndi matenda a Crohn , opaleshoni ingafunike ngati vutoli silingathe kuthetsedwa ndi mankhwala. |
| Khansa ya m'matumbo ndi matenda a precancerous | Kuletsa kufalikira kwa maselo a khansa ya m'matumbo kapena m'matenda monga Familyal Adenomatous Polyposis (FAP) , yomwe ndi vuto lobadwa nalo lomwe limayambitsa mazana a ma polyps omwe ali ndi mwayi waukulu woti akhale khansa. |
| Zifukwa zina | Mavuto monga kufa kwa minofu ya m'mimba chifukwa cha kutayika kwa magazi (ischemia), kudzimbidwa kwambiri, kuvulala kwambiri m'matumbo, kapena diverticulitis . |
Kodi mumatsuka bwanji chimbudzi mukatha opaleshoni?
Funso lalikulu lomwe anthu ambiri amafunsa ndi ili. Pamene m'matumbo ndi m'matumbo mwachotsedwa, njira yachibadwa yotulutsira ndowe imatayika. Kodi mumatani kuti muchotse ndowe? Yankho la funsoli limadalira mtundu wa proctocolectomy yomwe mwachita. Dokotala wanu adzasankha njira yoyenera kwambiri kutengera matenda anu.
Pali njira zingapo zazikulu:
1. Njira ya Ileostomy
Izi zimaphatikizapo kulumikiza gawo lomaliza la matumbo anu ang'onoang'ono, lotchedwa ileum, ndi kabowo kakang'ono (stoma) komwe kamapangidwa pakhungu la mimba yanu. Kenako thumba la ostomy limalumikizidwa ku kabowo kuti litenge ndowe. Izi zitha kukhala zokhazikika kapena zakanthawi . Kwakanthawi kumachitika kokha mpaka thupi lanu litachira. Izi zitha kusinthidwa pambuyo pake ndi opaleshoni ina.
2. Ileoanal Pouch (kupanga thumba lamkati)
Iyi ndi njira yosangalatsa kwambiri. Imatchedwanso Restorative Proctocolectomy. Gawo la matumbo anu ang'onoang'ono (ileum) limatengedwa ndipo thumba laling'ono limapangidwa kuchokera pamenepo. Ganizirani ngati gawo latsopano la thupi lanu lomwe lingagwire ndowe yanu kwakanthawi, monga momwe zimakhalira m'matumbo anu. Kenako, thumba limalumikizidwanso ku anus yanu. Pambuyo pa njirayi, mudzatha kupita kuchimbudzi ndikuchita chimbudzi nthawi zonse pakapita kanthawi. Njira yodziwika kwambiri pa izi imatchedwa J-pouch .
3. Kuchotsa Proctocolectomy (kusunga gawo limodzi)
Mu izi, gawo lina la matumbo akuluakulu limasiyidwa. Ngati n'kotheka, gawo lotsala la matumbo likhoza kulumikizidwanso ku anus kapena mbali ina yonse ya rectum (anastomosis). Komabe, nthawi zina, pangafunike kupangidwa mpata wakanthawi m'mimba ndikuyika thumba la chopondapo (colostomy) mpaka malo olumikiziranawo atachira.
Chofunika kwambiri ndi chakuti dokotala wanu akambirane nanu njira zomwe zili zoyenera kwa inu. Choncho, kambiranani mafunso kapena nkhawa zilizonse zomwe muli nazo ndi dokotala wanu.
Chimachitika opaleshoni isanachitike, panthawi yake, komanso itatha
Musanachite opaleshoni
Ngati si opaleshoni yadzidzidzi, mudzakhala ndi nthawi yokonzekera.
- Masabata angapo isanafike: Dokotala wanu adzakufotokozerani za opaleshoniyi, zoopsa zake, ndi zomwe mungasankhe.
- Masabata awiri musanayambe kumwa: Ngati mukumwa mankhwala ochepetsa magazi, mudzauzidwa kuti musiye kapena kuchepetsa kumwa mankhwalawa. Mudzalangizidwa kudya zakudya zokhala ndi ulusi wambiri komanso kumwa madzi ambiri.
- Maola 24 musanayambe: Mudzapatsidwa mankhwala oyeretsera matumbo anu mokwanira. Mudzauzidwanso kuti mudye zakumwa zokha patsiku. Mungathenso kupatsidwa mankhwala opha tizilombo toyambitsa matenda kuti mupewe matenda mutachita opaleshoni.
Pa nthawi ya opaleshoni
Mudzagonekedwa pansi pa opaleshoni yoletsa kupweteka, kotero simudzamva chilichonse. Opaleshoniyi ingachitike m'njira ziwiri zazikulu:
- Opaleshoni Yotseguka: Njira yachikhalidwe, yochitidwa kudzera mu kudula kwakukulu m'mimba.
- Opaleshoni ya Laparoscopic: Imadziwikanso kuti opaleshoni ya "keyhole", izi zimachitika mwa kudula pang'ono m'mimba ndikuyika kamera ndi zida zofewa kudzera mwa izo. Njirayi imapangitsa kuti munthu achire mwachangu komanso kuti asamamve ululu kwambiri.
Dokotalayo amachotsa mosamala gawo la m'mimba lomwe ladwala ndikuchita njira zofunika (ileostomy, pouch, kapena re-connection) monga tafotokozera kale.
Pambuyo pa opaleshoni
Muyenera kukhala m'chipatala kwa pafupifupi sabata imodzi. Panthawiyi, mudzasintha pang'onopang'ono kuchoka pa zakudya zamadzimadzi kupita ku zakudya zolimba. Ngati muli ndi ostomy (thumba), namwino wophunzitsidwa bwino (WOCN - Wound Ostomy Continence Nurse) adzakuphunzitsani momwe mungagwiritsire ntchito ndikusunga khungu lanu loyera.
Kodi mavuto omwe angakhalepo ndi ati?
Monga momwe zimakhalira ndi opaleshoni iliyonse, pali zoopsa ndi zovuta zomwe zingachitike, koma nthawi zambiri izi zimakhala zakanthawi kochepa.
| Mtundu wa vuto | Kufotokozera |
|---|---|
| Mavuto ofala a opaleshoni | Kuyankha chifukwa cha mankhwala oletsa ululu, kutuluka magazi mkati, matenda, kutsekeka kwa matumbo, ndi zina zotero. |
| Mavuto okhudzana ndi ostomy (thumba) | Matenda a pakhungu ozungulira stoma, omwe amalowa kapena kutuluka m'mimba.Vuto lotchedwa phantom rectum lingachitikenso. Uku ndi kumva ngati ukuyenera kuchita chimbudzi ngakhale kuti rectum yachotsedwa. Izi zidzachepa pakapita nthawi. |
| Mavuto okhudzana ndi Ileoanal Pouch (thumba lamkati) | Matenda a pouchitis , kutuluka kwa madzi m'thupi, komanso kusadziletsa kwa ntchentche msanga. Zambiri mwa izi zimatha kuchiritsidwa. |
Kodi ndi zinthu ziti zadzidzidzi zomwe zimafuna kuti dokotala apite kuchipatala?
Ngati mukukumana ndi zizindikiro zotsatirazi mutachita opaleshoni, imbani dokotala wanu nthawi yomweyo kapena pitani ku Dipatimenti Yothandiza Pangozi (ETU) ya chipatala.
- Kutupa, kupweteka m'mimba, nseru, ndi kudzimbidwa (izi zitha kukhala zizindikiro za kutsekeka kwa matumbo).
- Kupweteka kwambiri m'mimba, kutentha thupi, mafinya akutuluka m'chidutswacho (izi ndi zizindikiro za matenda).
Musaiwale, ngati mukumva china chake chachilendo, musachinyalanyaze. Ndi bwino kufunsa upangiri wa dokotala.
Uthenga Wopita Nawo Kunyumba
- Ngakhale kuti opaleshoni ya proctocolectomy ndi opaleshoni yaikulu, imatha kuchiritsa matenda omwe angakupheni ndikukuthandizani kukhala ndi moyo wabwino.
- Pali njira zosiyanasiyana zochitira chimbudzi mukatha opaleshoni. Anthu ena amakhala ndi thumba la ostomy, pomwe ena ali ndi njira zina zomwe zimawathandiza kuti achite chimbudzi mwachizolowezi. Dokotala wanu adzasankha chomwe chili chabwino kwa inu.
- Zimatenga nthawi kuti munthu achire. Mutha kubwerera ku moyo wabwinobwino pakatha miyezi ingapo. Ndikofunikira kwambiri kukhala oleza mtima ndikutsatira malangizo a dokotala wanu panthawiyi.
- Khalani omasuka kukambirana ndi dokotala wanu za mantha anu onse, kukayikira kwanu, ndi mafunso anu. Izi zidzakupatsani mphamvu zambiri zamaganizo.
- Ngakhale kukhala ndi thumba la ostomy kungakhale kovuta poyamba, mukangozolowera, mutha kupitiriza kugwira ntchito bwino. Pali zipangizo ndi njira zambiri zomwe zilipo masiku ano zothandizira izi.
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