Uburyo bwa Hartmann bwo gukora ni ubuhe? Reka tubyige mu buryo bworoshye.

Bite ho niba ufite ubwandu bukomeye, kuziba, cyangwa kanseri mu mara yawe kandi ukaba ukeneye kubagwa cyane? Hari igihe abaganga bagomba kubagwa vuba cyane. Uburyo bumwe bwihariye bukoreshwa muri bene ubwo buryo bwitwa Hartmann's Procedure. Izina rishobora kumvikana nk'aho riteye ubwoba gato, ariko reka tuvuge neza kandi mu buryo bwumvikana ku bibaho koko, impamvu bikorwa, n'ibiba nyuma yo kubagwa.

Mu magambo make, iyi gahunda ya Hartmann ni iyihe?

Uburyo bwo kubaga bwa Hartmann bukorerwa mu mara manini (colon). By’umwihariko, bukubiyemo gukata no gukuraho igice cy’amara manini gifite indwara, cyane cyane igice cya nyuma aho umwanda usohoka, ari wo mura utaringaniye, ndetse rimwe na rimwe n’igice cyo hejuru cy’umura.

Noneho tekereza ko nyuma yo gukuraho igice cy’amara cyarwaye, ibice bibiri bisigaye bizima bigomba kongera guhuzwa. Ariko, ni akaga cyane kongera guhuza ibice bibiri icyarimwe iyo hari ubwandu bukomeye, kubyimba, cyangwa izindi ngorane. Kubikora bishobora gutuma ubwandu bwongera gukwirakwira, bishobora kuba ikibazo gikomeye.

Niyo mpamvu abaganga baha umwanya ibice bibiri bisigaye by'amara kugira ngo bikire.

1. Impera y'amara ifatanye n'ikibuno (agatsinsino k'inyuma) iradodwa by'agateganyo.

2. Impera nziza y'amara manini, iri hejuru, ifatanye n'umwobo muto (stoma) ukorerwa mu rukuta rw'inda.

Aha niho umwanda usohokera unyuze muri uyu mwenge mushya uri mu nda. Ibi byitwa colostomy . Kugira ngo uyu mwanda ukurweho, hashyirwaho agafuka kadasanzwe (colostomy bag) inyuma y'uwo mwenge.

Kuki ukeneye ubu buvuzi?

Hari impamvu nyinshi z'ingenzi zo gukora igikorwa cya Hartmann. Hari impamvu zitandukanye zo gukuraho igice cy'amara no gushyiraho colostomy.

Kuki igice cy'amara gikurwaho?

• Kuziba: Iyo hari ahantu mu mara hafunganye bigatuma umwanda utagenda.
• Gutobora: Iyo umwobo utangiye ku rukuta rw'amara maze umwanda ukajya mu nda, ibi bishobora gukwirakwiza ubwandu mu nda yose (peritonitis).
• Indwara cyangwa indwara idashobora kugenzurwa: Hari indwara zimwe na zimwe (urugero: diverticulitis igoye) cyangwa indwara nka kanseri zishobora gusaba gukuraho igice cy’indwara kugira ngo hirindwe ko cyakwirakwira kurushaho.

Kuki hakorwa isuzuma rya colostomy?

Nkuko byavuzwe haruguru, iyo habaye kubagwa mu gihe cy’impanuka, umubiri w’umurwayi uracika intege kandi ibyago byo kwandura bikaba byinshi cyane. Muri iyo mimerere, guhuza ibice bibiri by’amara (anastomose) ni ikibazo gikomeye. Kubwibyo, intego ya mbere y’abaganga ni ukurokora ubuzima bw’umurwayi. Gukoresha colostomy biha amara umwanya wo gukira, hanyuma bigatuma yongera kubagwa neza kandi bidatera ibyago byinshi kugira ngo ubuzima bugaruke.

Uburyo bwo kubaga bukorwa n'uburyo bikorwa

Uku kubagwa gushobora gukorwa mu buryo bubiri bw'ingenzi:

1. Kubaga bifunguye: Kubaga bikorwa hifashishijwe icyuma kinini cyo mu nda. Ubu buryo bukunze gukoreshwa mu bihe byihutirwa kandi bigoye.

2. Kubaga Laparoscopic: Kubaga bikorwa binyuze mu gukata uduce duto mu nda, hakoreshejwe kamera n'ibikoresho byihariye. Nubwo gukira byihuta, ubu buryo ntibukwiriye abarwayi bose.

Mbere yo kubagwa

Niba witegura kubagwa, uzasabwa kwiyiriza ubusa amasaha 6-12. Ushobora kandi guhabwa amazi yihariye (gutegura amara) kugira ngo usukure amara yawe. Nyuma yo kwinjira mu bitaro, hazashyirwamo saline cannula mu mitsi iri mu kuboko kwawe hanyuma uhabwe amazi n'imiti.

Mu gihe cyo kubaga

Kubagwa bikorwa hifashishijwe ikinya rusange. Umuganga akuramo igice cy'amara cyarwaye, agafunga impera y'ururenda, hanyuma agafata indi mpera ku nda.Igisebe gifatishwa ku mwenge. Amaherezo, agasakoshi k'inkari karafatishwa hanyuma ibikomere byo kubagwa bigashyirwamo imisumari. Iki gikorwa cyose gishobora gufata amasaha abiri kugeza kuri ane.

Nyuma yo kubagwa

Nyuma yo kubagwa, ubanza kujyanwa mu cyumba cyo gukira hanyuma woherezwe mu cyumba cy’ubuvuzi igihe indwara yawe imaze kumera neza. Uzakenera kumara iminsi 7-10 mu bitaro.

• Mu minsi ya mbere, imiti igabanya ububabare, imiti igabanya ubukana, n'amazi bizatangwa binyuze mu munyu.
• Bishobora gufata iminsi myinshi kugira ngo amara yongere gukora.
• Ubwa mbere, bahabwa ibiryo by'amazi hanyuma buhoro buhoro bakagezwa ku biribwa bikomeye.
• Umuforomo wahuguwe byihariye azakwigisha wowe n'umuryango wawe uburyo bwo gusukura no guhindura agasakoshi ko mu gifu, n'uburyo bwo kwita kuri stoma (ubuvuzi bwa stoma).

Ni izihe ngaruka zishobora guterwa n'ingaruka mbi?

Nkuko bigenda mu kubaga kose, hari ingaruka zimwe na zimwe, ariko bifatwa nk'uburyo butekanye.

• Ingaruka zishobora kubaho: kwandura ibikomere, kwandura ibihaha (pneumonia), kuva amaraso imbere mu nda, kuva amaraso mu mara, kwangirika kw'ingingo zikikije, no kurema hernia.
• Ingaruka mbi zishobora kubaho:
• Ileus y'igihe gito: Bifata igihe kugira ngo amara yongere gukora nyuma yo kubagwa.
• Amasohoro yo mu kibuno: Nubwo waba utarimo kwituma, hari igihe amazi asa n'ay'ururenda ashobora gusohoka mu gice gisigaye cy'ururenda. Ibi ni ibisanzwe.
• Imboro mbi: Ni gake cyane, kubagwa bishobora kwangiza imitsi ikora ku mibonano mpuzabitsina. Vugana na muganga wawe niba ufite impungenge kuri ibi.

Gukira no gukira

Bifata igihe kugira ngo umuntu akire neza.

• Icyumweru cya 4-6: Gabanya ikoreshwa ry'imiti igabanya ububabare, subira ku ndyo isanzwe, hanyuma wongere usubiremo imyitozo ngororamubiri yoroheje.
• Amezi 3-6: Kumenyera ubuzima hamwe n'agakapu ko mu bwoko bwa colostomy, kumva meze neza mu mubiri.

Ese isuzuma rya colostomy rishobora guhindurwa? (Gusubira inyuma)

Iki ni cyo kibazo gikomeye ku bantu benshi. Yego, akenshi gishobora gusubizwa inyuma.

Nyuma y'amezi agera kuri 6-12 nyuma yo kubagwa bwa mbere, umuganga wawe azasuzuma ubuzima bwawe. Niba ufite ubuzima bwiza, amara yawe yakize neza, kandi ukaba ushobora kwihanganira ubundi bubagwa, ushobora guhitamo kubagwa mu buryo bwo gusubira inyuma .

Ariko, niba kanseri yarakwirakwiriye umubiri wose, niba hari indwara ikomeye y’umubiri, cyangwa niba umurwayi afite intege nke cyane, muganga ashobora kudasaba ko habaho ubundi bubagwa. Ushobora kuganira na muganga wawe ku bwumvikane kuri ibi bintu byose.