Ese iyo urya wumva uhaze? Cyangwa uruka kenshi? Impamvu imwe ishobora kuba ikibazo cy'imitsi iri ku mpera y'igifu cyawe, cyangwa aho ibiryo binyura biva mu gifu bijya mu mara mato. Iyi mvange twita 'pylorus'. Iyo iri rembo ridafungutse neza, ibiryo birahaguma. Pyloroplasty ni ukubaga bizagufasha mu bihe nk'ibyo. Reka tubiganireho uyu munsi.
Mu magambo make, Pyloroplasty ni iki?
Tekereza igifu cyawe nk'agafuka. Ibiryo turya bibikwa muri aka gafuka, bigashongeshwa, hanyuma bigashyirwa mu mara mato. Ku mpera y'aka gafuka ko mu nda, hari impeta y'imitsi ikora nk'irembo. Yitwa pylorus . Iri rembo rifungura iyo bikenewe, rigatuma ibiryo byashongeshejwe bijya mu mara mato, hanyuma bigafunga.
Rero, niba ku mpamvu runaka uyu mwenge ufunze, ugafunganye, cyangwa ntufunguke neza, ibiryo ntibishobora gusohoka mu nda. Muri icyo gihe, uyu mwenge twita pylorus uburyo bwo kubaga bukoreshwa mu kuvugurura no kwagura. Hari igihe, iyo iki gice cyangiritse bitewe n'ubundi bubagwa, ubu buryo bwo kubaga bukorerwa no kugisana.
Ni mu bihe ibihe kubagwa kwa pyloroplasty biba ngombwa?
Niba pylorus yawe idakora neza, bivuze ko gusohora igifu byatinze, ubu buryo bwo kubaga bushobora kugufasha. Pyloroplasty ikunze kwitabwaho mu bihe bikurikira:
1. Ibisebe byo mu gifu (Indwara y'ibisebe byo mu gifu)
Hari ibisebe bikomeye byo mu gifu bisaba kubagwa. Urugero, niba ufite ibisebe bikomeza kuva amaraso cyangwa bidakira hakoreshejwe imiti, muganga wawe ashobora kukugira inama yo gukora uburyo bwitwa vagotomy kugira ngo ugabanye aside yo mu gifu. Ibi bikubiyemo gukata imitsi imwe n'imwe ijya mu gifu.
Ariko hari akantu gato hano. Nubwo ubu buryo bwo kubaga imyakura igabanya aside yo mu gifu, imitsi imenyesha ko pylorus igomba gufungura no gufunga na yo ishobora kudakora. Hanyuma irembo ntirifunguke. Niyo mpamvu, niba ukoze kubaga imyakura isanzwe, ukora kandi pyloroplasty kugira ngo irembo rirusheho kwaguka burundu.
Byongeye kandi, hari igihe igisebe gishobora kubyimba cyangwa inkovu ikavuka, igafunga burundu inzira inyura muri pylorus. Mu bihe nk'ibi byihutirwa, ubu buvuzi nabwo burakenewe.
2. Gastroparesis
Iki gihe imitsi yo mu nda, harimo na pylorus, idakora neza. Ni nk'aho imitsi yo mu nda yacitse intege igice. Ibi bitera gutinda cyane mu igogora no gusohora ibiryo mu nda. Iyo ibi bikomeye, bishobora gutera isesemi no kuruka bihoraho, bigatuma bidashobora kuboneka. Niba ubundi buryo bwo kuvura budakora neza, muganga wawe ashobora kukugira inama yo gufungura pylorus akoresheje pyloroplasty.
3. Stenose ya Piloriki
Iyi ndwara ikunze kugaragara cyane ku bana bavutse . Muri iyi ndwara, inkuta z'igifu cy'umwana ziba nini, zigafunga inzira y'ibiryo. Kubera iyo mpamvu, umwana ntashobora kubona amata yanyoye kandi aruka kenshi. Ku bana nk'abo, ubu buryo bwo kubagwa ni ngombwa niba bashaka kwinjiza ibiryo mu mibiri yabo neza.
Uku kubagwa bikorwa gute kandi ni ubuhe buryo?
Ubu buryo bwo kubaga bushobora gukorwa mu buryo bubiri. Bumwe ni ukubaga mu buryo bworoshye, bukubiyemo gukata inda. Ubundi ni ukubaga mu buryo bwa laparoscopic , bukubiyemo gukata uduce duto mu nda no gukoresha kamera n'ibikoresho byoroshye. Uko byagenda kose, uzashyirwa munsi y'ikinya rusange, bityo ntuzumve ikintu icyo ari cyo cyose.
Hari uburyo bwinshi bw'ingenzi bwo kubaga pyloroplasty. Muganga ahitamo uburyo bukwiye cyane bitewe n'uko umurwayi amerewe.
| Uburyo bwo Kubaga | Ibisobanuro byoroshye |
|---|---|
| Heineke-Mikulicz Pyloroplasty | Ubu buryo ni bwo busanzwe. Umuganga ubaga agaca pylorus mu buryo burambuye hanyuma akadodana mu buryo bwambukiranya. Ibi bigabanya umwanya kandi bikagabanya imitsi. |
| Ivuriro ry'imitsi (Ramstedt Pyloroplasty) | Ubu buryo bukoreshwa cyane cyane ku bana bavutse. Aha, imitsi yo hanze ya pylorus ni yo icibwa, hagasigara igice cyo imbere cyoroshye (mucosa). Ibi bituma igice cyo imbere kibyimba inyuma, bikongera umwanya imbere. |
| Kwaguka kwa Piloriki | Ubu si uburyo bwo kubaga. Bisa na endoscopy , aho umuyoboro winjizwa mu kanwa, hanyuma pylorus ikavugururwa hakoreshejwe igikoresho cyihariye. |
| Jaboulay/Finney Pyloroplasty | Ubu buryo ntabwo bukunze gukoreshwa cyane. Bukoreshwa iyo hari ububyimbirwe bukomeye cyangwa inkovu muri pylorus. Ibi bisaba kunyura kuri pylorus no gushyiraho isano nshya hagati y'igifu n'amara mato (gastroduodenostomy) . |
Ni iki kibaho nyuma yo kubagwa?
Nyuma yo kubagwa, niba warakorewe laparoscopic, ushobora gutaha uwo munsi. Niba warakorewe kubagwa ku mugaragaro, uzakenera kumara iminsi mike mu bitaro kuko aho wacitse ari hanini. Ntabwo uzahabwa ibiryo bikomeye mu minsi mike ya mbere. Uzahabwa ibiryo binyuze mu muyoboro washyizwe mu mazuru cyangwa ukoresheje saline mu mitsi.
Ni izihe ngorane zishobora guterwa no kubagwa?
Nkuko bigenda mu kubagwa kose, hari ingaruka zimwe na zimwe, ariko amahirwe yo kuba ibi bibaho ni make.
- Kuva amaraso
- Indwara zandurira mu mubiri
- Kuvura amaraso
- Kwangirika kw'ingingo zikikije
Uretse izi ngaruka rusange, hari ingorane nyinshi zihariye zijyanye no kubaga pyloroplasty.
1. Indwara yo gutakaza ubwiherero
Iyi ni yo ngaruka mbi ikunze kugaragara nyuma y’uku kubagwa. Ni ikinyuranyo cy’ikibazo cyaguteye kubagwa. Ni ukuvuga ko ibiryo biva mu nda byinjira vuba mu mara mato. Ibi akenshi biba iby’igihe gito.
Ibimenyetso bya "dumping syndrome" bishobora kugaragara mu byiciro bibiri. Nyuma gato yo kurya, ushobora kugira kuribwa mu gifu, isesemi, no gucibwamo. Nyuma y'amasaha make, isukari mu maraso yawe iragabanuka mu buryo butunguranye, bigatera ibimenyetso nko gucika intege, isereri, ibyuya, no gutera umutima cyane.
Nubwo ibi bishobora kugorana mu ntangiriro, bishobora kugenzurwa hakoreshejwe impinduka mu mirire , ndetse nibiba ngombwa, imiti yandikiwe na muganga wawe.
2. Kugaruka kw'ibinure mu nda
Iyo valve ya pyloric ihinduwe, ntabwo ifunga neza, bigatuma ibiri mu mara mato, cyane cyane inyo , bisubira mu gifu. Inyo ni ikintu kibabaza igifu. Ibi nibikomeza, bishobora gutera indwara ya gastritis .
Uburyo bwo kugarura ubuzima n'intsinzi
Abantu benshi, cyane cyane abakorewe laparoscopic, bakira vuba. Bashobora gusubira mu mirimo yabo isanzwe no mu mirire mu byumweru bike. Niba ufite ibimenyetso bya dumping syndrome, ugomba kwitondera indyo yawe kugeza igihe bizimiye (wenda amezi make).
Pyloroplasty ni uburyo bwiza cyane bwo kuvura gastroparesis no kuziba igifu, aho igipimo cyo kuvura kigera kuri 90%.
Amaherezo, kuziba gato kwa pylorus bishobora guhungabanya uturemangingo twose tw’igogora. Hari uburyo bwo kuvura ibi bitari ukubaga, ariko iyo bidakoze, kubaga bishobora kuba igisubizo cyiza kandi cyizewe.
Ubutumwa bwo kujyana mu rugo
- Pyloroplasty ni uburyo bwo kubaga butuma igifu cyagura umwobo, bigatuma ibiryo binyura mu mara mato byoroshye bidafata.
- Ubu buryo bwo kubaga bukorerwa cyane cyane mu gihe cy'ibisebe bikomeye byo mu gifu, gastroparesis, na stenosis ya pyloric ku bana bavutse.
- Ibi bishobora gukorwa nk'ukubaga bifunguye cyangwa kubagwa hakoreshejwe laparoscopic (imfunguzo). Muganga wawe ni we uzagena uburyo bukubereye.
- Ingaruka mbi zikunze kugaragara nyuma yo kubagwa ni indwara yo gusimbuka, aho ibiryo biva mu nda vuba cyane. Ariko, ibi akenshi biba iby'igihe gito kandi bishobora kugenzurwa no guhindura indyo yawe.
- Mbere yo kubagwa, ni ngombwa cyane kuganira na muganga wawe ku byiza n'ibibi byose no gufata umwanzuro.
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