Ese umaze iminsi ubabara mu nda kandi ukumva utameze neza? Muganga wawe ashobora kuba yarakubwiye ko ufite indwara yo kubyimba amara (IBD) nk'indwara ya Crohn. Iyo umaze igihe kinini ufite iyi ndwara, hari ibice bimwe na bimwe mu mara yawe bitangira kugabanuka buhoro buhoro. Ni nk'aho umuyoboro w'amazi ufunga hagati. Rero, ubu buryo bwitwa operasiyo yihariye kugira ngo twagure utu duce duto 'Strictureplasty'. Uyu munsi, tuzavuga kuri byose mu magambo yoroshye.
Mu by'ukuri, Strictureplasty ni iki?
Muri make, strictureplasty ni uburyo bwo kubaga butuma agace gato cyangwa gafunganye mu mara yawe (byitwa stricture). Ibi akenshi biterwa no kubyimba guhoraho, guterwa n'indwara zo mu mara ziterwa n'ububyimba (IBD) nka Crohn's disease na Ulcerative Colitis. Uku kubyimba gutera inkovu ku nkuta z'amara, bigatuma zibyimba kandi zigafunga.
Ubwo bwoko bw'imizigo ikunze kugaragara muri:
- Igice cyo hasi cy'amara mato (ileum)
- Ku bijyanye n'agakingirizo gahuza amara mato n'amara manini (`agakingirizo ka ileocecal`).
Ariko, iyi ndwara ishobora no kugaragara mu mara, mu nda no mu kibuno. Intego nyamukuru y'ubu buvuzi ni ukwagura igice cy'amara cyagabanutse no gusubiza ibiryo mu buryo busanzwe, hatabayeho gukuraho igice cy'amara.
Kuki ukeneye ubu buvuzi?
Iyo igice cy'amara yawe cyagabanutse gutya, ibiryo ntibishobora kugenda neza. Ibi bishobora gutera ibimenyetso byinshi bibabaza kandi bibabaza.
| Ibimenyetso | Ibisobanuro byoroshye |
|---|---|
| Kubabara cyane mu gifu no gucumbagira | Ubu bubabare buterwa n'uko amara arushaho kwifata iyo agerageza kohereza ibiryo mu gihe bizibye. |
| Kubyimba inda no kubyimba mu nda | Igifu kirabyimba kuko ibiryo n'umwuka bidashobora kumanuka neza ngo bifatirwe ahantu hamwe. |
| Isesemi no kuruka | Iyo ikibazo gikomeye, ibiryo bishobora kutagabanuka kandi bishobora kongera kuzamuka. |
| Impatwe | Kwiyuhagira biragorana bitewe n'uko igogora rigenda buhoro. |
| Kubura ubushake bwo kurya no kugabanya ibiro | Bitewe n'ububabare n'imibabaro, icyifuzo cyo kurya kirabura, kandi umubiri ntubashe kwinjiza intungamubiri neza. |
| Umunaniro n'amaraso makeya | Akenshi, ibisebe biba muri utwo duce duto. Ibi bisebe biva amaraso buhoro buhoro, bigatera kubura amaraso uko igihe kigenda gihita. Iyi ndwara irashira nyuma yo kubagwa. |
Igikuru cyane: Iyo uku kugabanuka kw'amara gukomeje kwiyongera, amara ashobora kuziba burundu (gufunga amara). Iyi ni indwara iteje akaga cyane ndetse ishobora no gushyira ubuzima mu kaga. Kubwibyo, niba ufite ibimenyetso, ni ngombwa guhita ubonana na muganga.
Ni nde uku kubagwa kubereye kandi kutabereye?
Kubaga strictureplasty si ibya buri wese. Muganga wawe azafata icyemezo cyiza bitewe n'uko umerewe.
| Abakwiriye kubagwa | Ingero z'aho kubagwa bitagomba kwitabwaho |
|---|---|
| Iyo hari uduce twinshi duto duto ahantu hamwe n'igice kirekire cy'amara. | Niba hari uduce twinshi mu gice gito cy'amara, shyira hamwe. |
| Niba warigeze gucibwa amara mbere. | Iyo hari igikomere, ububyimbirwe, fistula, cyangwa gukura ku buryo budasanzwe ku gace kari kafunganye. |
| Niba ufite indwara y'amara magufi. | Kugabanuka kw'ibinure biri hafi y'aho babanje kubaga (anastomose). |
| Iyo hari ukugabanuka gusa, nta kubyimba cyangwa gukomereka ku gace kari kari kari. | Niba ufite amara afite icyuho. |
| Niba ukunze kugira ibimenyetso by'indwara ya Crohn. | Niba urwaye indwara y'imirire mibi ikabije. |
Witegura ute mbere yo kubagwa?
Kubera ko ubu ari ukubagwa guteganyijwe, muganga wawe azakora ibizamini byinshi mbere y'uko arwara.
- Ibizamini byo Gupima: Ikizamini nka CT scan cyangwa Magnetic Resonance Enterography (MRE) kizakorwa kugira ngo harebwe neza aho uduce tw’amara turi n’igihe tungana.
- Ibizamini by'amaraso: Ibizamini by'amaraso bizakorwa kugira ngo harebwe uko imirire yawe ihagaze. Niba ufite imirire mibi, ushobora guhabwa inyongeramusaruro binyuze mu mitsi (`IV`) iminsi mike mbere yo kubagwa. Ibi bizagufasha gukira vuba nyuma yo kubagwa.
- Stoma (agafuka k'amagufwa): Hari ubwo, nyuma yo kubagwa, hashobora gukenerwa ko hakorwa umwenge w'agateganyo (`stoma`) ku ruhu rw'inda kugira ngo umwanda unyuremo, kandi hashobora gukenerwa ko hashyirwaho agafuka (`agafuka k'amagufwa`) kugeza igihe amara akize. Ntugahangayike. Niba ari ngombwa, muganga wawe azagusobanurira neza mbere yo kubagwa.
Kubagwa bikorwa gute?
Strictureplasty ni ukubagwa gukomeye gukorwa hifashishijwe ikinya rusange. Uzakenera kumara iminsi mike mu bitaro. Mbere yuko ubagwa utangira, uzahabwa ikinya rusange, bityo ntuzumva ububabare cyangwa ngo wibuke uko wabazwe.
Mu gihe cyo kubagwa, umuganga ubaga atema igice cy’amara cyagabanutse maze akagifungura. Tekereza nko gukata umuyoboro wafunzwe mu burebure, ugatandukanya impera zombi z’amara, hanyuma ukazidoda hamwe. Iyo amara ari manini, ibiryo bishobora kongera kunyuramo byoroshye. Niba ufite stricture nyinshi, akenshi ushobora kuzivura zose mu gikorwa kimwe.
Hari ubwoko butandukanye bwa Strictureplasty bitewe n'uburebure bw'aho ipfundikirwa:
Heineke-Mikulicz Strictureplasty
Ubu buryo ni bwo bukoreshwa cyane. Bukorwa ku bipimo bigufi kurusha santimetero 10 (hafi santimetero 4).
Finney cyangwa Jaboulay Strictureplasty
Ibi bikoreshwa mu kugabanya uburebure buri hagati ya santimetero 10-20 (hafi santimetero 8). Muri ubu buvuzi, amara azunguruka mu ishusho ya 'U'.
Michelassi Strictureplasty
Ubu ni uburyo bwihariye bwo gufunga uburebure burenga santimetero 20. Muri ubu buryo, igice cy'amara gifunganye gishyirwamo kabiri, impande zombi zigahuzwa, hagakorwa icyuho kirekire, hanyuma byombi bigadoderwa hamwe.
Bifata igihe kingana iki kugira ngo umuntu akire nyuma yo kubagwa?
Ubu ni ukubagwa gukomeye, bityo bizatwara igihe kugira ngo ukire. Ushobora kumara icyumweru kimwe mu bitaro . Niba hari ingorane, ushobora kumara igihe kirekire.
- Ububabare: Ushobora kugira ububabare mu gifu mu minsi mike ya mbere nyuma yo kubagwa. Muganga azaguha imiti igabanya ububabare kuri ibi.
- Imbogamizi: Ntuzashobora gukora ibintu nko guterura ibyuma cyangwa gutwara imodoka mu gihe cy'ibyumweru bike.
- Itondere indwara zandura: Ugomba kwitonda cyane ku bijyanye no kwandura indwara nyuma yo kubagwa. Niba ufite ibimenyetso nko kubabara cyane, umuriro, gutukura cyangwa kubyimba aho bakorewe, cyangwa kuva amaraso mu gisebe bidasanzwe, ugomba kubimenyesha muganga wawe vuba .
- Indyo: Bitewe n'uburwayi bwawe, muganga wawe cyangwa inzobere mu mirire bashobora kukugira inama yo kurya indyo yihariye (`indyo yoroshye ya GI`).
- Uburyo bwo kuvura indwara ya IBD: Ikintu cy'ingenzi ugomba kwibuka ni uko ubu buryo bwo kubaga butuma habaho kwagura gusa. Ntabwo buvura indwara ya IBD (nk'iya Crohn). Kubwibyo, uzakenera gukomeza gufata indi miti ijyanye n'uburwayi bwawe.
Ni irihe tandukaniro riri hagati ya `Strictureplasty` na `Amara Resection`?
Iki ni ikibazo abantu benshi bibaza. Hari itandukaniro rinini hagati y’ubu buryo bwo kubaga bubiri.
| Ibiranga | Strictureplasty (kwagura) | Guca amara |
|---|---|---|
| Icyo gukora | Igice cy'amara cyagabanutse kiragutse . | Igice cy'amara cyagabanutse kiracibwamo ibice bibiri bisigaye. |
| Inyungu nyamukuru | Uburebure bwose bw'amara burabungabungwa, bigabanya ibyago byo kurwara indwara ya "Short Arowel Syndrome" (ibibazo byo kwinjiza imirire) . | Ingaruka zo kongera kugira ikibazo ahantu hamwe zishobora kugabanuka gato. |
| Ingaruka z'ejo hazaza | Hari amahirwe menshi ko kubagwa bizakenerwa mu gihe kiri imbere. | Hari amahirwe make yo gukenera kongera kubagwa mu gihe kiri imbere. |
Abaganga bakunze kugerageza strictureplasty mbere na mbere, kuko kubungabunga uburebure bw'amara ari ingenzi cyane mu mirire.
Ubutumwa bwo kujyana mu rugo
- Strictureplasty ni uburyo bwo kubaga bwo kwagura ibice by'amara bifunganye bitewe n'indwara nka Crohn's. Ntabwo bikubiyemo gukata ibice by'amara.
- Uku kubagwa gushobora gukuraho ibimenyetso nko kubabara mu gifu no kubyimba, no kugabanya ibyago byo kuziba amara burundu.
- Ubu buryo bwo kubaga ntibukwiriye buri wese. Muganga wawe ni we uzaguhitiramo uburyo bwiza bwo kuvura bitewe n'uburwayi bwawe.
- Ubu ni ukubagwa gukomeye, bityo bifata igihe kugira ngo bikire. Hari ibyago nko kwandura no kuva amaraso.
- Uku kubagwa bizakiza gusa kugabanuka kw'imitsi. Indwara y'ibanze (IBD) igomba kuvurwa buri gihe.
- Niba ufite ikibazo icyo ari cyo cyose kuri ibi, ntutinye kuvugana na muganga wawe kugira ngo agusobanurire neza.
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