Maziso ako neganda rako zvinonzwa kunge yero here? Kana kuti une kuvaviwa kusingatsungiririki mumuviri wako wese here? Izvi dzimwe nguva zvinogona kuva zviratidzo zvinoitika kana migero inotakura mvura inonzi 'bile' kubva muchiropa chedu yavharika. Mvura iyi inonzi 'bile' inokosha pakugaya chikafu mumuviri wedu. Saka kana iyi duct yebile yavharika, inogona kudzokera kuchiropa yokonzera matambudziko akawanda. Nhasi, tiri kutaura nezvekurapa kwakakosha kunoitwa navanachiremba mumamiriro ezvinhu akadaro. Kunonzi Biliary Drainage.
Zvichitaurwa zviri nyore, chii chinonzi Biliary Drain iyi?
Duru remvura rinobuda muchubhu chenyongori ichubhu yakatetepa uye inochinjika. Chubhu iyi inoshandiswa kunzvenga kuvharika kwemugero wenyongori unobatanidza chiropa chedu neura hudiki uye kubvisa nyongori mumuviri kana kuidzosera kuura hudiki.
Fungidzira tsvina yakanamatira pakati pepombi yemvura. Ipapo mvura inozara panzvimbo imwe, kumanikidzwa kunowedzera, uye pombi inogona kukuvara, handiti? Ndizvo zvinoita kuti ducts dze bile dzivharike. Bile rinoungana muchiropa. Mukurapa tinoti chirwere ichi chinonzi cholestasis . Kana izvi zvikaitika, chirwere chejaundice, chinoshanduka kuita yero mumaziso neganda, chinoitika, sezvambotaurwa. Pamwe chete neizvi, panogona kuva nekukwenya kwakanyanya mumuviri wese.
Saka, chinoitwa nechubhu iyi yemudumbu ndechekudzivirira kuvharika kwayo uye kugadzira nzira yekuti nyongo idzoke nayo. Dzimwe nguva, nyongo iyi inounganidzwa mubhegi riri kunze kwemuviri.
Ndedzipi nzira idzi dzekuisa machubhu? (Mhando dzeKudhonza Matumbu)
Kune nzira mbiri huru dzekurapa uku. Zvichienderana nemamiriro ako ezvinhu, chiremba wako ndiye achasarudza kuti ndeipi nzira yakakunakira.
1. Kuyerera kwemvura muropa (PTBD)
Izvi zvinosanganisira kuisa chubhu tete (catheter) nepaganda riri kurudyi rwedumbu rako, kuburikidza nechiropa chako, uye mudura rako renyongo. Izvi zvinoitwa uchishandisa fluoroscopy, nzira yakakosha yeX-ray. Chubhu inoiswa mushure mekuona nzvimbo chaiyo yakavharika. Zvadaro, rimwe divi rechubhu iyi rakabatana nebhegi riri kunze kwemuviri. Nyongo inozounganidzwa mubhegi iroro.
2. Kuyerera kwemvura muEndoscopic Biliary (EBD)
Chinoitika pano ndechekuti chubhu tete ine kamera yakabatana, inonzi endoscope , inopinzwa nemuromo wako yodzika nepaipi yako yechikafu kusvika paburi remukoto wenyongo (kutanga kweura hudiki). Zvadaro, imwe chubhu tete inopfuudzwa nepaendoscope yopinzwa mumukoto wenyongo wakavharika kuti ibudise nyongo.
Nzira iyi inogonawo kuitwa nenzira dzakasiyana.
- Kuyerera kwemvura muEndoscopic Nasobiliary (ENBD):Pano, tsvina inofamba nemuchubhu inopinzwa nemumhino youngana mubhegi riri kunze kwemuviri.
- Kuisa stent mukati: Izvi zvinosanganisira kuisa chubhu diki yakaita sestent munzvimbo yakavharika uye kubvumira nduru kuti ifambe nepakati payo. Izvi zvinobvumira nduru kuti ifambe zvakananga muura hudiki, pane kubuda mumuviri. Iyi ndiyo nzira inonyanya kushandiswa.
Sei munhu angade kuisa pombi yakaita seiyi?
Pane zvikonzero zvakawanda zvinoita kuti duct yenyongo ivharwe kana kuvharwa. Kurapa uku kunodiwa nekuda kwechirwere chinonzi cholestasis chinoitika kana izvi zvikaitika. Ngatitarisei zvikonzero zvikuru.
| Chikonzero chekuvharika | Tsananguro iri nyore |
|---|---|
| Matombo emudumbu kana nyongo (choledocholithiasis) | Matombo emunduru anoumbwa munduru uye anovhara duct yenyongo ndiyo inonyanya kukonzera. |
| Chipembenene | Dumbu renyongo rinogona kudzvinyirirwa kunze nekuda kwekuzvimba kwepancreas. |
| Matambudziko egomarara | Mugero unogona kuvharwa nemabundu ari mupancreas, bile duct, gallbladder, kana chiropa. |
| Kukuvadzwa kwenzira dzemudumbu | Mapaipi emudumbu anogona kukuvara, kunyanya panguva yekuvhiyiwa kwakadai sekubviswa kwenyongo. |
| Zvimwe zvirwere zvinotapukira | Kunyange zvazvo zvisingawanzoitiki muSri Lanka, mamwe marudzi ehonye anogona kukonzera kuvharika kwenzira dzemudumbu. |
| Kurwara Kwepfungwa Kwekutanga Cholangitis | Ichi chirwere chisingaperi umo maburi enyongo anova nemavanga uye anovharika zvishoma nezvishoma. |
Unofanira kugadzirira sei usati warapwa?
Zvakakosha kutevedzera mirairo yachiremba wako usati watanga kurapwa uku. Kazhinji, unofanira kungwarira nezvezvinhu izvi.
- Unofanira kurega kudya, kunwa, uye kusvuta maawa matanhatu usati watanga kurapwa . Ungabvumirwa kunwa mvura, asi chiremba wako achakuudza chaizvo zvekuita.
- Udza chiremba wako nezve allergies dzauinadzo kare, kunyanya mishonga inonyaradza marwadzo, dhayi yekuenzanisa inoshandiswa muX-rays, mapurasitiki, kana simbi.
- Udza chiremba wako nezvemishonga yese nemavhitamini auri kutora pari zvino .
- Kana uri kutora mishonga inodzivirira kuumbwa kweropa (semuenzaniso, mishonga inorwisa kuungana kweropa yakaita seaspirin newarfarin), taura nachiremba wako nezvekuti unofanira kuimisa here usati warapwa uye kuti ungazviita sei.
- Kana uine pamuviri kana kuti ungangobata pamuviri, iva nechokwadi chekutizivisa.
- Sezvo usingazokwanisi kutyaira mota mushure mekurapwa nekuda kweanesthesia, zvakakosha kuronga kuti mumwe munhu akuendese kumba nemotokari nguva isati yakwana.
Chii chinoitika panguva yekurapwa?
Panogona kunge paine misiyano mishoma pane zvinoitika zvichienderana nemaitiro auchaita, asi chiremba achakutsanangurira zvese zvisati zvaitika.
Maitirwo enzira ye percutaneous (PTBD)
1. Kutanga, chiremba achachenesa ganda riri padumbu rako nemushonga unouraya utachiona uye obvisa ganda racho.
2. Zvadaro, tsono diki inopinzwa nepaganda mugwara remudumbu riri muchiropa.
3. Dhayi remhando yepamusoro rinonzi contrast rinoiswa kuti rionekwe zvakajeka mutsinga dzemudumbu paX-ray.
4. Mushure mekuona nzvimbo chaiyo yakavharika, chubhu yekubuditsa nyongo inopinzwa nepairi uye nyongo inobvumirwa kubuda.
5. Mugumo wekunze wechubhu unoburitswa kubva paganda remudumbu wobatanidzwa nebhegi. Tsvina inoungana mubhegi iroro. Bhegi iri rinofanira kubudiswa kakawanda pazuva.
Maitiro e endoscopic procedure (EBD)
1. Uchanzwa kurara hope dzakadzama kana kuti ucharara hope huru.
2. Usati waisa endoscope nemuromo, mushonga unopfapfaidzwa pahuro kuti pahuro pave nechiveve.
3. Chiremba anobva apinza endoscope nemuromo, oipfuudza nepaipi yekudya, opinda muchikamu chepamusoro cheura hudiki.
4. Kubva ipapo, imwe chubhu yakatetepa (catheter) inopinzwa kuburikidza ne endoscope mu duct ye bile yakavharika.
5. Kuvharika kunobviswa uye nyongo inobvumirwa kubuda. Kana stent iri kuiswa mukati, izvi zvinoitwa panguva ino. Kana chubhu iri kubviswa, chubhu inobviswa mumhino yobatanidzwa nebhegi.
Pane njodzi dziripo here?
Sezvinongoita chero kurapwa kupi zvako, kune njodzi nematambudziko anogona kuitika. Chiremba wako achakuudza nezve zvese izvi.
Yeukai, mikana yekuti matambudziko aya aitike yakaderera zvikuru. Uye njodzi yekuti nyongo ivharike yakakwira zvikuru.
| Njodzi/Matambudziko | Tsananguro |
|---|---|
| Njodzi dzakajairika | |
| Utachiona | Utachiona hunogona kupinda panzvimbo yakapinzwa chubhu. Mishonga inorwisa mabhakitiriya inopiwa kudzivirira izvi. |
| Kubuda ropa | Izvi hazviwanzoitiki, uye zvinogona kutoda kuti munhu apiwe ropa. |
| Marwadzo | Panogona kunge paine kusagadzikana kana kurwadziwa paiiswa chubhu. |
| Chubhu inobuda kana kuti yakavharika | Matambudziko anogona kumuka nekudhonza chubhu netsaona kana kuti nekuvharika kwemukati. |
| Njodzi dzine chekuita nenzira dzakananga | |
| Kubuda kwenyongo (PTBD) | Mvura inogona kubuda mumuviri ichibva pachubhu. |
| Pneumothorax (PTBD) | Kashoma, mapapu anogona kukuvara uye mhepo inogona kuungana yakaapoteredza. |
| Chipembenene (EBD) | Mushure mekurapwa kweEBD, kuzvimba kwechinguva kwepancreas kunogona kuitika. |
Unoita sei kuti pombi ishande kana wasvika kumba?
Kana uine chubhu nebhegi zvakaiswa kunze kwemuviri wako, mukoti achakupa mirairo yakadzama yekuti ungazvichengeta sei. Tevedzera mirairo iyoyo nokungwarira.
- Inwa zvinwiwa zvine electrolyte zvakaenzana nehuwandu hwenyowa inowedzerwa mubhegi. Chiremba wako achakuudza zvekunwa uye huwandu hwekunwa.
- Zorora zvakakwana mushure mekurapwa. Zvakanaka kuva nemumwe munhu anokubatsira husiku hwekutanga.
- Usarara uine uremu hwako padivi pane chubhu . Nenzira iyi, pane mukana mudiki wekuti chubhu itenderere.
- Unogona kutangazve mabasa ako emazuva ese mushure memaawa makumi maviri nemana, asi usasimudze chinhu chinorema kupfuura 5 kg .
- Inwa mishonga yese yawakanyorerwa nachiremba sezvawakanyorerwa .
- Unogona kugeza mushure memaawa makumi mana nemasere. Zvisinei, usashambire mumadziva, mugungwa, kana munzizi zvachose kusvika pombi yacho yapinda.
Unofanira kuona chiremba nekukasika rini?
Kana ukaona chimwe chezviratidzo zvinotevera, chinogona kunge chiri chiratidzo chehutachiona. Saka fonera chiremba wako nekukasika kana kuenda kuEmergency Department (ETU) yechipatara chiri pedyo.
- Kana kurwadziwa, kuzvimba, kana kutsvuka panzvimbo yekuisa chubhu kukawedzera .
- Kana hurwa kana chimwe chinhu chiri kubuda kubva panzvimbo yechubhu.
- Kana ukanzwa fivha .
Teererawo kune izvi zvinhu:
- Kana ganda kana maziso zvichinge zvatsvuka kana kuti zvichiwedzera kutsvuka .
- Kana ruvara kana kunhuhwirira kwetsvina yakaunganidzwa mubhegi kukangoerekana kwachinja .
- Kana pombi yacho ichiita seyakasununguka kubva payakanga yakaiswa.
- Kana muine kurwadziwa kwemudumbu kutsva kana kuti kurwadziwa kwawagara uchiita kukawedzera.
- Kana kurutsa kukaramba kuripo .
- Kana dumbu risingabudisi chinhu kana mweya usingabude .
Zvakajairika kuti unzwe kutya kana ukanzwa nezverudzi urwu rwekurapa. Asi yeuka, izvi ndezvekubatsira muviri wako kubvisa kusagadzikana kwauri kukonzera uye kuita kuti udzokere pahutano hwakanaka. Taura nachiremba wako nezvemibvunzo kana zvinokunetsa. Iye achakutsanangurira zvese.
Mharidzo Yekuenda Nayo Kumba
- Kubvisa tsvina kubva munyongo inzira yakakosha yekurapa inoshandiswa kubvumira nyongo kuti ifambe nemumugero wenyongo wakavharika.
- Izvi zvinogona kuitwa zvakanyanya kuburikidza neganda (PTBD) kana kuburikidza ne endoscope (EBD).
- Zvakakosha kunyatsotevera mirairo yachiremba (kutsanya, ruzivo rwemishonga) usati warapwa.
- Kana uine chubhu yakaiswa kunze kwemuviri wako, dzidza kuitarisira zvakanaka uye kuita zvinoenderana nazvo.
- Kana ukaona zviratidzo zvehutachiona zvakaita sefivha, kurwadziwa kana kuzvimba panzvimbo yakaisirwa, kana kuti urwa, tsvaga rubatsiro rwechiremba nekukasika.
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