Maziso ako neganda zviri kuchinja ruvara rweyero here uye muviri wako wese uri kuvava zvisingatsungiririki? Izvi ndizvo zviratidzo zvezvatinoziva tese sejaundice. Kazhinji, chikonzero cheizvi kuvharika kwemugero wenyongo, inova mvura inobva muchiropa chedu uye inobatsira mukugaya. Kana izvi zvavharika, mvura iyoyo inodzokera muchiropa, zvichikonzera kuvava uye kutsvuka. Saka, nzira yakakosha yekurapa inoshandiswa navanachiremba muzviitiko zvakadaro inonzi Biliary Drainage. Zvichitaurwa zviri nyore, izvi zvinosanganisira kuisa chubhu diki mumugero wenyongo wakavharwa uye kubvumira nyongo kubuda. Ngatitaurei nezvazvo zvakadzama nhasi.

Chii chinonzi Biliary Drainage? Pane mhando dzacho here?

Kubvisa tsvina yemudumbu inzira inoshandisa chubhu yakatetepa uye inochinjika (catheter) kuti dumbu rifambe nepaburi remutsinga wedumbu, iro rinobva muchiropa richienda muura hudiki. Zvakafanana nekugadzira nzira itsva yemvura yakavharika. Izvi zvinoitwa nenzira mbiri huru. Chiremba wako achasarudza kuti ndeipi nzira yakakunakira zvichienderana nemamiriro ako ezvinhu.

Chii chinonzi stent placement?

Mune zvimwe zviitiko, kunyanya kana kuvharika kwacho kuri kwechigarire (semuenzaniso, nekuda kwegomarara), chiremba wako anogona kuisa zvachose chubhu diki yakaita semesh, inonzi stent, mukati memugero wenyongo yako kuti irambe yakavhurika. Izvi zvinowanzoitwa mazuva mashoma mushure mekunge chubhu yekutanga yaiswa.

Sei munhu angada kurapwa kwakadai?

Chikonzero chikuru chekuda kurapwa uku kuvharika kana kutetepa kwemugero we bile (`stricture`). Izvi zvinokonzera kuti mvura ye bile iungane muchiropa (`cholestasis`). Fungidzira, chimwe chinhu chakaita sepaipi yedhiraini mumba medu painovharika, mvura inoungana pano. Panogona kuva nezvikonzero zvakasiyana-siyana zvekuvharika kwemugero we bile:

• Matombo ari mudundira renyongo kana ducts dzenyongo (choledocholithiasis).
• Pancreatitis kana kenza yepancreatic.
• Kenza yemudumbu (Cholangiocarcinoma).
• Kenza yechiropa kana kenza yenduru .
• Kuzvimba kwema lymph nodes pedyo nechiropa kana pancreas nekuda kwegomarara.
• Zvimwe zvirwere zvinotapukira .
• Kukuvadzwa kwenzira dzemudumbu panguva yekuvhiyiwa kumwe.
• Zvirwere zvekufema zvinogara kwenguva refu, zvakaita se 'primary sclerosing cholangitis'.

Unogadzirira sei usati warapwa?

Pane zvinhu zvishoma zvaunofanira kuita usati warapwa. Chiremba wako achakupa mirairo yakajeka nezveizvi. Zvakakosha kutevedzera mirairo iyoyo nemazvo. 1. Chikafu Nezvinwiwa: Unofanira kurega kudya, kunwa, uye kusvuta maawa matanhatu usati warapwa. Chiremba wako anogona kukuudza kuti unogona kunwa riini mvura, senge mvura. 2. Kurwara: Iva nechokwadi chekuudza chiremba wako nezve chero allergies yaunayo, kunyanya kune anesthetics, contrast dye inoshandiswa muX-rays, kana kune mapurasitiki kana simbi. 3. Mishonga:Udza chiremba wako nezvemishonga yese yauri kutora parizvino (kusanganisira mavhitamini). Kunyanya kana uri kutora mishonga inobvisa ropa (anticoagulants) yakadai seaspirin newarfarin, bvunza kana uchifanira kurega kuitora uye kuti riini. 4. Kubata pamuviri: Iva nechokwadi chekuudza chiremba wako kana uine pamuviri kana kuti ungangobata pamuviri. 5. Kutyaira: Hauzokwanisi kutyaira mushure mekurapwa nekuti unenge uri pasi peanesthesia. Saka ronga kuuya nemumwe munhu kuti akutore uende naye kumba.

Chii chinoitika panguva yekurapwa?

Matanho ekuita izvi anosiyana zvishoma zvichienderana nemaitiro auri kuita (PTBD kana EBD). Asi musazvidya mwoyo, chiremba wenyu achakutsanangurirai zvese zvisati zvaitika.

Maitirwo enzira ye percutaneous (PTBD):

• Kutanga, ganda riri padumbu rako rinocheneswa uye nzvimbo yacho inoshaya simba.
• Chiremba anobva aisa tsono diki nepaganda muburi remuchiropa.
• Mvura yakakosha (dhayi yekuenzanisa) inopinzwa kuti X-ray ionekwe.
• Kana nzvimbo chaiyo yakavharwa yaonekwa, chubhu yekubuditsa mvura inopinzwa munzvimbo iyoyo uye mvura yenyongo inobvumirwa kubuda.
• Kumwe kuguma kwechubhu iyi kunobuda paganda rako uye kwakabatana nebhegi riri kunze. Mvura yenyongo inoungana mubhegi iri. (Bhegi iri rinofanira kudururwa kakawanda pazuva.)

Maitiro e endoscopic procedure (EBD) anoitwa sei:

• Muizvi, uchapihwa anesthesia yakajairika kana anesthesia yakapfava, saka hauzonzwi chero chinhu.
• Huro yako iri kurira.
• Chiremba anoisa chubhu ine kamera (endoscope) nemuromo, oipfuudza nepaipi yechikafu, oitungamirira kunzvimbo ine duct yenyongo.
• Zvadaro, imwe chubhu (catheter) inopfuudzwa nepachubhu iyoyo yopfuudzwa nemumugero wakavharika kuti nyongo ifambe.
• Kana chikwekwe chikabviswa kunze, chubhu inopinzwa nepamhino yobatanidzwa nebhegi. Kana chikabviswa mukati, stent inoiswa mukati.

Njodzi uye kutarisirwa mushure mekurapwa

Sezvinoita chero kurapwa kupi zvako, kune njodzi nematambudziko anogona kuitika.

• Matambudziko angangoitika:
• Kusunungura, kumonyoroka, kana kuvharika kwechubhu yakaiswa netsaona.
• Kurwadziwa kana kusagadzikana.
• Utachiona (chiremba achakupa mishonga inorwisa mabhakitiriya kudzivirira izvi).
• Kubuda ropa.
• Kuchinja kwehuwandu hwema electrolyte mumuviri (`Kusarongeka kweElectrolyte`).
• Kashoma, matambudziko emapapu (`Pneumothorax`) anogona kuitika.

Chiremba achakutsanangurirai zvakajeka njodzi idzi uye achakupai mazano ekuita kana paine matambudziko.

Ungazvitarisira sei kumba?

Kana uine chubhu nebhegi zvakaiswa kunze kwemuviri wako, vashandi vekuchengeta varwere vachakudzidzisa maitiro ekutarisira.

• Usarara uine uremu hwako parutivi pacho pane chubhu. Izvi zvinogona kukonzera kuti chubhu itenderere.
• Kana chiremba wako akakukurudzira kuti ugeze chubhu nemunyu zvishoma zuva nezuva, ita izvozvo.
• Inwa zvinwiwa zvine electrolyte kuti udzore huwandu hwemvura inobuda mubhegi. Bvunza chiremba wako kuti unonwei uye kuti unonwa yakawanda sei.
• Unogona kugeza mushure memaawa makumi mana nemasere mushure mekurapwa. Zvisinei, usashambire mumadziva kana mugungwa/murwizi mvura ichiripo.
• Usasimudza zvinorema kusvika chiremba wako akuudza kuti udaro.

Unofanira kutsvaga rubatsiro rwechiremba nekukasika rini?

Kana ukaona chimwe chezviratidzo zvinotevera, fonera chiremba wako nekukasika, kana kuti enda kuEmergency Department (ETU) yechipatara chiri pedyo.

• Kupindwa nechando .
• Kana paine kurwadziwa kuri kuwedzera, kuzvimba, kana kutsvuka panzvimbo yakapinzwa chubhu.
• Kana hurwa kana chimwe chinhu chiri kubuda kubva panzvimbo yechubhu.
• Kana kurwadziwa kwemudumbu kukawedzera kana kuti kuchiitika zvakare.
• Kana ganda kana maziso zvikashanduka kuita yero zvakare.
• Kana uchirutsa.
• Kana pombi ichiita seyakasununguka.
• Kana tsvina ikasabuda kana mweya ukasabuda.

Kubuda kwemvura munyongo inzira inoshanda zvikuru yekurapa kuvharika kwemugero wenyongo. Chikwata chenyu chekurapa chichakubatsirai kusarudza sarudzo yakanakira dambudziko renyu. Sunungukai kuvabvunza chero mibvunzo kana zvinokunetsai. Kubuda kwemvura mudumbu, Kuvharwa kwenzira dzemudumbu, Jaundice, PTBD, EBD, Zvirwere zveChiropa, Matombo eGallstone, chinyorwa chekurapa cheSinhala