Maziso ako kana ganda rako rava kuita yero here, uye uri kutambura nekuvaviwa kwakanyanya, kusingatsungiririki here? Izvi zviratidzo zvezvatinowanzodaidza kuti jaundice. Izvi zvinowanzoitika kana ducts dze bile—machubhu anotakura bile kubva muchiropa chako kuti abatsire kugaya—avharwa. Kana kuvharika uku kukaitika, bile rinoungana muchiropa, zvichiita kuti ganda rako rive yero uye kuvaviwa kunoramba kuripo. Muzviitiko zvakadaro, vanachiremba vanoshandisa nzira yakakosha inonzi biliary drainage. Zvichitaurwa zviri nyore, izvi zvinosanganisira kuisa chubhu diki mumugero we bile wakavharwa kuti bile rifambe zvakasununguka zvakare. Ngatikurukurei zvese zvamunoda kuziva nezvemaitiro aya.
Chii chinonzi Biliary Drainage, uye Ndeapi Marudzi Awo?
Kuburitsa mvura muchubhu (bile drainage) inzira inoshandisa chubhu yakatetepa, inochinjika (catheter) kuti isavharike muchubhu yako yechubhu, zvichiita kuti nyongo ibude ichibva muchiropa ichienda muura hudiki. Funga nezvazvo sekugadzira nzira yekubvisa mvura yakavharika.
Izvi zvinoitwa nenzira mbiri. Chiremba wako ndiye achasarudza kuti ndeipi nzira inonyatsokodzera chirwere chako.
| Rudzi rweMaitiro | Tsananguro Iri Nyore |
|---|---|
| Kuyerera kwemvura muropa (PTBD) | Nenzira iyi, chiremba anopinza chubhu kuburikidza neganda rako uye zvakananga muchiropa kuti asvike mudura renyongo. Achishandisa nzira yakakosha yeX-ray (fluoroscopy), chiremba anotungamira chubhu yacho panzvimbo chaiyo. Nyongo inobva yabuda nemuchubhu ichipinda mubhegi diki rekunze. |
| Kuyerera kwemvura muEndoscopic Biliary (EBD) | Pakuita izvi, chubhu yakatetepa, ine kamera (endoscope) inopfuudzwa nemumuromo mako ichidzika nemudumbu mako kuti isvike mudura renyongo. Kana yasvika, chiremba anoshandisa endoscope kubvisa kuvharika kana kuisa chubhu diki (stent) kuti nyongo idzokere mudumbu nenzira yechisikigo. |
Chii chinonzi Stenting?
Mune zvimwe zviitiko, kunyanya kana kuvharika kwacho kuri kwechigarire (senge nekuda kwebundu), chiremba wako anogona kuisa chubhu diki, yakaita semesh inonzi stent kuti duct yenyongo igare yakavhurika zvachose. Izvi zvinowanzoitwa mazuva mashoma mushure mekunge chubhu yekutanga yemvura yaiswa.
Sei Maitiro Aya Achidikanwa?
Chikonzero chikuru cheiyi nzira ndeyekuvharika kana kutetepa (`stricture`) mu duct ye bile, izvo zvinoita kuti bile riungane muchiropa (`cholestasis`). Kungofanana nedhiraini rakavharika mu sinki yako yekicheni, kuvharika kwacho kunodzivirira kuyerera kwakajairika.
Zvinowanzo kukonzera kuvharika kwenzira dze bile duct zvinosanganisira:
- Matombo emunduru (`choledocholithiasis`).
- Pancreatitis kana kenza yepancreatic .
- Kenza yemudumbu (`Cholangiocarcinoma`).
- Kenza yechiropa kana kenza yenduru .
- Kuzvimba kwema lymph nodes pedyo nechiropa kanapancreatic nekuda kwekenza.
- Zvimwe zvirwere zvinotapukira .
- Kukuvara kwemutsinga dzenyongo kwakamboitwa pakuvhiyiwa.
- Kuzvimba kwenguva refu kwemutsinga dzenyongo, zvakaita sePrimary Sclerosing Cholangitis.
Chinonyanya kukosha ndechekuti kana uine zviratidzo izvi, ndapota shanyira chiremba wako nekukasika kuti uone chikonzero chacho. Usaedze kuzvirapa wega.
Unofanira Kugadzirira Sei?
Chiremba wako achakupa mirairo chaiyo, yaunofanira kutevedzera zvakasimba.
1. Zvekudya Nekunwa: Ungangoda kurega kudya, kunwa, uye kusvuta maawa matanhatu usati watanga kuvhiyiwa. Chiremba wako achakuudza kana uchigona kunwa mvura shoma.
2. Kurwara: Udza chiremba wako nezve allergies, kunyanya kune anesthesia, contrast dyes dzinoshandiswa paX-rays, kana mapurasitiki/simbi.
3. Mishonga: Udza chiremba wako nezvemishonga yese yauri kutora parizvino, kusanganisira mavhitamini. Kana uri kushandisa mishonga inobvisa ropa rakanyanya senge aspirin kana warfarin, bvunza chiremba wako kuti unofanira kurega kuishandisa riini usati watanga kurapwa.
4. Kubata Pamuviri: Kana uine pamuviri kana kuti uchifunga kuti ungave uine pamuviri, unofanira kuzivisa timu yako yezvekurapa.
5. Kutakurwa: Nekuti muchapiwa mushonga wekuderedza kushushikana, hamuzokwanisi kutyaira. Ndokumbirawo muronge kuti mumwe munhu akutorei aende nemi kumba.
Chii Chinoitika Munguva Yekurapwa?
Matanho acho anosiyana zvichienderana nekuti uri kuita PTBD here kana kuti EBD, asi iva nechokwadi chekuti timu yako yezvekurapa ichatsanangura zvese zvisati zvaitika.
Mashandiro anoita PTBD:
- Ganda riri padumbu rako richacheneswa uye richapera simba.
- Chiremba achaisa tsono diki nepaganda muburi renyongo riri muchiropa.
- Dhayi yemhando ye contrast inoiswa jekiseni kuitira kuti ducts dzionekwe paX-rays.
- Kana gomba ravharwa, chubhu yekudonhedza mvura inoiswa kuti nyongo ibude.
- Mugumo wekunze wechubhu uchabatanidzwa nebhegi rekunze rinounganidza nyongo. (Uchafanira kubvisa nyongo iyi nguva nenguva).
Mashandiro EBD:
- Uchapihwa mushonga wekutindivadza wepanzvimbo kana kuti wepanzvimbo kuti ugare wakasununguka.
- Endoscope inopfuudzwa nemuromo wako yodzika ichipinda munzvimbo yemugero.
- Chiremba anoshandisa maturusi anopfuudzwa nepa endoscope kuti asavharidzike.
- Zvichienderana nemamiriro ezvinhu, vanogona kuisa stent kuti duct irambe yakavhurika mukati.
Njodzi uye Kutarisirwa Mushure meKuvhiyiwa
Sezvinongoita chero nzira ipi zvayo yekurapa, kune njodzi dzinogona kuitika.
- Matambudziko Angangoitika:
- Chubhu inogona kudonha, kumonyoroka, kana kuvharika.
- Kusagadzikana kana kurwadziwa.
- Utachiona (chiremba wako achakupa mishonga inorwisa mabhakitiriya kudzivirira izvi).
- Kubuda ropa.
- Kusawirirana kwema electrolyte.
- Kashoma, matambudziko emapapu akadai sepneumothorax.
Chiremba wako achakurukura newe nezvenjodzi idzi uye achakupa mazano ezvekuita kana paine matambudziko.
Kuzvitarisira Pamba:
Kana uine chubhu nebhegi rekunze, vashandi vekuchengeta varwere vachakudzidzisa maitiro ekuvachengeta.
- Dzivisa kumanikidzwa panzvimbo inopinzwa, sezvo izvi zvinogona kumonyorora chubhu.
- Kana zvataurwa, sukurudza chubhu zuva nezuva nesaline sezvakarairwa.
- Ramba uine mvura yakakwana mumuviri wako kana ukaudzwa nachiremba kuti udzore kurasikirwa nemvura mumuviri wako.
- Unogona kugeza maawa makumi mana nemasere mushure mekuvhiyiwa, asi usashambire mumadziva, mugungwa, kana mumadhamu apo pombi yacho iripo.
- Dzivisa kusimudza zvinhu zvinorema kusvika chiremba wako akubatsira.
Ndirini Paunofanira Kutsvaga Rubatsiro Rwekukurumidzira?
Kana ukasangana nechimwe chezvinotevera, taura nachiremba wako nekukasika kana kuti enda kuchipatara chiri pedyo newe.
- Fivha kana kutonhora.
- Kuwedzera kwekurwadziwa, kuzvimba, kana kutsvuka panzvimbo yechubhu.
- Urwa kana kubuda kwemvura zvisina kujairika kubva panzvimbo yacho.
- Marwadzo matsva kana kuti ari kuwedzera mudumbu.
- Kudzoka kweganda kana maziso eyero.
- Kurutsa nguva dzose.
- Kana chubhu ichiita seiri kudhonza kana kuti yakasununguka.
- Kana usingakwanise kubvisa tsvina kana gasi.
Kubuda kwemvura munyongo inzira inoshanda zvikuru yekurapa kuvharika kwemukoto wenyongo. Chikwata chenyu chekurapa chichakubatsirai kusarudza nzira yakanakira hutano hwenyu. Sunungukai kuvabvunza chero mibvunzo yamungave nayo.
Zvinhu Zvinokosha Zvaunofanira Kuziva
- Kubvisa tsvina kubva munyongo inzira yekubvisa kuvharika kwenzira dzenyongo kuitira kuti nyongo ifambe zvakanaka.
- Zviratidzo zvinowanzo sanganisira jaundice (kutsvuka kweganda/maziso), kuvaviwa, uye weti yakasviba.
- Maitiro acho anoitwa nePTBD (yakavakirwa paganda) kana EBD (endoscopic).
- Kutevera mirairo yekutanga maererano nekutsanya nemishonga kwakakosha.
- Tsvaga rubatsiro rwekukurumidzira kana ukaita fivha, kurwadziwa kwakanyanya, kana kubuda ropa panzvimbo yacho mushure mekuvhiyiwa.
Kubuda kwemvura munyowani, nzira dzekubvisa bile dzakavharika, jaundice, PTBD, EBD, chirwere chechiropa, matombo emunduru, nyaya yekurapa yeNirogi Lanka
