Chiremba wako akakuudza here kuti une kanyama kadiki kasina kujairika, bundu, kana polyp mudumbu mako, ndiko kuti, mudumbu mako kana pagurokuro? Patinonzwa izvozvo, kutya kunouya mupfungwa dzedu ndekwekuti, "Ah, ndichafanira kuvhiyiwa zvakanyanya izvozvi here?" Asi nesainzi yekurapa yanhasi, hapana chikonzero chekuvhiya kunokonzera kucheka kukuru kwechinhu chese. Ndosaka tichizotaura nezvenzira yakanaka yekurapa inogona kukonzera kukuvara kushoma mumuviri uye kupora nekukurumidza.
Zvichitaurwa zviri nyore, chii chinonzi Endoscopic Submucosal Dissection?
Kunyange zvazvo zita racho ringanzwika serakaoma, nzira yacho iri nyore. Endoscopic Submucosal Dissection , kana kuti ESD muchidimbu, inzira isingakuvadzi inobvisa nyama dzisina kurongeka, mapundu emasero anogona kuita kenza, kana mabundu madiki kubva mudumbu rako.
Fungidzira izvi zvichiitwa nachiremba wezvekudya. Anoshandisa chubhu refu, inochinjika ine kamera kumucheto. Tinoti izvi iendoscope.
- Kana dambudziko riri mudumbu rako repamusoro (semuenzaniso, gumbo, dumbu), endoscope iyi inopinzwa nemuromo wako.
- Kana dambudziko riri mudumbu rako rezasi (ura guru, rectum), rinopinzwa nepaburi remudumbu.
Izvi zvinoitwa uchishandisa chinhu chidiki chekuvhiya chinoiswa muchubhu uye, pasi pekutungamirirwa nekamera, chinoshandiswa kucheka nekubvisa nyama isina kunaka. Chinhu chakanakisa ndechekuti, zvese izvi zvinoitika mumuviri. Sezvo pasina mavanga ekunze, unogona kupora nekukurumidza, kurwadziwa kushoma, uye kudzivirira mavanga.
Ndezvipi zvirwere zvinoshandiswa neESD?
Kurapa uku kweESD kunowanzo shandiswa kubvisa kenza isati yatanga kana kuti kenza iri muchikamu chekutanga chekugaya chikafu. Ngationei kuti ndedzipi.
| Dambudziko rehutano | Tsananguro iri nyore |
|---|---|
| Huro yaBarrett | Dambudziko rekuti chikamu chedumbu (chikafu) chinoshanduka uye, nekufamba kwenguva, pane njodzi yekubatwa nekenza. |
| Kenza yemudumbu | Mabundu ekenza ari padanho rekutanga anoumbwa muura kana mudumbu. |
| Kenza yemudumbu | Kenza yemudumbu inotanga padanho rekutanga. |
| Kenza yemudumbu mudiki | Kenza dzinokura muura hudiki, kunyanya duodenum, chikamu chayo chekutanga. |
| Kenza yemudumbu | Zvirwere zvegomarara zvepakutanga zvinoitika mudumbu. |
Chii chiri musiyano uripo pakati peESD neEMR?
Ungave wakambonzwa nezveimwe nzira yakafanana, inonzi Endoscopic Mucosal Resection (EMR) . Kunyange zvazvo nzira dzese dziri mbiri dzisinganyanyi kukuvadza, pane musiyano mudiki.
Madziro emudumbu wedu akaumbwa nezvikamu zvakasiyana-siyana. Rutivi rutete rwemukati runonzi mucosa.
- Nzira yeEMR: Izvi zvinonyanya kubvisa bundu riri mukati memukati mebundu rinonzi mucosa. Izvi zvinosanganisira kubaya jekiseni remvura pasi pebundu, kurisimudza, uye kuricheka nechinhu chakaita sesimbi.
- Nzira yeESD: Iyi inzira yepamusoro zvishoma kupfuura EMR. Inogona kubvisa bundu riri mu mucosa, pamwe chete nemabundu akapararira kusvika pasi payo. Chinhu chikuru cheizvi ndechekuti nyama isina kujairika, zvisinei nekuti yakakura sei, inogona kubviswa muchikamu chimwe chete . Zvadaro zviri nyore kuitumira kurabhoritari uye kunyatsoona kana kenza yabviswa zvachose.
Zvichitaurwa zviri nyore, nzira yeEMR ndiyo inonyanya kukodzera bundu diki riri pamusoro. Nzira yeESD inoshandiswa kubvisa bundu rakakura kana rakadzama muchikamu chimwe chete.
Ndinofanira kugadzirira sei kurapwa uku ndisati ndatanga?
Chiremba wako achakupa mirairo yakajeka usati watanga kurapwa. Zvakakosha kuti uitevere nemazvo.
- Kana uri kurapwa padumbu repamusoro: (mudumbu, mudumbu) unofanira kurega kudya nekunwa zvachose kwemaawa akati wandei usati watanga kurapwa. Izvi zvinoreva kuti dumbu rako rinofanira kunge risina chinhu.
- Kana uri kurapwa chirwere chedumbu rako rezasi: (ura guru), uchakumbirwa kuti ugadzirire "ura." Izvi zvinosanganisira kubvisa ura hwako hwese nekunwa mvura yakakosha ( laxative ). Izvi zvinobvumira chiremba kuona zviri mukati zvakajeka ne endoscope.
Chii chinoitika panguva yekurapwa?
Hauzonzwi kusagadzikana kana kurwadziwa panguva yekurapwa uku. Izvi zvinokonzerwa nekuti ucharapwa usina kunzwa kurwadziwa. Unogona kurara zvachose (General Anesthesia), kana kuti ungapiwa rudzi rweanesthesia inoita kuti unzwe hope uye wakasununguka (Monitored Anesthesia Care).
Panguva yekurapwa, chiremba wako achatevera matanho aya:
1. Endoscope inopinzwa nemuromo kana mudura.
2. Uchishandisa kamera, endoscope inotumirwa kunzvimbo ine nyama isina kurongeka.
3. Uchishandisa mudziyo unopfuudzwa nepa endoscope, chiratidzo chinogadzirwa chakakomberedza bundu kuti ribviswe.
4. Zvadaro, mvura yakakosha inopinzwa mumembrane iri pasi pebundu. Izvi zvinogadzira piro pasi pebundu, richirisimudza kubva munyama ine hutano yakapoteredza. Izvi zvinoita kuti zvive nyore kuriparadzanisa nekuricheka.
5. Pakupedzisira, uchishandisa mudziyo wakakosha wakaita sebanga remagetsi rinoshandisa magetsi akawanda, bundu rinochekwa nokungwarira pamutsetse wakanyorwa uye robviswa.
Maitiro ese anogona kutora pakati peawa imwe kusvika matatu , zvichienderana nehukuru nenzvimbo yenyama iri kubviswa.
Chii chinoitika mushure mekurapwa?
Kana kurapwa kwapera, nyama yakabviswa inotumirwa kurabhoritari uko nyanzvi yezvirwere inoiongorora kuti ione kana isina masero ekenza uye kana yakabviswa zvachose.
Uchaendeswa kukamuri revanorwara kwenguva pfupi mushure mekurapwa. Kana mushonga weanesthesia wapera zvachose, unogona kudzokera kumba zuva rimwe chete, kana kuti ungangoda kugara muchipatara husiku hwese. Unofanira kuperekedzwa nemumwe munhu kumba , sezvo zvinogona kutora maawa anosvika makumi maviri nemana kuti mushonga weanesthesia upere zvachose.
Pane migumisiro yakaipa uye njodzi here?
Sezvinongoita chero kurapwa kupi zvako, kune migumisiro midiki uye njodzi dzisingawanzoitiki.
Migumisiro midiki inogona kuitika
Izvi zvinowanzonyangarika zvachose mukati mezuva rimwe kana maviri.
- Kuzadza dumbu
- Marwadzo emudumbu
- Gasi uye marwadzo aro
- Kusvotwa kana kurutsa
- Huro inorwadza (kana endoscope yakaiswa nemuromo)
Zvingave zvakajairika kuva neropa shoma mutsvina yako, asi rinofanira kumira mukati memaawa makumi maviri nemana.
Matambudziko asingawanzoitiki
Mikana yekuti izvi zviitike yakaderera zvikuru, asi zvakakosha kuti uzvizive.
- Kubuda ropa: Kubuda ropa kubva panzvimbo yakabviswa nyama.
- Kuboorwa kwedumbu: Kuboorwa kwemadziro enzira yekugaya chikafu ne endoscope kana mudziyo.
- Mavanga: Kunyanya pakurapa gumbo, mavanga anoitika panguva yekupora anogona kukonzera kutetepa kwegumbo (esophageal strictures).
Ndezvipi zvakanakira nzira iyi?
Nzira yeESD ine zvakanakira zvakawanda zvichienzaniswa nekuvhiyiwa kwakavhurika.
- Marwadzo mashoma: Marwadzo mashoma nekuti hapana mavanga.
- Kupora nekukurumidza: Unogona kudzokera kuhupenyu hwako hwemazuva ese woshanda nekukurumidza.
- Hapana mavanga: Hapana mavanga anoonekwa kunze kwemuviri.
- Matambudziko mashoma: Pane njodzi shoma yematambudziko pane kuvhiyiwa kwepachivande.
- Kuchengetedza nhengo: Nzira iyi inogona kudzivirira zvinhu zvakaita sekubvisa chikamu chemudumbu kana ura izvo zvaizoitwa panguva yekuvhiyiwa kukuru.
Unofanira kuona chiremba nekukasika rini?
Kana wadzokera kumba mushure mekurapwa, kana ukaona zviratidzo zvinonyevera, zvakakosha kufonera chiremba wako kana kuenda kuchipatara chiri pedyo neEmergency Department (ETU) nekukurumidza .
| Zviratidzo zvinonyevera - teerera nekukasika! | |
|---|---|
| Chiratidzo | Tsananguro |
| Ropa muchigaro chetsvina | Kana ropa rakawanda mutsvina, pane kungoisa kadonhwe kadiki papepa rechimbuzi. |
| Kurwadziwa kwechipfuva | Kurwadziwa kwechipfuva kwakakomba kamwe kamwe. |
| Dzungu kana kuti musoro wakapfava | Kana uchinzwa dzungu kana kuti kupera simba. |
| Fivha kana kutonhora | Kana uchinzwa sekuti une fivha kana kuti uri kudedera. |
| Kutadza kufema zvakanaka (Dyspnea) | Kana uchinetseka kufema kana kuti uchinzwa kudzipwa. |
| Kurutsa ropa | Kana ukarutsa ropa. |
Zvinotora nguva yakareba sei kuti upore?
Vanhu vazhinji vanogona kudzokera kubasa mushure memazuva mashanu. Zvisinei, kana ukaita basa rakaoma zvikuru, sekusimudza zvinhu zvinorema, chiremba wako anogona kukukurudzira kuti uzorore kwenguva yakati rebei. Panogona kunge paine shanduko diki mumaitiro emudumbu kweinenge vhiki mushure mekurapwa.
Kazhinji uchazoona chiremba wako zvakare mushure memavhiki maviri. Panguva iyoyo, vachakutsanangurira zvabuda muongororo yerabhoritari uye vachasarudza kana paine kumwe kurapwa kwaunoda kana kwete.
ESD mushonga unobudirira zvikuru. Dzimwe ongororo dzakaratidza kuti njodzi yekuti bundu ridzokezve panzvimbo imwe chete kune vanhu vakamborapwa iyi yakaderera kusvika pa1%.
Mharidzo Yekuenda Nayo Kumba
- Endoscopic Submucosal Dissection (ESD) inzira yekurapa yepamusoro-soro, isinganyanyi kukuvadza inobvisa nyama dzisina kunaka kubva mudumbu.
- Sezvo izvi zvisingasanganisire mavanga makuru, kurwadziwa kushoma, nguva shoma yekupora, uye mavanga haawaniki.
- Izvi zvinobvisa nyama isina kujairika muchikamu chimwe chete, kuitira kuti zvigone kuonekwa nemazvo kana kenza yacho yabviswa zvachose.
- Kana paine zviratidzo zvinonyevera (semuenzaniso, kubuda ropa rakawanda, fivha, kurwadziwa pachipfuva) zvikaitika mushure mekurapwa, tsvaga rubatsiro rwechiremba nekukasika.
- Kana muine mimwe mibvunzo nezvenyaya iyi, musatya kutaura nachiremba wenyu kuti mutsanangurirwe zvese.
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