Chiremba wako akakuudza here kana mumwe munhu wemumhuri mako kuti unofanira kuvhiyiwa kunonzi "Hartmann's Procedure"? Ungave wakatya zvishoma pawakanzwa zita iroro. Zvakajairika. Asi uku kuvhiyiwa kwakakosha zvikuru kunoitirwa kuponesa hupenyu. Saka nhasi, ngatitaure nezvazvo zviri nyore, nenzira ichabvisa mibvunzo yese nekutya kwaungave uinako nezvazvo.
Zvichitaurwa zviri nyore, chii chinonzi Maitiro aHartmann?
Funga nezvegadziriro yedu yekugaya chikafu sechubhu refu. Mugumo wechubhu iyi ndimo matinodaidza kuti colon. Muchirongwa cheHartmann, mugumo wechubhu une chirwere uye wakakuvara (unonzi sigmoid colon) uye dzimwe nguva chikamu cherectum, uko kunochengeterwa tsvina, zvinobviswa.
Zvichitaurwa zviri nyore, uku kuvhiyiwa kunobvisa chikamu cheura hukuru (colectomy). Zvisinei, hunyanzvi ndehwekuti mushure mekubviswa kwechikamu, zvikamu zviviri zvasara zveura hazvibatanidzwizve ipapo ipapo.
Pane kudaro, chiremba anovhiya anoita chimwe chinhu chakadai:
1. Mugumo weura wakabatana nerectum wakasonerwa wakavharwa.
2. Chikamu chine hutano cheura hwako chinobuda pamusoro chakabatana neburi diki (rinonzi stoma) rinogadzirwa muganda redumbu rako.
Zvadaro, bhegi recolostomy rinoiswa kunze kweburi iri. Tsvina yako inobva yabuda mumuviri wako ichipinda mubhegi iri. Kunyange zvazvo izvi zvinganzwika sekuchinja kukuru, kazhinji ndezvenguva pfupi. Mushure mekunge ura hwako hwapora, mwedzi inenge 6 kusvika 12 gare gare, kumwe kuvhiyiwa kunogona kuitwa kubvisa bhegi uye kubatanidzazve zvikamu zviviri zveura hwako.
Sei zvichikosha kuita oparesheni yakadai?
Pane zvikonzero zviviri zvikuru zvekuita chirongwa cheHartmann. Chimwe ndechekubvisa chikamu cheura. Chimwe ndechekuisa bhegi rekubvisa dumbu. Ngatitarisei zvikonzero zvechimwe nechimwe cheizvi.
Sei chikamu cheura chichichekwa chobviswa?
Munhu angangoda kubviswa chikamu chemudumbu nekuda kwezvikonzero zvinotevera:
- Kuvharika kweura: Kana chikamu cheura chakavharwa zvachose nekuda kwebundu, kenza, kana chimwe chikonzero, chikamu ichocho chinofanira kubviswa.
- Kuboorwa kweMatumbu: Kana hutachiona kana tsaona zvikakonzera buri muura, zvichiita kuti tsvina ibude mudumbu, zvinogona kuisa upenyu panjodzi. Saka, chikamu chakakuvara chinofanira kubviswa nekukasika.
- Utachiona husingadzoreki kana chirwere: Kuti kumisa kupararira kwehutachiona (semuenzaniso, diverticulitis yakanyanya) kana zvirwere zvakaita sekenza, chikamu chine chirwere chinofanira kubviswa zvachose.
Sei bhegi re colostomy richiiswa?
Kubvisa chikamu cheura uye kubatanidzazve zvikamu zviviri zvasara mukuvhiyiwa kumwe chete kunonzi "primary anastomosis." Zvisinei, kuti izvi zviitike, mamiriro emurwere anofanira kunge akanaka kwazvo, uye panofanira kunge pasina njodzi yehutachiona.
Asi nzira yekurapa yaHartmann inowanzoitwa kana paine dambudziko.Kureva kuti, kana murwere aine hutachiona hwakanyanya kana kuzvimba mukati medumbu. Mumamiriro ezvinhu ane njodzi akadaro, kana zvikamu zviviri zveura zvakabatana, machira anogona kusapora zvakanaka, uye tsvina inogona kubuda zvakare, zvichiita kuti mamiriro acho awedzere kuipa.
Saka, chinoitwa nachiremba ndechekutanga kugadzirisa dambudziko riripo ipapo ipapo (kubvisa chikamu chine chirwere) uye kupa ura nguva yekupora. Ndizvo zvinoita bhegi re colostomy. Zvadaro, kana zvese zvapora, panobva pava nemukana wekuvhiyiwa zvakare kuti zvidzokere pakare panguva yakakodzera.
Ndezvipi zvikonzero zvikuru zvekuvhiyiwa kweHartmann?
Kune zvirwere zvakawanda zvinowanzoda kuvhiyiwa uku.
| Dambudziko rehutano | Tsananguro iri nyore |
|---|---|
| Diverticulitis yakaoma | Matumba madiki ari mumadziro eura guru anotapukirwa uye anoputika, zvichiparadzira hutachiona mudumbu rose (peritonitis). Ichi chirwere chakakomba zvikuru. |
| Kenza yeColoral Ectopic | Kuvhiyiwa uku kunogona kuitwa kana paine dambudziko, senge apo bundu rekenza rinokonzera kuvharika kwemudumbu, kubooka, kana kubuda ropa rakawanda. |
| Zvimwe zvikonzero | Muzviitiko zvakaita sekuvharika kwemudumbu nekuda kwemavanga ekuvhiyiwa kwakamboitwa, kurasikirwa neropa rinoenda mudumbu, tsaona yakakura, kana kusona kubva pakuvhiyiwa kwakamboitwa kare kuchibuda mvura. |
Kuvhiyiwa uku kunoitwa sei?
Kuvhiyiwa kwaHartmann kunogona kuitwa nenzira mbiri.
1. Kuvhiyiwa Kwakavhurika: Mukuita izvi, kuvhiyiwa kunoitwa nekucheka dumbu zvishoma uye kuvhura dumbu.
2. Kuvhiyiwa kweLaparoscopic:Izvi zvinonziwo "keyhole surgery." Kuvhiyiwa uku kunoitwa nekucheka kadiki mudumbu, uye kamera (laparoscope) nezvimwe zvinhu zvakakosha zvinoiswa. Nzira iyi inoita kuti mavanga mashoma asavepo uye ine nguva pfupi yekupora.
Zvisinei, zvichienderana nekuoma kwechirwere chako, unogona kutanga ne laparoscopic approach wozochinja woenda ku open surgery panguva yekuvhiyiwa. Izvi zvichasarudzwa nachiremba wako.
Chii chinoitika kuvhiyiwa kusati kwaitwa?
- Uchakumbirwa kurega kudya nekunwa maawa matanhatu kusvika gumi nemaviri usati wavhiyiwa.
- Zvichienderana nemamiriro ako ezvinhu, unogona kupiwa chinwiwa chakakosha chekuchenesa ura hwako.
- Paunopinda muchipatara, katheta yemutsinga inopinzwa mutsinga iri muruoko rwako.
- Chiremba achakutsanangurira mishonga inoderedza marwadzo pachine nguva.
Chii chinoitika panguva yekuvhiyiwa?
Uchapihwa mushonga weanesthesia, saka hauzonzwi chero chinhu. Kuvhiyiwa uku kunogona kutora maawa maviri kusvika mana. Chiremba achabvisa chikamu cheura chine chirwere, ogadzira colostomy sezvatakambokurukura, uye osona mavanga acho.
Chii chekutarisira mushure mekuvhiyiwa?
Mushure mekuvhiyiwa, muchatanga maendeswa kukamuri revanopora. Kana mamiriro enyu agadzikana, muchaendeswa kuchipatara.
- Kugara muchipatara: Kazhinji, unofanira kugara muchipatara kwemazuva angangoita manomwe kusvika gumi.
- Chikafu: Chikafu chemvura chete ndicho chinopihwa pakutanga. Zvishoma nezvishoma, vanotanga kudya chikafu chenguva dzose.
- Marwadzo: Mishonga inoderedza marwadzo inopinzwa netsinga inopihwa kwemazuva mashoma ekutanga, yozochinjwa kuita mapiritsi.
- Kushanda kweura: Zvinogona kutora mazuva mashoma kuti ura hutange kushanda zvakare mushure mekuvhiyiwa.
- Bhegi reColostomy: Mukoti akadzidziswa basa rake (stoma nurse) achakuratidza mashandisirwo, kuchenesa, uye kuchinja. Usazvidya mwoyo, zvinotora nguva kuti ujairire.
Ndingaenda kumba riini?
- Kana zvinhu zvakaita sekurova kwemoyo wako neBP zvadzoka pakuva zvakajairika.
- Kana uchigona kumuka wofamba pasina rubatsiro rwemunhu.
- Kana tsvina yatanga kubuda mubhegi re colostomy.
- Kana marwadzo achigona kudzorwa nemapiritsi.
- Kana uchigona kuchinja bhegi re colostomy wega.
Ndezvipi njodzi dzinogona kuitika uye migumisiro yadzo?
Sekunge kune chero kuvhiyiwa kupi zvako, kune njodzi dzinobatanidzwa, uye zvakakosha kukurukura izvi nachiremba wako.
- Matambudziko angangoitika: Kutapukirwa nemaronda, pneumonia, kubuda ropa mukati, kuumbwa kweropa, kuumbwa kwehernia, nezvimwewo.
- Migumisiro yakaipa:
- Kusashanda zvakanaka kwemudumbu kwenguva pfupi (Ileus): Mushure mekuvhiyiwa, zvinogona kunonoka kuti ura hushande. Mumazuva iwayo, kudya kunopihwa kuburikidza nemunyu.
- Kubuda kwetsvina: Kunyangwe tsvina isingabude, mvura yakaita semanyoka inogona kubuda dzimwe nguva kubva muchikamu chasara chetsvina.
- Mhedzisiro pakushanda kwepabonde: Kashoma, kukuvara kwetsinga munzvimbo yekuvhiyiwa kunogona kukonzera shanduko mukunzwa kana kushanda kwepabonde. Kana uine chero zvinokunetsa nezveizvi, taura nachiremba wako pachena.
Bhegi re colostomy rinogona kubviswa zvakare here? (Kuvhiyiwa Kwekudzokera Kumashure)
Iri ndiro dambudziko guru rine vanhu vazhinji. Ehe, vanhu vazhinji vanogona kudzosa izvi kune zvakajairika.
Pakati pemwedzi mitanhatu kusvika gumi nemiviri mushure mekuvhiyiwa kwaHartmann, chiremba wako achaongorora hutano hwako zvakare. Kana uri kupora zvakanaka uye usina zvimwe zvirwere zvakakomba, kumwe kuvhiyiwa kunogona kuitwa kubvisa colostomy bag uye kubatanidza zvikamu zviviri zveura hwako.
Zvisinei, vamwe vanhu vangasakwanisa kuvhiyiwa kwechipiri uku. Semuenzaniso:
- Kana kenza yapararira kune dzimwe nhengo dzemuviri.
- Kana uine zvimwe zvirwere zvakakomba zvakaita sechirwere chemwoyo kana chirwere chemapapu.
- Kana usingakwanise kuvhiyiwa zvakare nekuda kwezera kana kufuta zvakanyanya.
Chiremba wako ndiye munhu akakodzera kusarudza izvi.
Mharidzo Yekuenda Nayo Kumba
- Nzira yaHartmann haisi yekutya. Inowanzoitirwa kukuponesa kubva kune chimwe chinhu chinotyisidzira hupenyu, senge kenza kana hutachiona hwakakomba.
- Zvinotora nguva kuti ujairire kugara nebhegi re colostomy, asi zvinokwanisika. Chipatara chichakupa mazano nerutsigiro rwaunoda.
- Chinhu chinonyanya kukosha ndechekuti kune vanhu vazhinji chirwere ichi chinongova chenguva pfupi. Pane mukana wekuti vachapora mushure mekuvhiyiwa kumwezve mumwedzi mishomanana.
- Ikodzero yako kutaura pachena nachiremba wako nezvemibvunzo, kutya, kana kusava nechokwadi kwaungave nako.
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