Unonzwa bundu pahuro kana pachipfuva chako here paunodya kana kunwa? Dzimwe nguva unotya kudya nekuti unonzwa sekunge chikafu chako hachisi kudzikira here? Izvi zvinogona kunge zvichikonzerwa nechirwere chisingawanzoitiki chinonzi Achalasia. Kurarama nechirwere ichi hakusi nyore. Zvakaoma kumedza chikafu, uye kusadya zvakanaka kunogona kutokonzera kushomeka kwezvekudya. Saka nhasi tichataura nezvekuvhiyiwa kunonzi Heller Myotomy, kunoitwa sekurapa izvi.
Chii chinonzi Heller Myotomy surgery?
Zvichitaurwa zviri nyore, Heller Myotomy inyaya diki yekurapa Achalasia . Achalasia chirwere chisingawanzoitiki chinokanganisa gumbo redu, kana kuti pombi dzechikafu. Apa ndipo apo nzira yekutumira chikafu nemvura kubva mugumbo kuenda mudumbu isingashande nemazvo.
Izwi rekuti "myotomy" rinoreva kucheka tsandanyama. MuHeller Myotomy, chiremba anochera kakati wandei mudenderedzwa retsandanyama riri pasi pegurokuro rako, rinonzi Lower Esophageal Sphincter (LES) . LES tsandanyama yakakora iri pakati pechikamu chezasi chegurokuro rako nechikamu chepamusoro chedumbu rako. Yakaita sevharuvhu.
Kana uine achalasia, tsandanyama yeLES haivhurike kana kuvhara zvakanaka. Izvi zvinodzivirira chikafu kuti chisapfuure kubva mugurokuro kuenda mudumbu. Heller Myotomy surgery inoshanda nekuzorodza tsandanyama yeLES nekuivhura.
Kuvhiyiwa uku kunowanzoitwa pamwe chete neimwe nzira inonzi fundoplication . Izvi zvinosanganisira chiremba anotora chikamu chedumbu rako ochiputira pagurokuro rako. Izvi zvinoderedza njodzi yekuti acid yemudumbu idzokere mugurokuro rako (reflux).
Chinhu chakakosha ndechekuti kuvhiyiwa kweHeller Myotomy hakusi mushonga wakakwana weAchalasia. Kunopa zororo kwenguva refu, zvisinei, zvingave zvakakosha kuti kuvhiyiwa uku kudzokororwe nekufamba kwenguva.
Unogadzirira sei usati wavhiyiwa?
Kuti uve nechokwadi chekuti wakakodzera kuvhiyiwa, chiremba wako achakuraira bvunzo dzinoverengeka usati wavhiyiwa. Semuenzaniso, kuongororwa ropa, X-ray yechipfuva, uye ECG.
Usati wavhiyiwa, chiremba weanotindivadza achakunyaradza achataura newe. Achakubvunza mibvunzo yakaita seiyi:
- Wakambobatwa nechirwere cheanesthesia here uye zvakaitika sei?
- Ndeapi makwenzi, mishonga, kana mavhitamini aunoshandisa?
- Unoshandisa fodya, doro, kana zvimwe zvinodhaka here?
Pane zvinhu zvishoma zvaunofanira kuita kuti ugadzirire kuvhiyiwa. Izvi zvinofanira kukurukurwa uye kusimbiswa nachiremba wako.
| Zvekuita | Sei izvozvo zvichikosha? |
|---|---|
| Kurega kushandisa nicotine (chero rudzi, kusanganisira fodya ne e-cigarettes) | Nikotini inokanganisa kufamba kweropa rako, izvo zvinogona kunonotsa kupora kwemaronda mushure mekuvhiyiwa. |
| Kutsanya. | Chiremba wako anogona kukuudza kuti usadye chero chinhu kwemaawa matanhatu kana kupfuura usati wavhiyiwa. Unogona kunwa mvura yakachena (senge mvura) kwenguva yakati usati wavhiyiwa. Asi iva nechokwadi chekubvunza chiremba wako nezvenyaya iyi. |
| Kuronga kugara muchipatara. | Uku kuvhiyiwa kukuru, saka uchafanira kugara muchipatara kwezuva rimwe chete mushure mekuvhiyiwa. Uyewo, ronga kuti mumwe munhu akuendese kumba nemotokari uye agare newe kwemaawa makumi maviri nemana ekutanga. |
| Kuronga kupora. | Mushure mekuvhiyiwa, chiremba anogona kunyora mishonga inoderedza marwadzo. Hauzokwanisi kutyaira kusvika wainwa, saka tsvaga mumwe munhu anokubatsira pamabasa iwayo. |
Kuvhiyiwa uku kunoitwa sei?
Iye zvino ngatitarisei zvinoitika mukati mekuvhiyiwa. Kazhinji, izvi zvinoitwa ne laparoscopically . Kureva kuti, nerubatsiro rweteresikopu. Pano, chiremba anoshandisa mudziyo mutete une kamera yakabatanidzwa pairi kuti atarise mukati megurokuro rako uye midziyo midiki kwazvo kuti aite kuvhiyiwa.
- Kutanga, chiremba weanotindivadza achaisa tambo yemutsinga (semuchubhu unoisa saline) mutsinga iri muruoko rwako uye achakupa mushonga wekurara. Hauzonzwi chero chinhu panguva yekuvhiyiwa.
- Tevere, chiremba anovhiya achaita mavanga madiki mashanu mudumbu mako (dumbu).
- Zvadaro, mudumbu mako muzere negasi recarbon dioxide. Izvi zvinoitirwa kuti zvive nyore kufambisa zvishandiso zvekuvhiya uye kuti zvive nyore kuona gurokuro nechikamu chepamusoro chedumbu.
- Zvino chiremba anoisa kamera nezvishandiso zvidiki zvekuvhiya kuburikidza nemachekwa iwayo.
- Uchishandisa zvishandiso izvi, tsandanyama dziri pasi pegurokuro dzinochekwa neurefu uye LES inovhurwa.
- Zvadaro, nzira inonzi fundoplication inoitwa. Izvi zvinosanganisira kutora chikamu chepamusoro chedumbu wochiputira pagurokuro. Izvi zvinodzivirira acid yemudumbu kuti isabude.
- Pakupedzisira, kamera nemidziyo zvinobviswa, uye zvidimbu zvidiki izvozvo zvinosonwa.
Kuvhiyiwa uku kwese kunowanzotora maawa maviri.
Chii chinoitika mushure mekuvhiyiwa?
Zvinoitika mushure mekuvhiyiwa zvinogona kusiyana zvishoma kubva pamunhu nemunhu. Asi kazhinji, unogara muchipatara husiku hwese. Munguva iyi, uchapihwa mvura uye chikafu kuburikidza nemutsara weIV. Mushure meizvozvo, nguva yekupora inotanga.
Chinhu chinonyanya kukosha ndechekuti gumbo rako ringave rakazvimba mushure mekuvhiyiwa. Zvinogona kutora mwedzi miviri kuti kuzvimba uku kudzikire zvachose. Saka uchafanira kuchinja kudya kwako zvishoma nezvishoma.
Chikwata chenyu chezvekurapa chichakutsanangurirai izvi, asi chirongwa chekudya chakajairika ndecheichi chinotevera.
| Nguva | Chikafu chiripo |
|---|---|
| Zuva rekutanga nerechipiri | Zvinwiwa zvakajeka. Semuenzaniso: muto wehuku/nyama yemombe (yakasanganiswa), jeli, mapakiti echando, mvura. |
| Kubva pazuva rechitatu kusvika pazuva rechinomwe | Zvekudya zvemukaka. Semuenzaniso: ice cream, soup yekirimu yakasvinwa, porridges dzakadai seCream of Wheat kana Cream of Rice. |
| Kubva pazuva rechisere kusvika pakuongororwa kwemavhiki maviri | Zvekudya zvakapfava. Chiremba wako achakuudza kuti ungatanga riini kuwedzera zvekudya zvakasimba. |
Ndezvipi zvakanakira uye njodzi dzekuvhiyiwa uku?
Mabhenefiti
Vanhu vazhinji vane achalasia vanoshandisa Heller Myotomy kana mamwe marapirwo asina kuvhiyiwa akakundikana. Chinhu chikuru chinoita kuti nzira iyi ishande ndechekuti zviratidzo zveachalasia zvinopera mushure mekuvhiyiwa.
Ongororo yakaitwa munguva pfupi yapfuura yakaratidza kuti pakati pe87% ne92% yevanhu vakamborapwa mushonga uyu zviratidzo zvavo zvakapera. Zvisinei, sezvatakambotaura, izvi hazvirapise achalasia zvachose. Zviratidzo zvinogona kudzokazve makore mashanu kusvika gumi mushure mekuvhiyiwa.
Njodzi
Sekunge kune chero kuvhiyiwa kukuru, Heller Myotomy ine njodzi. Njodzi dzakajairika dzinosanganisira kubuda ropa rakawanda uye hutachiona. Pamusoro pezvo, matambudziko chaiwo anogona kuitika anosanganisira:
- Huro yaBarrett
- Utachiona hwepadumbu
- GERD (chirwere chegastroesophageal reflux)
- Kuputika kwegurokuro
Nguva yekuona chiremba
Kana uine chimwe chezviratidzo zvinotevera mushure mekuvhiyiwa, fonera chiremba wako nekukasika, kana kuenda kuEmergency Department (ETU) yechipatara chiri pedyo.
- Kana nzvimbo yekuvhiyiwa yakatsvuka uye yakazvimba.
- Kana urwa huri kubuda kubva paronda rekuvhiyiwa.
- Kana usingakwanise kumedza mvura.
- Kana mishonga yekurwadziwa inopiwa nachiremba isingaderedzi marwadzo.
Kusiyana pakati peHeller Myotomy nekuvhiyiwa kwePOEM
Ungave wakambonzwawo nezvenzira inonzi POEM. POEM ishoko rinotsanangura Peroral Endoscopic Myotomy . Kufanana naHeller Myotomy, iyi imishongawo yechirwere cheAchalasia.
Musiyano uripo pakati pezviviri izvi ndewekuti mukuvhiyiwa kwePOEM, hapana mavanga anochekwa mudumbu mako. Pane kudaro, chiremba wako anoisa endoscope (chubhu ine kamera yakabatanidzwa) kuburikidza nemuromo wako uye pasi pegurokuro rako. Tsandanyama dzeLES dzinobva dzachekwa kubva mukati. MuHeller Myotomy, izvi zvinoitwa kubva kunze kuburikidza nemavanga madiki mudumbu mako.
Mharidzo Yekuenda Nayo Kumba
- Heller Myotomy kuvhiyiwa kunoitwa kurapa achalasia, chirwere chinoita kuti zviome kumedza.
- Izvi zvinowanzoitwa ne laparoscopically kuburikidza nekuchekwa kudiki mudumbu, uko sphincter yepazasi yegurokuro inorerutswa.
- Kunyangwe kuvhiyiwa uku kuchipa zororo renguva refu kubva kuzviratidzo, hakusi mushonga wakakwana weAchalasia.
- Munguva yekupora mushure mekuvhiyiwa, uchafanirwa kutevedzera kudya kwakakosha kwemavhiki akati wandei.
- Zvakakosha kutevedzera mirairo yachiremba wako sezvainopihwa usati wavhiyiwa uye mushure mekuvhiyiwa.
- Tsvaga rubatsiro rwechiremba nekukasika kana ukaona zviratidzo zvekunyevera, zvakaita sekuzvimba, hurwa, kana kutadza kumedza mvura panzvimbo yekuvhiyiwa.
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