Pamwe iwe kana mumwe munhu waunoziva akaudzwa nachiremba kuti anofanira kuvhiyiwa kunonzi 'proctocolectomy'. Zvakajairika kunzwa kutya uye kutya zvishoma paunonzwa izwi iri. Pamwe une mibvunzo yakawanda mumusoro mako, yakaita sekuti "Chii chinonzi kuvhiyiwa uku? Sei ndichida izvi? Hupenyu hwangu huchava hwakaita sei mushure meizvi?" Usazvidya mwoyo. Ngatitaurei nezvese izvi nenzira iri nyore, nhanho nhanho, sekunge waizotaura neshamwari.
Zvichitaurwa zviri nyore, chii chinonzi Proctocolectomy?
Kuvhiyiwa kweproctocolectomy inzira yekuvhiya inobvisa chikamu cheura hwako hukuru kana kuti hwese (ura hwemukati) uye rectum.
Ngatitsanangurei izvi zvishoma. Sisitimu yedu yekugaya ine chikamu chinonzi ura hukuru. Chinosanganisira zvikamu zvitatu: ura hwemukati, rectum, uye huro. Funga nezvazvo sechubhu refu.
- Colon: Iyi ndiyo chikamu chikuru chechubhu iyi. Ndipo pano apo marara anosara mushure mekugaya chikafu chatinodya anotorwa uye anoshandurwa kuita chimiro chakasimba, chinonzi tsvina.
- Dhure: Ichi chikamu chipfupi cheura hukuru chinochengeta tsvina kwenguva pfupi chisati chabuda mumuviri.
- Huro: Iyi ndiyo nzvimbo inobuda tsvina mumuviri.
Mukuvhiyiwa kweproctocolectomy, "procto" zvinoreva rectum uye "colectomy" zvinoreva kubviswa kweura. Saka , proctocolectomy kuvhiyiwa kunobvisa ura neura. Dzimwe nguva, kana ura hukabviswa chete, hunonzi colectomy. Kana rectum chete ikabviswa, inonzi proctectomy. Unonzwisisa musiyano here?
Sei uchifanira kuvhiyiwa kwerudzi urwu?
Vanachiremba vanokurudzira kuvhiyiwa kukuru kwakadai chete kana paine chikonzero chakakomba. Kuvhiyiwa uku kunowanzoitwa kana chirwere chiri muura kana rectum chichitadzisa hura kana rectum kushanda zvakanaka, kana kuti chirwere chacho chiri pangozi yehupenyu.
Heano mamwe ezvikonzero zvikuru:
- Zvirwere zveInflammatory Uwel Diseases (IBD): Aya ndiwo mamiriro ezvinhu anokonzera kuzvimba kwenguva refu uye maronda muura. Ulcerative Colitis neCrohn 's Disease ndiwo mienzaniso mikuru. Vamwe vanhu vanofanira kubviswa zvikamu zveura zvine chirwere kana zvisingagone kudzorwa nemishonga.
- Kenza yemudumbu uye zvirwere zvegomarara: Kana masero egomarara akura muura kana rectum, kana kuti kana ma polyps anogona kuita kenza akura (zvirwere zvakaita seFamilial Adenomatous Polyposis ), mushonga wakanakisa ndewokubvisa zvachose nzvimbo dzine chirwere.
- Zvimwe zvikonzero:
- Ischemia inoitika kana ropa richiyerera muura robva rapera uye nyama yofa.
- Matambudziko akaoma eDiverticulitis .
- Kukuvara kwemudumbu nekuda kwetsaona yakakomba.
- Kuzvimba kwakanyanya kusingarapike nemishonga.
Chinhu chinonyanya kukosha ndechekuti kuvhiyiwa uku kuri kuitwa kuti uponeswe uye kuti uve nehupenyu huri nani uye hwakagadzikana.
Unoita sei kuti ubvise tsvina mushure mekuvhiyiwa?
Uyu ndiwo mubvunzo mukuru uri mupfungwa dzemunhu wese. Mushure mekunge ura hwemukati nerectum zvabviswa, nzira yakajairika yekubuda tsvina inenge yapera. Saka unobvisa sei tsvina?
Mhinduro yacho inoenderana nerudzi rweproctocolectomy yauri kuita. Chiremba wako ndiye achasarudza rudzi rwekuvhiyiwa kwakakunakira zvichienderana nemamiriro ako ehutano uye chikonzero chekuvhiyiwa. Ngatitarisei mhando dzacho.
Ndeapi marudzi ekuvhiyiwa kweproctocolectomy?
Kune nzira dzakasiyana siyana dzekuita kuvhiyiwa uku. Chiremba wako achasarudza nzira yakakunakira.
| Rudzi rwekuvhiyiwa | Tsananguro iri nyore yezviri kuitika |
|---|---|
| Kuvhiyiwa kweProctocolectomy neIleostomy (ne ileostomy) | Mukuita uku, ura hwemukati nerectum zvinobviswa zvachose. Zvadaro, chikamu chekupedzisira cheura hudiki, chinonzi ileum , chinoburitswa nepaganda redumbu uye panobva pabuda buri (stoma). Tsvina inobuda nepaburi iri. Bhegi rinosungirirwa kunze kwaro. Vamwe vanhu vanofanira kupfeka iri zvachose, vamwe kwenguva pfupi chete. |
| Kuvhiyiwa kweProctocolectomy neIleoanal Pouch (Kuvhiyiwa kwekutsiva) | Mukuita uku, ura nerectum zvinobviswawo, asi anus inosiyiwa panzvimbo yayo. Tevere, chikwama chemukati chinogadzirwa kubva kumagumo eura hudiki (ileum). Chikwama ichi, serectum yekutanga, chinobatsira kuchengetedza tsvina kwenguva yakati. Chikwama ichi chinozobatanidzwa neanus (ileoanal anastomosis).Izvi zvinokutendera kuti ubvise tsvina zvakanaka. Izvi zvinogona kuitwa nekuvhiyiwa kamwe chete kana kaviri. |
| Kuvhiyiwa kweProctocolectomy yeSubtotal (kubvisa chikamu) | Izvi zvinosanganisira kusiya chikamu chemudumbu kana rectum. Semuenzaniso, nzira yeHartmann inobvisa chikamu chekupedzisira chemudumbu (sigmoid colon) nerectum chete. Kana izvi zvikaitwa, zvikamu zvasara zvine hutano zvemudumbu zvinogona kubatanidzwazve (anastomosis) , kuitira kuti ugone kuita zvemukati zvakajairika. Dzimwe nguva colostomy yenguva pfupi (kuvhurika kwemudumbu) inogona kuiswa kusvika ronda rapora. |
Chii chaunofanira kuita usati wavhiyiwa?
Kana kusiri kuvhiyiwa kwekukurumidzira, uchava nenguva yakakwana yekugadzirira.
- Mavhiki mashoma pachine nguva: Taura nachiremba wako nezvekuvhiyiwa, mhando dzakwo, njodzi, uye mabhenefiti. Bvunza chero mibvunzo yaunayo.
- Mavhiki maviri usati watora mishonga yekuderedza ropa, chiremba wako achakukurudzira kuti urege kana kuderedza. Zvakare, edza kuchengetedza ura hwako hwakanaka nekudya fiber yakawanda uye kunwa mvura yakawanda panguva iyi.
- Maawa makumi maviri nemana usati wavhiyiwa: Zuva risati rasvika rekuvhiyiwa, uchapihwa mushonga wekuchenesa ura hwako zvachose. Uchabvumirwa kunwa mvura yakachena chete, yakaita semvura nesobho, pazuva iroro. Unogonawo kupiwa mishonga inorwisa utachiona kudzivirira hutachiona mushure mekuvhiyiwa.
Chii chinoitika panguva yekuvhiyiwa?
Kana waenda kuchipatara, uchaiswa chipfeko chekuvhiya. Katheta yemutsinga ichaiswa mutsinga yako uye uchapihwa saline nemishonga chero ipi zvayo inodiwa. Uchaendeswa kukamuri rekuvhiya.
Chiremba weanotindivadza achakuisa pasi peanesthesia. Hauzonzwi chero chinhu panguva yekuvhiyiwa. Uchabatanidzwa nemuchina (ventilator) kuti ukubatsire kufema.
Kuvhiyiwa Kwepachena Here? Kuvhiyiwa kweLaparoscopic?
Mazuva ano, kuvhiyiwa kwakawanda kweproctocolectomy kunoitwa ne laparoscopically . Izvi zvinoreva kuti pachinzvimbo chekuchekwa kukuru mudumbu, kuvhiyiwa uku kunoitwa kuburikidza nemaburi mashoma madiki, umo kamera nezvishandiso zvidiki zvekuvhiya zvinoiswa. Nzira iyi inobvumira kupora nekukurumidza, marwadzo mashoma, uye mavanga madiki. Zvisinei, nzira iyi haikodzeri munhu wese. Muzviitiko zvakaoma kana zvekukurumidzira, kuvhiyiwa kwekare kwakavhurika kunodiwa.
Panguva yekuvhiyiwa, chiremba anobvisa nokungwarira ura hwakarwara nerectum. Zvadaro, sezvakambotaurwa, ileostomy/colostomy inogadzirwa kana kuti ura hunosanganiswa zvakare (anastomosis).
Chii chinoitika mushure mekuvhiyiwa?
Mushure mekuvhiyiwa, muchafanira kugara muchipatara kweinenge vhiki. Munguva iyi, muchatanga kudya zvekudya zvine mvura zvishoma nezvishoma uye zvishoma nezvishoma muchatanga kudya zvekudya zvakasimba.
Kana uine ostomy (ileostomy/colostomy), Wound Ostomy Continence Nurse (WOCN) achakubatsira. Vachakudzidzisa zvese zvaunoda kuziva nezvekushandisa ostomy bag uye kuchengetedza stoma yako (yakavhurika mudumbu mako) yakachena. Kunyangwe iri ostomy yenguva pfupi, zvinotora mwedzi yakati wandei usati wakwanisa kukurukura matanho anotevera (kuibvisa kana kugadzira bhegi remukati) nachiremba wako.
Ndezvipi njodzi nematambudziko zvinosanganisirwa nekuvhiyiwa uku?
Sekunge kune chero kuvhiyiwa kupi zvako, kune dzimwe njodzi dzinobatanidzwa, asi idzi hadziwanzoitika.
| Rudzi rwedambudziko | Zvinhu zvinogoneka |
|---|---|
| Njodzi dzinowanzoitika dzekuvhiyiwa | Kubatwa nechirwere chinopedza simba, kukuvara kwenhengo dzakapoteredza, kubuda ropa rakawanda, uye hutachiona. |
| Matambudziko anokonzerwa nekuvhiyiwa | - Kuvharika kwedumbu: Mavanga anobva pakuvhiyiwa anogona kukonzera kuti ura huvhare. - Kukuvadzwa kwetsinga: Kuvhiyiwa kwekubuda netsvina kunogona kukuvadza tsinga dzinobatanidzwa pakuita weti kana kuita weti. Dzinowanzo pora nekufamba kwenguva. |
| Matambudziko Akabatana neOstomy (Ileostomy/Colostomy) | - Kurwara neganda: Ganda rakatenderedza dumbu rinogona kutsvuka uye kuvaviwa nekusangana netsvina. - Kuchinja kwestoma: Stoma inogona kunyura mukati kubva paganda (kudzokera shure) kana kubuda zvakanyanya (kudonha). - Huremu Hwechikadzi: Kunyangwe huremu hukabviswa, vamwe vanhu vanogona kuramba vachinzwa kuda kuita tsvina. Izvi zvinodzikira nekufamba kwenguva. |
| Matambudziko Akabatana Nehomwe Yemukati | - Pouchitis: Kuzvimba kwemukati mebhegi idzva. Izvi zvinorapwa nemishonga inorwisa mabhakitiriya. - Kubuda kwemvura mudumbu: Kubuda kwemvura panzvimbo yekubatana kwemudumbu. Ichi chirwere chisingawanzoitiki asi chakakomba. - Kuomerwa kwenguva pfupi kudzora kufamba kwedumbu: Pakutanga, zvinogona kuoma kudzora kufamba kwedumbu nekuda kwetsandanyama dzisina simba dzekumashure. Izvi zvichavandudzika nekurovedza muviri nenguva. |
Ko kurapwa kwemusana mushure mekuvhiyiwa kwacho kwakamira sei?
Zvinogona kutora mwedzi yakati wandei kuti upore zvizere. Munguva iyi, zvakakosha zvikuru kutevedzera mirairo yachiremba wako nokungwarira.
- Kutarisirwa kweronda: Chiremba kana nesi achakudzidzisai nzira yekuchenesa ronda uye kuchinja bhandi.
- Kutarisirwa kweOstomy: Uchadzidza kudurura bhegi reOstomy kakawanda pazuva uye kuchengetedza ganda rakatenderedza stoma rakachena.
- Chikafu: Kana wasvika kumba kubva kuchipatara, tanga kudya chikafu chakasimba zvishoma nezvishoma. Pane kudya chikafu chakawanda panguva imwe chete, idya zvishoma kakawanda pazuva. Chenga chikafu chako zvakanaka.
- Kunyungudutsa: Izvi zvakakosha zvikuru. Sezvo chikamu chikuru cheura hwako chakabviswa, muviri wako uchanwa mvura shoma. Saka zvakakosha kunwa mvura yakawanda nemvura mukati mezuva.
Nguva yekuona chiremba
Mushure mekudzokera kumba kubva kuvhiyiwa, kana uine chimwe chezviratidzo zvinotevera , fonera chiremba wako nekukasika kana kuenda kuEmergency Department (ETU) yechipatara chiri pedyo.
- Zviratidzo zvekuvharika kwemudumbu zvinosanganisira kuvimbiwa, kurwadziwa mudumbu, kuzvimba, uye kuda kurutsa.
- Zviratidzo zvechirwere chinotapukira zvakaita sekurwadziwa mudumbu, kuzvimba, kubuda kwehurwa kubva paronda, uye fivha.
Kuvhiyiwa kweproctocolectomy kuvhiyiwa kukuru. Asi kunogona kukubatsira kuti uwane zororo kubva kuchirwere chenguva refu uye kuvandudza hupenyu hwako. Nehunyanzvi hwemazuva ano, mabhegi e ostomy anogona kuitwa kuti asaonekwe uye anzwe akasununguka. Taura nachiremba wako nezvesarudzo dzako uye ita sarudzo yakakunakira.
Mharidzo Yekuenda Nayo Kumba
- Kuvhiyiwa kweproctocolectomy inzira inoponesa hupenyu inobvisa ura hwemukati nerectum. Inowanzoitirwa zvirwere zvakakomba zvakaita seIBD nekenza.
- Nzira yekubvisa ura mushure mekuvhiyiwa inosiyana. Kune dzimwe nzira dzakadai se ileostomy (paketi yekunze) kana kuti paketi yemukati (paketi yemukati).
- Taura pachena nachiremba wako nezverudzi rwekuvhiyiwa kwakakunakira uye mibvunzo yako yese inopindurwa.
- Zvinotora nguva kuti upore kubva pakuvhiyiwa. Munguva iyi, nyatsotevedzera mirairo yachiremba wako, kunyanya panyaya yechikafu uye mvura inonwiwa.
- Kunyangwe kurarama ne ostomy kungaita sekunge kwakaoma pakutanga, kana ukadzidziswa zvakanaka uye uchitsigirwa, zvinogona kuva chikamu chehupenyu hwemazuva ese.
- Kana ukaona zviratidzo zvisingawanzoitiki (kurwadziwa kwakanyanya, fivha, kuda kurutsa) mushure mekuvhiyiwa, tsvaga rubatsiro rwechiremba nekukasika.
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