'Ukuvuza' kwangaphakathi emva kotyando? (Ukuvuza kwe-Anastomotic) Masifunde ngayo ngokulula!

Ngaba wakha wacinga ukuba emva kotyando olukhulu, iingxaki zinokuvela emzimbeni esingacingi nokucinga ngazo? Njengokuba xa udibanisa imibhobho emibini yamanzi, ngamanye amaxesha amanzi amancinci aphuma kwilungu, into efanayo inokwenzeka xa imithambo yegazi emibini emzimbeni wethu idibene ngotyando. Kwizonyango, oku sikubiza ngokuba kukuvuza kwe-anastomotic . Ekubeni oku kunokuba yinto embi kakhulu, kubaluleke kakhulu ukuba wena nabantu obathandayo nikwazi ngako.

Yintoni kanye kanye into yokuvuza kwe-anastomotic?

Ngamafutshane, i-anastomosis yinkqubo yotyando apho iziphelo zeetyhubhu ezimbini zomzimba zidibene khona. Khawucinge ukuba bekufuneka ususe inxalenye yamathumbu akho. Emva koko kufuneka uphinde udibanise iziqwenga ezibini zamathumbu. Elo qhagamshelo libizwa ngokuba yi-anastomosis.

Ngoku, oku kuvuza kwe-anastomotic kwenzeka xa uqhagamshelo lungavaleki kakuhle, kwaye umxholo waloo mbhobho uphuma. Oku kunokuba yingozi, kuba akulunganga ukuba umxholo wemibhobho yomzimba wethu uye kwezinye iindawo. Umzekelo, kukho iibhaktheriya kwimixholo yenkqubo yakho yokugaya ukutya. Ukuba ezi zifika kwezinye iindawo esiswini sakho, zinokubangela usulelo.

Kuza kwenzeka ntoni ukuba kukho ukuvuza emva kotyando lwamathumbu?

Ukususwa kwamathumbu yindlela eqhelekileyo apho kwenziwa i-anastomosis, kwaye ukuvuza kwe-anastomotic kunokwenzeka. Ukuba umxholo wamathumbu uvuza ungene kwisisu, ulwelo lwesisu (i-peritoneum) lunokosuleleka kwaye ludumbe. Oku kubizwa ngokuba yi-peritonitis . Olu sulelo lunokusasazeka kwamanye amalungu esiswini nakwigazi. Ukuba luba nzima, lunokukhokelela kwimeko esongela ubomi ebizwa ngokuba yi-sepsis . I-Sepsis yindlela umzimba osabela ngayo ngokugqithisileyo kusulelo. Oku kunokukhokelela ekuthukeni , ukungasebenzi kakuhle kwamalungu omzimba, okanye ekufeni.

Khawucinge ngento enokwenzeka ukuba izinto ezikwinkunkuma yethu yasekhitshini zingachitheka kwigumbi lokuhlala. Into efanayo ingenzeka ukuba izinto ezisemathunjini ethu zingachitheka esiswini sethu. Yiyo loo nto oku kuyingozi kangaka.

Enye into enokuvuza kwisisu yindlela yakho yokuchama. Umzekelo, ngexesha lokufakelwa kwezintso okanye i-prostatectomy, unokufuna i-anastomosis. Ukuba oku kuyavuza, umchamo ungaqokelelana ngaphakathi kwisisu. Oku kubizwa ngokuba yi-urinoma . Kukwakho nomngcipheko wosulelo kunye ne-sepsis ngaphandle kwesisu. Umzekelo, ukuba uvuza kwisisu sakho, okuyinxalenye yombhobho wakho wokutya, kunokukhokelela kusulelo kwisifuba sakho.

Kwenzeka nini ukuvuza kwe-anastomotic?

Ngamanye amaxesha oku kuvuza kunokuba khona ngexesha lotyando. Kodwa oogqirha bayakujonga ngelo xesha. Oku kwenzeka rhoqo ngexesha lokuphiliswa. Uninzi lokuvuza luvela kwiveki yokuqala emva kotyando , kodwa okunye kunokulibaziseka. Oogqirha baya kujonga oku kangangeeveki ezimbalwa emva kotyando. Ukuvuza okuncinci, okuncinci kunokuthatha ixesha elide ukubonisa iziphumo zako. Ukuvuza okwenzeka emva kweentsuku ezingama-30 (`(Ukuvuza okuLibazisekileyo kwe-Anastomotic)`) kunqabile kakhulu.

Ixhaphake kangakanani le meko?

Kubikwa ukuba ukuvuza kwe-anastomotic kwenzeka malunga ne-5% yotyando lwe-anastomosis. Kula ma-75% anxulunyaniswa notyando lwe-colectomy. Le ngozi iphezulu kakhulu kutyando olwenziwa ekupheleni kwekholoni, i-rectum okanye i-sigmoid colon. Oku kungenxa yokuba indawo incinci kwaye kunzima ukuyityanda, ingakumbi kumadoda.

Ngubani onokuthi abe nokuvuza okubangelwa kukungafumani manzi emzimbeni?

Enyanisweni, nabani na oye wafunyanwa ene-anastomosis unokufumana le ngxaki. Nangona kunjalo, kukho izinto ezithile ezinokubangela umngcipheko woko.

Izinto ezinobungozi zezi:

• Ukutshaya.
• Ukungondleki kakuhle okanye i-anemia.
• Ukusetyenziswa kwe-immunosuppressants.
• Ukuba neethumba ezikumgangatho ophantsi.
• Emva kokufumana unyango lwemitha.
• Sele unemeko ebizwa ngokuba yi-"Sepsis" okanye "Septic Shock" emzimbeni.
• Ukuba ndifumene igazi ngexesha lotyando (`(Intraoperative Blood Transfusion)`).
• Ukuba nokutyeba kakhulu okanye isifo seswekile (`(iDiabetes Mellitus)`).
• Utyando olungxamisekileyo.
• Utyando luthatha ixesha elide kakhulu.
• I-Anastomosis yeRectal.
• Ukuba yindoda ekuzalweni (`(Isini Esinikwe Indoda)`).

Yintoni ebangela oku kuvuza?

Ukuvuza kwe-anastomosis kudla ngokubangelwa kukungaphumeleli kwenkqubo yokuphiliswa kwenxeba . Kunzima ukuchonga unobangela omnye, kodwa zininzi izinto ezinokubangela oko. Umzekelo:

• Uxinzelelo olugqithisileyo kwindawo yotyando: Yile nto oogqirha abazama ukuyiphepha ukuthintela ukuvuza. Olu nxibelelwano lunokutsalwa okanye luqiniswe ngexesha lokuhamba. Lo mngcipheko mkhulu ukuba indawo yotyando incinci okanye kunzima ukufikelela kuyo.
• Usulelo lwangaphambili emzimbeni: Ukuba kukho usulelo lwangaphambili, lunokubangela ukuba izicwili zidumbe kwaye zivuvuke. Usulelo oluhlala ixesha elide lunokubangela ukwehla kwe-collagen . Oogqirha botyando baya kuhlamba loo ndawo ngezisombululo ze-antiseptic baze banike amayeza okubulala iintsholongwane.Nokuba uzama ukulawula usulelo ngee-antibiotics, izicubu zisenokuba buthathaka ngexesha lotyando.
• Ukuncipha kokuhamba kwegazi ukuya kwimithambo yegazi edibanisayo (`(Ischemia)`): `(Ischemia)` inokuba yimeko esele ikho okanye inokwenzeka njengempendulo yotyando.
• Ubuthathaka bomzimba: Ezinye iimeko zempilo, ukutshaya, ukutya okungondleki kakuhle, okanye ukusebenzisa `(Immunosuppressants)` kunokwenza buthathaka umzimba. Unyango lwemitha luyonakalisa izicubu kwaye lubuthathaka umzimba. Oku kungenxa yokuba abantu abaninzi abenza utyando lwe-`(Anastomosis)` bangabaguli bomhlaza.

Zithini iimpawu zokuvuza kwe-anastomotic?

Iimpawu zokuqala neziqhelekileyo ezibonakala kule meko zezi:

• Intlungu Yesisu (`(Intlungu Yesisu)`) .
• Umkhuhlane (`(Umkhuhlane)`) .
• Ukudumba kwesisu (kusenokuba kubangelwa yiPeritonitis).
• I-ileus engapheliyo yokungaphumli kwamathumbu (ukungasebenzi kakuhle kwamathumbu) emva kotyando .

Xa imeko iba mandundu kancinci, iimpawu ezifana nezi zinokuvela:

• Ukubetha kwentliziyo ngokukhawuleza (iTachycardia) .
• Ukuphambana (`(Ukuphambana)`) .
• I-Sepsis `(i-Sepsis)` .
• Umothuko .

Uyibona njani le nto kanye kanye?

Xa usiya kugqirha wakho emva kotyando, uza kujonga imeko yakho ngononophelo. Iimpawu zakho ezibalulekileyo (ezifana nokubetha kwentliziyo yakho, izinga lokuphefumla, ubushushu, kunye noxinzelelo lwegazi), uvavanyo lwegazi, kunye nokusebenza kwamathumbu kuya kuhlolwa rhoqo. Ukuba uneempawu zosulelo okanye amathumbu akho awenzi kakuhle emva kotyando lwamathumbu amakhulu, ugqirha wakho unokurhanela ukuba kukho ukuvuza kwe-anastomotic. Baza kusebenzisa iimvavanyo zomfanekiso (ezifana neeskeni) ukuqinisekisa oku - ngesiqhelo i-CT scan , esebenzisa idayi yokwahlulahlula .

Iphathwa njani?

Ukuba ufunyaniswe ukuba unolu hlobo lokuvuza, uza kunyangwa ngamayeza okubulala iintsholongwane ukulawula usulelo. Unyango luya kuxhomekeka kubukhulu bokuvuza kunye nobunzima bemeko yakho. Oku kunokuquka:

• Ukukhupha amanzi: Umzimba kufuneka ukhuphe ulwelo kunye/okanye ukudumba okuqokelelene ngenxa yosulelo. Ukuba kunokwenzeka, ugqirha uya kwenza oku ngecala – oko kukuthi, ngenaliti engenanto efakwe ngomngxuma omncinci eluswini.
• Ukuphumla kwamathumbu: Ukuba ukuvuza kungaphakathi kwamathumbu, kuya kufuneka uyeke ukutya okanye ukusela ngomlomo ngexesha lonyango. Ugqirha wakho unokukunika ulwelo olufakwa kwimithambo yegazi.iza kunikwa, kwaye ukuba kuyimfuneko, iza kunikwa isondlo esifakwa kwimithambo yegazi.
• Utyando Oluphindaphindwayo: Ugqirha otyandayo unokufuna ukuphinda ahlolisise i-anastomosis aze enze olunye utyando. Ukuba kunokwenzeka, baya kusebenzisa inkqubo engangenisi kakhulu, efana ne -laparoscopy . Oku kubandakanya ukufaka ikhamera nge-incision encinci ukuze bahlole umngxuma wesisu. Basenokusebenzisa nezixhobo ezincinci ukukhupha ithumba okanye ukuhlamba umngxuma ngezisombululo ze-antiseptic. Ukuba oku akusebenzi, umngxuma wesisu unokufuna ukuvulwa kwakhona ukuze kufikelelwe ekuvuzayo. I-anastomosis inokufuna ukuqinisa okanye entsha inokufuna ukwenziwa kwindawo eyahlukileyo enezicubu eziphilileyo. Ngamanye amaxesha, umzimba kufuneka unikwe ixesha elingakumbi lokuphiliswa ngaphambi kokuba i-anastomosis iphinde yenziwe. Ngexesha lotyando lwamathumbu, ugqirha otyandayo unokufuna ukuhambisa inxalenye yamathumbu okwethutyana kwi- ostomy (umngxuma omtsha odlula i-anastomosis kwaye uvumele ixesha elingakumbi lokuphiliswa).

Kuthatha ixesha elingakanani ukuphiliswa?

Ukuvuza okubangelwa kukungafumani gazi kunokubangela ukuba umntu ahlale esibhedlele iiveki ezine nangaphezulu.

Ngaba oku kuvuza akunakuthintelwa?

Kukho izinto ezininzi ezinokubangela ukuvuza kwe-anastomotic, uninzi lwazo olungenakutshintshwa. Umzekelo, impilo yesigulana, ubunzima botyando, kunye nezinye izinto ezenzeka ngexesha lokuphiliswa. Nangona kunjalo, oogqirha botyando banokujonga ukuvuza ngexesha lotyando.

Uvavanyo

Uvavanyo olwenziwayo ukujonga ukuvuza emva kwe-anastomosis zezi:

• Uvavanyo Lomoya: Umzimba uzaliswe yisisombululo setyuwa kwaye umoya ungeniswa kwityhubhu yomzimba. Ukuba amaqamza abonakala kwisisombululo, kukho ukuvuza kwindawo eqhagamshelweyo. Ngokwesiqhelo, oku kuvuza kulungiswa ngokufaka kwakhona uqhagamshelo okanye ukuluthungela.
• Uvavanyo lolwelo: Isicombululo sokubulala iintsholongwane sifakwa kwityhubhu yomzimba size sihlolwe ukuba akukho kuvuza na.
• Uvavanyo lokwahlulahlula: Kwimeko yotyando lwamathumbu, ugqirha angasebenzisa i-CT scan kunye nedayi yokwahlulahlula ukuze abone ukuba kukho ukuvuza na. Idayi yokwahlulahlula idluliselwa kwi-anus ukuya kwi-anastomosis ukuze kubonwe ukuba kukho ukuvuza na.

Nangona ezi mvavanyo zenziwe ngexesha lotyando zingenakuthintela ukuvuza konke, zinokunciphisa inani lazo kwaye zichonge abo basengozini enkulu yokuvuza kwakhona.

I-Stoma yokuthintela (`(I-Stoma yokuthintela)`)

Ngexesha lotyando lwamathumbu, oogqirha banokususa indle emathunjini ngexesha lokuphiliswa, bethintela iziphumo ezimbi kakhulu zokuvuza kwamathumbu. Bakwenza oku ngokwenza i -colostomy yexeshana okanye i-ileostomy.Kwenziwa enye, umxholo wamathumbu ususwe kwindawo yokudibanisa uze uthunyelwe ebhegini. Nangona oku kungathinteli ukuvuza kwe-anastomotic, kuthintela umxholo wamathumbu ukuba ungene esiswini ukuba kukho ukuvuza.

I-ostomy idala umngxuma omtsha, owenziweyo wokwenziwa ukuze indle idlule, obizwa ngokuba yi-stoma . Oku kuvumela amathumbu ukuba aphole ngaphandle kokungakhululeki kokuphuma kwendle. Ngamanye amaxesha, oogqirha botyando benza i-ostomy yexeshana, yokuthintela. I-ostomy yexeshana iyacetyiswa njengendlela yokuthintela abantu abasengozini enkulu yokufumana ukuvuza kwe-anastomotic.

Iyintoni imbono yabo bathe baba nokuvuza kwegazi emzimbeni?

Ukuvuza okufunyenweyo kudla ngokulungiswa. Nangona kunjalo, ukuxilongwa kwangoko kunye nonyango kubalulekile ukulawula usulelo kunye nokuthintela i-sepsis. Ngokubanzi, abantu abanokuvuza okuphuma kwi-anastomotic basengozini enkulu yeengxaki zempilo kunye nokufa kwixesha elizayo. Akucaci ukuba ezi ziphumo zibangelwa kukuvuza okuphuma kwi-anastomotic, okanye ukuba ukuvuza luphawu lwengxaki yempilo ngokubanzi.

Ndifanele ndimbone nini ugqirha wam?

Ukuba uyaphola emva kokufumana i-anastomosis, hlala usondelelene nogqirha wakho kwaye uxele naziphi na iimpawu ezingalindelekanga. Funa uncedo lwezonyango ngokukhawuleza ukuba uneempawu zosulelo. Umzekelo:

• Ifiva.
• Isisu esibuhlungu.
• Ukudumba (ububomvu, ukudumba).

Yeyiphi imibuzo endifanele ndiyibuze ugqirha wam ngaphambi kokuba ndiye kutyandwa nge-anastomosis?

Ukuba une-anastomosis kwaye ukhathazekile ngokuvuza kwe-anastomotic, ungabuza ugqirha wakho ngezinto ezikubangela umngcipheko, ngamanyathelo okuthintela anokuthathwa, kunye nongenelelo abalucebisayo kuwe. Umzekelo:

• Ingaba utyando lwam lusemngciphekweni omkhulu wokuvuza kwe-anastomotic?
• Ngaba mna ngokwam ndisengozini enkulu?
• Ulawula njani `(Ukuvuza kwe-Anastomotic)`?
• Ngaba uyayijonga into yokuba akukho manzi avuzayo ngexesha lotyando?
• Ndingayijonga njani into yokuba akukho kuvuza emva kotyando?
• Kuza kwenzeka ntoni ukuba ndinokuvuza emva kotyando?

Ukuba kufuneka wenze i-anastomosis, mhlawumbi yindlela esindisa ubomi. Ngexesha elinje, kunzima nokucinga ngengxaki esongela ubomi evela kutyando ngokwalo. Nangona oogqirha besoyika, ukuvuza kwe-anastomotic kusoloko kunokwenzeka. Kodwa ngokubanzi, umngcipheko uphantsi. Kwaye, ngokwazi kunye nokungenelela kwangethuba, iimeko ezininzi zinokulawulwa.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

• Ukuvuza kwe-anastomotic kukuvuza komxholo ovela kwiityhubhu ezimbini ezixhunyiweyo emva kotyando.
• Oku kungenzeka naphi na, njengasemathunjini okanye kwindlela yomchamo.
• Ukuba ufumana iimpawu ezinje ngomkhuhlane, iintlungu zesisu, okanye ukudumba, bonana nogqirha ngokukhawuleza.
• Le ngozi inokwandiswa zizinto ezifana nokutshaya, isifo seswekile, kunye nokungondleki kakuhle.
• Ukuba ifunyenwe kwaye inyangwa kwangethuba, inokuhlala inyangeka. Nangona kunjalo, ukuba ayinyangwa, inokuba yingozi.
• Ukuba uza kutyandwa, thetha nogqirha wakho ngokukhululekileyo ngaloo nto. Cacisa ngemingcipheko yakho, into omawuyenze ukuyithintela, kunye nento omawuyenze xa kuvela ukuvuza. Ukwazi yeyona ndlela ilungileyo yokuzikhusela!

Ukuvuza kwe- Anastomotic, Iingxaki zotyando, utyando lwamathumbu, i-peritonitis, i-sepsis, ukhathalelo emva kotyando, iingozi zotyando