Ngaba amehlo akho nolusu lwakho luvakala lutyheli? Okanye ngaba urhawuzelelwa kumzimba wonke? Ngamanye amaxesha ezi zinokuba ziimpawu ezenzekayo xa imibhobho ethwala ulwelo olubizwa ngokuba yi-'bile' evela esibindini sethu ivaliwe. Olu lwelo olubizwa ngokuba yi-'bile' lubalulekile kwinkqubo yokugaya ukutya emzimbeni wethu. Ngoko ke ukuba le duct ye-bile ivaliwe, inokubuyela esibindini kwaye ibangele iingxaki ezininzi. Namhlanje, sithetha ngonyango olukhethekileyo oluqhutywa ngoogqirha kwiimeko ezinjalo. Lubizwa ngokuba yi-Biliary Drainage.
Ngamafutshane, yintoni le Biliary Drain?
Umsele wenyongo yityhubhu encinci neguquguqukayo. Le tyhubhu isetyenziselwa ukuthintela ukuvaleka komsele wenyongo odibanisa isibindi sethu namathumbu amancinci kwaye isuse inyongo emzimbeni okanye iyibuyisele emathunjini amancinci.
Khawucinge nje ngenkunkuma enamathele phakathi kombhobho wamanzi. Emva koko amanzi azaliswa kwindawo enye, uxinzelelo luyanda, kwaye umbhobho unokonakala, akunjalo? Yiyo le indlela imibhobho yenyongo evalwayo ngayo. Inyongo iqokelelana esibindini. Ngokwezonyango le meko siyibiza ngokuba yi-cholestasis . Xa oku kusenzeka, imeko ye- jaundice, ejika ibe tyheli emehlweni naselusu, iyenzeka, njengoko bekutshiwo ngaphambili. Kunye noku, kunokubakho ukurhawuzelela okukhulu emzimbeni wonke.
Ngoko ke, into eyenziwa yile duct yenyongo kukudlula kwindawo evalekileyo ize idale indlela yokuba inyongo ibuye idlule kuyo. Ngamanye amaxesha, le nyongo iqokelelwa kwingxowa engaphandle komzimba.
Zeziphi ezi ndlela zokufaka iityhubhu? (Iintlobo zeBiliary Drainage)
Kukho iindlela ezimbini eziphambili zokwenza olu nyango. Ngokuxhomekeke kwimeko yakho, ugqirha wakho uya kugqiba ukuba yeyiphi indlela efanelekileyo kuwe.
1. Ukukhupha iBiliary Drainage nge-Percutaneous Transhepatic (PTBD)
Oku kuquka ukufaka ityhubhu encinci (i-catheter) ngesikhumba esikwicala lasekunene lesisu sakho, ngesibindi sakho, nakwi-bile duct yakho. Oku kwenziwa kusetyenziswa i-fluoroscopy, indlela ekhethekileyo ye-X-ray. Ityhubhu ifakwa emva kokufumana indawo echanekileyo yokuvaleka kwayo. Emva koko, elinye icala lale tyhubhu liqhagamshelwe kwingxowa engaphandle komzimba. Emva koko i-bile iqokelelwa kuloo ngxowa.
2. I-Endoscopic Biliary Drainage (EBD)
Okwenzekayo apha kukuba ityhubhu encinci enekhamera eqhotyoshelweyo, ebizwa ngokuba yi-endoscope , ifakwa ngomlomo wakho ize yehle ngombhobho wakho wokutya iye emngxunyeni we-bile duct (isiqalo samathumbu amancinci). Emva koko, enye ityhubhu encinci idluliselwa nge-endoscope ize ifakwe kwi-bile duct evaliweyo ukuze kukhutshwe i-bile.
Le ndlela ingenziwa ngeendlela ezahlukeneyo.
- Ukukhupha amanzi e-Endoscopic Nasobiliary Drainage (ENBD):Apha, ilindle lihamba ngetyhubhu efakwe ngempumlo lize liqokeleleke kwingxowa engaphandle komzimba.
- Ukufaka i-Stent Yangaphakathi: Oku kuquka ukubeka i-stent encinci efana nombhobho ngaphakathi kwindawo evalekileyo nokuvumela i-bile ukuba idlule kuyo. Oku kuvumela i-bile ukuba idlule ngqo emathunjini amancinci, endaweni yokuphuma emzimbeni. Le yeyona ndlela ixhaphakileyo.
Kutheni umntu angafuna ukubeka umbhobho onje?
Zininzi izizathu zokuba umbhobho wenyongo uvaleke okanye uvaleke. Olu nyango luyimfuneko ngenxa yemeko ebizwa ngokuba yi-cholestasis eyenzeka xa oku kusenzeka. Makhe sijonge izizathu eziphambili.
| Isizathu sokuvaleka | Ingcaciso elula |
|---|---|
| Amatye enyongo okanye enyongweni (i-choledocholithiasis) | Amatye enyongo aqala kwinyongo aze avale umbhobho wenyongo zezona zinto zixhaphakileyo. |
| I-Pancreatitis | Umjelo wenyongo unokucinezelwa ngaphandle ngenxa yokudumba kwepancreas. |
| Iimeko zomhlaza | Umjelo ungavalwa zizimila kwi-pancreas, kwi-bile duct, kwi-gallbladder, okanye kwisibindi. |
| Ukonakala kwimibhobho yenyongo | Imibhobho yenyongo ingonakala, ingakumbi ngexesha lotyando olufana nokususwa kwenyongo. |
| Ezinye izifo ezibangelwa zizinambuzane | Nangona kungaqhelekanga eSri Lanka, ezinye iintlobo zeempethu zinokubangela ukuvaleka kwemibhobho yenyongo. |
| I-Primary Sclerosing Cholangitis | Esi sisifo esingapheliyo apho imibhobho yenyongo iba namanxeba ize ivaleke kancinci kancinci. |
Ufanele uzilungiselele njani ngaphambi konyango?
Kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngaphambi kokuba ufumane olu nyango. Ngokubanzi, kufuneka uzilumkele ezi zinto.
- Ufanele uyeke ukutya, ukusela, nokutshaya ubuncinane iiyure ezi-6 ngaphambi konyango . Ungavunyelwa ukuba usele amanzi, kodwa ugqirha wakho uza kukuxelela into omawuyenze.
- Xelela ugqirha wakho ngazo naziphi na ii-allergies onazo kwangaphambili, ingakumbi kwi-anesthetics, idayi echaseneyo esetyenziswa kwi-X-ray, kwiplastiki, okanye kwiintsimbi.
- Yazisa ugqirha wakho malunga nawo onke amayeza kunye neevithamini ozisebenzisayo okwangoku .
- Ukuba usela amayeza athintela ukujiya kwegazi (umz., amayeza alwa nokujiya kwegazi afana ne-aspirin kunye ne-warfarin), thetha nogqirha wakho malunga nokuba kufuneka na uwayeke ngaphambi konyango kunye nendlela yokwenza oko.
- Ukuba ukhulelwe okanye ungakhulelwa, qiniseka ukuba uyasazisa.
- Ekubeni ungayi kukwazi ukuqhuba emva konyango ngenxa ye-anesthesia, kubalulekile ukulungiselela ukuba umntu akuqhubele ekhaya kwangethuba.
Kwenzeka ntoni ngexesha lonyango?
Kusenokubakho umahluko omncinci kwinto eyenzekayo kuxhomekeke kwinkqubo oza kuyenza, kodwa ugqirha uza kukuchazela yonke into kwangaphambili.
Indlela eyenziwa ngayo indlela ye-percutaneous (PTBD)
1. Okokuqala, ugqirha uza kucoca ulusu olusesiswini sakho ngesisombululo sokubulala iintsholongwane aze ayenze loo ndawo ibe nentlungu.
2. Emva koko, kufakwa inaliti encinci eluswini iye kwi-bile duct esibindini.
3. Kufakwa ulwelo olukhethekileyo olubizwa ngokuba yidayi yokungafani ukuze kubonakale ngokucacileyo inkqubo ye-bile duct kwi-X-ray.
4. Emva kokufumana indawo echanekileyo yokuvaleka, kufakwa umbhobho wokukhupha inyongo ngawo kwaye inyongo ivunyelwe ukuba ikhuphe amanzi.
5. Isiphelo sangaphandle setyhubhu sikhutshwa eluswini lwesisu size siqhagamshelwe kwingxowa. Indle iqokelelana kuloo ngxowa. Le ngxowa kufuneka ikhutshwe izihlandlo ezininzi ngemini.
Indlela eyenziwa ngayo inkqubo ye-endoscopic (EBD)
1. Uza kupholiswa ngokupheleleyo okanye ulale ubuthongo obunzulu.
2. Ngaphambi kokufaka i-endoscope ngomlomo, kufakwa isitshizi seyeza emqaleni ukuze umphimbo ungasebenzi kakuhle.
3. Emva koko ugqirha ufaka i-endoscope ngomlomo, ayidlulise kumbhobho wokutya, aze angene kwinxalenye ephezulu yamathumbu amancinci.
4. Ukusuka apho, kufakwa enye ityhubhu encinci (i-catheter) nge-endoscope kwi-bile duct evaliweyo.
5. Emva koko i-blockage iyasuswa kwaye inyongo iyavunyelwa ukuba iphume. Ukuba i-stent ifakwa ngaphakathi, oku kwenziwa ngeli xesha. Ukuba ityhubhu ikhutshwa, ityhubhu ikhutshwa empumlweni ize iqhagamshelwe kwibhegi.
Ngaba kukho naziphi na iingozi ezibandakanyekileyo?
Njengakwezinye iindlela zonyango, kukho iingozi kunye neengxaki ezinokubakho. Ugqirha wakho uza kukwazisa ngazo zonke ezi zinto.
Khumbula, amathuba okuba ezi ngxaki zenzeke mancinci kakhulu. Kwaye umngcipheko wokuba i-bile duct ivaleke uphezulu kakhulu.
| Umngcipheko/Ingxaki | Inkcazo |
|---|---|
| Iingozi eziqhelekileyo | |
| Usulelo | Iintsholongwane zingangena kwindawo apho ityhubhu ifakwe khona. Ii-antibiotics zinikwa ukuthintela oku. |
| Ukopha | Yinto engaqhelekanga kakhulu le, kwaye isenokufuna nokuba kunikelwe ngegazi. |
| Intlungu | Kusenokubakho ukungakhululeki okanye iintlungu apho kufakwe khona ityhubhu. |
| Ityhubhu evuzayo okanye evalekileyo | Iingxaki zinokuvela ngokutsala ityhubhu ngempazamo okanye ukuvaleka kwangaphakathi. |
| Iingozi ezinxulumene neendlela ezithile | |
| Ukuvuza kwenyongo (PTBD) | Ulwelo lunokuvuza emzimbeni luvela ngaphakathi kwityhubhu. |
| I-Pneumothorax (PTBD) | Kunqabile kakhulu ukuba imiphunga yonakale kwaye umoya ungaqokelelana ngeenxa zonke kuyo. |
| I-Pancreatitis (EBD) | Emva konyango lwe-EBD, ukudumba okwethutyana kwepancreas kunokwenzeka. |
Uyinyamekela njani ipayipi xa ufika ekhaya?
Ukuba unetyhubhu kunye nebhegi efakwe ngaphandle komzimba wakho, umongikazi uza kukunika imiyalelo eneenkcukacha malunga nendlela yokunyamekela. Landela loo miyalelo ngononophelo.
- Sela iziselo ze-electrolyte ezilingana nobungakanani benyongo eyongezwa kwibhegi. Ugqirha wakho uza kukuxelela ukuba usele ntoni kwaye usele malini.
- Phumla ngokwaneleyo emva konyango. Kungcono ukuba nomntu oza kukunceda ngobusuku bokuqala.
- Musa ukulala ubunzima bakho bubekwe ecaleni apho kukho khona ityhubhu . Ngale ndlela, amathuba okuba ityhubhu ijijeke mancinci.
- Ngokwesiqhelo ungaqhubeka nemisebenzi yakho yesiqhelo emva kweeyure ezingama-24, kodwa ungaphakamisi nantoni na enzima kune-5 kg .
- Thatha onke amayeza achazwe ngugqirha njengoko eyalelwe .
- Ungahlamba emva kweeyure ezingama-48. Nangona kunjalo, kuphephe ukudada emachibini, elwandle, okanye emilanjeni ngokupheleleyo de kube yilapho ityhubhu ikwindawo yayo.
Ufanele uye nini kugqirha ngoko nangoko?
Ukuba ufumana naziphi na kwezi mpawu zilandelayo, oko kungaba luphawu losulelo. Ngoko ke fowunela ugqirha wakho ngoko nangoko okanye uye kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele esikufutshane.
- Ukuba intlungu, ukudumba, okanye ukubomvu kwindawo yokufaka ityhubhu kuyanda .
- Ukuba ubomvu okanye olunye ulwelo luvuza kwindawo yombhobho.
- Ukuba ufumana umkhuhlane .
Kwakhona qaphela ezi mpawu:
- Ukuba kukho ukutyheli okutsha okanye okuya kusiba kubi ngakumbi kwesikhumba okanye amehlo.
- Ukuba umbala okanye ivumba lendle eqokelelwe ebhegini litshintsha ngequbuliso .
- Ukuba umbhobho ubonakala ngathi uyakhululeka apho wawubekwe khona.
- Ukuba uneentlungu zesisu ezintsha okanye ukuba intlungu onayo ngoku iba mandundu.
- Ukuba ukuhlanza kuyaqhubeka.
- Ukuba isisu asiphumi okanye umoya awuphumi .
Kuqhelekile ukuba noloyiko xa usiva ngolu hlobo lonyango. Kodwa khumbula, oku kukunceda umzimba wakho ukhulule ukungakhululeki okubangelayo uze ubuyisele kwimeko esempilweni. Thetha nogqirha wakho ngayo nayiphi na imibuzo okanye iinkxalabo onokuba nazo. Uza kukuchazela yonke into.
Umyalezo Wokuya Ekhaya
- Ukukhupha i-Biliary Drainage yindlela ebaluleke kakhulu yonyango esetyenziselwa ukuvumela i-bile ukuba ihambe nge-bile duct evalekileyo.
- Oku kungenziwa ikakhulu ngesikhumba (PTBD) okanye nge-endoscope (EBD).
- Kubalulekile ukulandela imiyalelo kagqirha ngokungqongqo (ukuzila ukutya, ulwazi ngamayeza) ngaphambi kokuba unyango luqale.
- Ukuba unetyhubhu ebekwe ngaphandle komzimba wakho, funda indlela yokuyinyamekela ngokufanelekileyo kwaye wenze ngokufanelekileyo.
- Ukuba ubonakalisa iimpawu zosulelo ezifana nomkhuhlane, iintlungu okanye ukudumba kwindawo efakwe kuyo, okanye ubomvu, funa ingcebiso kagqirha ngoko nangoko.
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