Ngaba amehlo okanye ulusu lwakho luba tyheli, kwaye ngaba unengxaki yokurhawuzelelwa okunamandla nokunganyamezelekiyo? Ezi ziimpawu zento esiyibiza ngokuba yi-jaundice. Oku kwenzeka rhoqo xa imibhobho yenyongo—iityhubhu ezithwala inyongo ezivela esibindini sakho ukunceda ekugayweni kwesisu—zivalekile. Xa oku kuvimbeka, inyongo iqokelelana esibindini, nto leyo ekhokelela ekubeni ulusu lwakho lube tyheli kwaye luhlale lurhawuzelelwa. Kwiimeko ezinjalo, oogqirha basebenzisa inkqubo ekhethekileyo ebizwa ngokuba yi-biliary drainage. Ngamafutshane, oku kuquka ukufaka umbhobho omncinci kumbhobho wenyongo ovalekileyo ukuze inyongo ihambe ngokukhululekileyo kwakhona. Makhe sixoxe ngayo yonke into ekufuneka uyazi ngale nkqubo.
Yintoni iBiliary Drainage, kwaye zeziphi iintlobo zayo?
Ukukhupha i-biliary drainage yinkqubo esebenzisa ityhubhu encinci neguquguqukayo (catheter) ukuthintela ukuvaleka kwendlela yakho yokukhupha i-bile duct, okuvumela i-bile ukuba iphume esibindini iye emathunjini amancinci. Cinga ngayo njengokudala indlela yokudlula kumbhobho wamanzi ovalekileyo.
Oku kwenziwa ngeendlela ezimbini. Ugqirha wakho uya kugqiba ukuba yeyiphi indlela efanelekileyo kwimeko yakho.
| Uhlobo lweNkqubo | Ingcaciso elula |
|---|---|
| Ukukhupha iBiliary Drainage nge-Percutaneous Transhepatic (PTBD) | Ngale ndlela, ugqirha ufaka ityhubhu eluswini lwakho aze ayifake ngqo esibindini ukuze ifikelele kwi-bile duct. Esebenzisa indlela ekhethekileyo ye-X-ray (i-fluoroscopy), ugqirha ukhokela ityhubhu ngqo kwindawo efanelekileyo. Emva koko i-bile iphuma ngetyhubhu iye kwibhegi encinci yangaphandle. |
| Ukukhupha amanzi kwi-Endoscopic Biliary Drainage (EBD) | Kule nkqubo, ityhubhu encinci, enekhamera (i-endoscope) idluliselwa emlonyeni wakho ize iye kwi-metabolism yakho ukuze ifikelele kwi-bile duct. Akufika apho, ugqirha usebenzisa i-endoscope ukucoca indawo evalekileyo okanye afake ityhubhu encinci (i-stent) ukuze i-bile ibuyele emathunjini ngokwendalo. |
Yintoni i-Stenting?
Kwezinye iimeko, ingakumbi ukuba ukuvaleka kuhlala kuhleli (njengokuba kubangelwa sisimila), ugqirha wakho unokubeka ityhubhu encinci, efana ne-mesh ebizwa ngokuba yi-stent ukugcina i-bile duct ivulekile ngonaphakade. Oku kudla ngokwenziwa emva kweentsuku ezimbalwa emva kokuba ityhubhu yokuqala yokukhupha amanzi ifakiwe.
Kutheni le nkqubo iyimfuneko?
Isizathu esiphambili sale nkqubo kukuvaleka okanye ukuncitshiswa (`stricture`) kwi-bile duct, okubangela ukuba i-bile iqokeleleke esibindini (`cholestasis`). Njengedreyini evalekileyo kwisinki yakho yasekhitshini, ukuvaleka kuthintela ukuhamba okuqhelekileyo.
Izizathu eziqhelekileyo zokuvaleka kwemibhobho yenyongo ziquka:
- Amatye enyongo (`choledocholithiasis`).
- I-Pancreatitis okanye umhlaza we-pancreatic .
- Umhlaza we-bile duct (`Cholangiocarcinoma`).
- Umhlaza wesibindi okanye umhlaza wenyongo .
- Ukudumba kwama -lymph nodes kufutshane nesibindi okanyeipancreas ngenxa yomhlaza.
- Ezinye izifo ezibangelwa zizinambuzane .
- Ukulimala kwangaphambili kotyando kwimibhobho yenyongo.
- Ukudumba okungapheliyo kwemibhobho yenyongo, njengePrimary Sclerosing Cholangitis.
Okubaluleke kakhulu, ukuba unale mpawu, nceda ubone ugqirha wakho ngoko nangoko ukuze ufumane unobangela. Musa ukuzama ukunyanga oku ngokwakho.
Ufanele Ulungiselele Njani?
Ugqirha wakho uza kukunika imiyalelo ethile, ekufuneka uyilandele ngokungqongqo.
1. Ukutya Neziselo: Kuya kufuneka uyeke ukutya, ukusela, nokutshaya ubuncinane iiyure ezi-6 ngaphambi kwenkqubo. Ugqirha wakho uya kukunika ingcebiso malunga nokuba ungasela na amanzi amancinci.
2. Ii-Allergies: Yazisa ugqirha wakho ngazo naziphi na ii-allergies, ingakumbi kwi-anesthesia, iidayi zokwahlulahlula ezisetyenziselwa ii-X-ray, okanye iiplastiki/iintsimbi.
3. Amayeza: Xelela ugqirha wakho ngawo onke amayeza owasebenzisayo ngoku, kuquka neevithamini. Ukuba usebenzisa amayeza okunciphisa igazi afana ne-aspirin okanye i-warfarin, buza ugqirha wakho ukuba uyayeka nini ukuwasebenzisa ngaphambi kokuba wenze inkqubo.
4. Ukukhulelwa: Ukuba ukhulelwe okanye ucinga ukuba ukhulelwe, kufuneka wazise iqela lakho lezonyango.
5. Uthutho: Ngenxa yokuba uza kufumana i-sedation, awuyi kukwazi ukuqhuba. Nceda ulungiselele ukuba umntu akuse ekhaya.
Kwenzeka ntoni ngexesha lenkqubo?
Amanyathelo ayahluka ngokuxhomekeke ekubeni une-PTBD okanye i-EBD, kodwa qiniseka ukuba iqela lakho lezonyango liza kukuchazela yonke into kwangaphambili.
Indlela i-PTBD esebenza ngayo:
- Ulusu olusesiswini sakho luya kucocwa kwaye luphelelwe ngamandla.
- Ugqirha uza kufaka inaliti encinci eluswini iye kwi-bile duct esibindini.
- Kufakwa idayi yomahluko ukuze imibhobho ibonakale kwi-X-ray.
- Nje ukuba kufumaneke ukuvaleka, ityhubhu yokukhupha amanzi ibekwa ukuze kuvunyelwe ukuba inyongo ihambe.
- Isiphelo sangaphandle setyhubhu siza kuncamathiselwa kwingxowa yangaphandle eqokelela inyongo. (Kuya kufuneka ukhuphe le ngxowa rhoqo).
Indlela i-EBD esebenza ngayo:
- Uza kunikwa i-anesthesia yendawo okanye ngokubanzi ukuze uhlale ukhululekile.
- I-endoscope idluliselwa emlonyeni wakho ize yehle iye kwindawo yombhobho.
- Ugqirha usebenzisa izixhobo ezidluliselwa kwi-endoscope ukuze aphephe ukuvaleka.
- Ngokuxhomekeke kwimeko, banokubeka i-stent ukugcina umbhobho uvulekile ngaphakathi.
Iingozi kunye nokhathalelo emva kotyando
Njengakweminye inkqubo yezonyango, kukho iingozi ezinokubakho.
- Iingxaki ezinokubakho:
- Umbhobho unokuphuma, ujijeke, okanye uvaleke.
- Ukungonwabi okanye intlungu.
- Usulelo (ugqirha wakho uza kukunika amayeza okubulala iintsholongwane ukuthintela oku).
- Ukopha.
- Ukungalingani kwe-electrolyte.
- Amaxesha amaninzi, iingxaki zemiphunga ezifana ne-pneumothorax.
Ugqirha wakho uza kuxoxa nawe ngale mingcipheko aze akucebise ngento omawuyenze xa kuvela nayiphi na ingxaki.
Ukuzinyamekela Ekhaya:
Ukuba unetyhubhu yangaphandle kunye nebhegi, abasebenzi bonyango baza kukufundisa indlela yokunyamekela abo bagulayo.
- Kuphephe ukuxinzelela kwindawo yokufaka, kuba oku kunokuyijika ityhubhu.
- Ukuba uyalelwe, hlambulula ityhubhu yonke imihla nge-saline njengoko kuyalelwe.
- Gcina ulwelo lumanzi ngokusela iziselo ezityebileyo nge-electrolyte ukuba ugqirha wakho uyalele ukuba ubuyisele ulwelo olulahlekileyo.
- Ungazihlamba emva kweeyure ezingama-48 emva kwenkqubo, kodwa ungaqubhi emachibini, elwandle, okanye emachibini ngelixa ityhubhu ikwindawo yayo.
- Kuphephe ukuphakamisa izinto ezinzima de ugqirha wakho akunike imvume.
Ufanele Ufune Nini Unyango Olungxamisekileyo?
Ukuba ufumana nayiphi na kwezi zilandelayo, qhagamshelana nogqirha wakho ngoko nangoko okanye uye kwicandelo elikufutshane lezonyango ezingxamisekileyo.
- Umkhuhlane okanye ukubanda.
- Ukwanda kwentlungu, ukudumba, okanye ukubomvu kwindawo yombhobho.
- Ubomvu okanye ukukhupha okungaqhelekanga okuphuma kwindawo leyo.
- Intlungu yesisu entsha okanye eyandayo.
- Ukuphinda-phinda kolusu okanye amehlo atyheli.
- Ukuhlanza okungapheliyo.
- Ukuba ityhubhu ibonakala ngathi iyaphuma okanye ikhululekile.
- Ukuba awukwazi ukuphuma indle okanye igesi.
Ukukhupha amanzi enyongweni lunyango olusebenzayo kakhulu lokuvaleka kwemibhobho yenyongo. Iqela lakho lezonyango liza kukunceda ukhethe eyona ndlela ifanelekileyo kwimpilo yakho. Zive ukhululekile ukubabuza nayiphi na imibuzo onokuba unayo.
Izinto ezibalulekileyo ekufuneka ziqwalaselwe
- Ukukhupha inyongo yindlela yokunciphisa ukuvaleka kwemibhobho yenyongo ukuze inyongo ihambe ngendlela eqhelekileyo.
- Iimpawu zihlala ziquka i-jaundice (ukutyheli kolusu/amehlo), ukurhawuzelela, kunye nomchamo omnyama.
- Le nkqubo yenziwa nge-PTBD (esekelwe kulusu) okanye nge-EBD (endoscopic).
- Ukulandela imiyalelo yangaphambi kwenkqubo malunga nokuzila ukutya kunye namayeza kubalulekile.
- Funa uncedo olungxamisekileyo ukuba uqalisa ukuba nomkhuhlane, intlungu eqatha, okanye ukuvuza kwindawo emva kwenkqubo.
Ukuqunjelwa kwenyongo, imibhobho yenyongo evalekileyo, i-jaundice, i-PTBD, i-EBD, isifo sesibindi, amatye enyongo, inqaku lezonyango laseNirogi Lanka
