Ngaba wakha waphawula ulwelo olungaqhelekanga, olufana nobisi oluvuza ngenxa yokwenzakala emzimbeni wakho, emva kotyando, okanye emva kwengozi enkulu? Okanye ingaba lubangela ukudumba kuloo ndawo? Ungakhathazeki, le isenokuba yimeko ebizwa ngokuba yiChyle Leak, esiza kuthetha ngayo namhlanje. Le yinto efuna ingqalelo ethile, kodwa ukuba uyayiqonda kwaye uyiphatha kakuhle, inokuphiliswa. Masithethe ngale nto ngokulula, ngendlela onokuyiqonda.
Yintoni iChyle Leak? Masiyiqonde ngokulula
Kulungile, masiqale sijonge ukuba yintoni le chyle leak. Umzimba wethu unenkqubo ebizwa ngokuba yi-lymphatic system . Oku kufana nenkqubo yeendlela ezincinci ngaphakathi emzimbeni wethu. Oku kunceda inkqubo yomzimba yethu yokuzikhusela komzimba kwaye kususe izinto ezingafunekiyo.
Ngoku, xa sisitya, ingakumbi ukutya okunamafutha, kuyagaywa kwaye kufunxwe ngamathumbu ethu. La mafutha afunxwayo kunye nezinye izondlo zibizwa ngokuba yi-chyle , ulwelo olumhlophe olufana nobisi. Le chyle ikwathwalwa kwiindawo ezifunekayo zomzimba ngemithambo yethu ye-lymphatic.
Ngoko ke, ngandlela ithile, khawucinge ukuba ukuba ezi mithambo ye-lymphatic zonakele, nokuba ngexesha lotyando okanye kwingozi enkulu, ulwelo lwe-chyle luqala ukuvuza kwindawo eyonakeleyo. Kulapho ulwelo lwe-chyle luqokelelana khona kwizicubu ezingqongileyo, nto leyo ebangela iimpawu ezifana nokudumba. Oku sikubiza ngokuba yi-chyle leak , ngamanye amaxesha ebizwa ngokuba yi-chylous leak okanye i-chylous fistula .
Oku kudla ngokuba yimiphumo engaqhelekanga kodwa embi kakhulu yotyando. Oogqirha badla ngokuyinyanga ngokutya okukhethekileyo, ukuphumla, kwaye, ukuba kuyimfuneko, amayeza.
Ixhaphake kangakanani i-chyle leak?
Ukuvuza kukaKyle yimeko engaqhelekanga kakhulu . Akwenzeki kuwo wonke umntu. Ixhaphake kakhulu xa kusenziwa utyando. Umzekelo:
- Le meko ixelwa ngaphantsi kwe-1% yotyando lokususwa kwe-thyroid.
- Kwezinye iintlobo zotyando lwentloko nentamo, isenokuba malunga ne-8%.
Kwakhona, olu hlobo lokuvuza kwe-chyle lunokwenzeka emva kotyando lwesisu, utyando lwesifuba, okanye utyando lokususa izintso (i-nephrectomy).
Ingakanani ingozi yokuvuza kwe-chyle?
IChyle Leak ayisiyonto yokuyithatha lula, yimeko enzima kakhulu . Kuba inokubangela iingxaki ezahlukeneyo emzimbeni wethu. Umzekelo:
- Ukuphelelwa ngamanzi emzimbeni: Ubungakanani bamanzi emzimbeni bunokuncipha.
- Ukungalingani kwe-electrolyte: Ibhalansi yee-electrolyte ezibalulekileyo emzimbeni inokuphazamiseka.
- Ukunciphisa amajoni omzimba:Amandla okulwa nezifo anokuncipha.
- Ukutya okungondleki kakuhle: Umzimba usenokungafumani izondlo ozifunayo.
Khawucinge nje, okwenzekayo koku kufana nolwelo olunezakhamzimba oluxabisekileyo oluphuma emzimbeni wethu. Yiyo loo nto oku kunokuba yinto enzulu.
Amaxesha amaninzi, le meko inokuba mandundu ngakumbi. Ukuba oku kuyenzeka:
- I-Chylothorax: Oku kukuqokelelana kolwelo lwe-chyle kwindawo ye-pleural, indawo ephakathi kwemiphunga nodonga lwesifuba. Ngamanye amaxesha ifunyanwa okokuqala njengemeko ebizwa ngokuba yi-pleural effusion.
- I-Chylous ascites: Oku kuxa i-chyle fluid iqokelelana kwisisu. I-Ascites yimeko apho isisu sizaliswa lulwelo.
Yintoni ebangela ukuvuza kwe-chyle?
Le meko idla ngokubangelwa kukwenzakala okubuhlungu esiswini, esifubeni, okanye entanyeni . Nangona kunjalo, kwiimeko ezininzi, imbangela ephambili kukulimala ngexesha lotyando . Njengoko bekutshiwo ngaphambili, esi sisiphumo esingaqhelekanga sotyando. Le ngozi iphezulu kakhulu xa kutyandwa intloko nentamo. Oku kwenzeka ngenxa yokonakala kwemithambo ye-lymphatic, ingakumbi imithambo yethu ephambili ye-lymphatic ebizwa ngokuba yi-thoracic duct .
Ngamanye amaxesha, ukuvuza kwe-chyle kunokubakho njengengxaki ye -lymphoma , umhlaza wee-lymph nodes.
Yintoni iThoracic Duct?
Umbhobho wesifuba, esithethe ngawo, ngumbhobho omkhulu kakhulu, obaluleke kakhulu kwinkqubo yethu ye-lymphatic. Ufana nendlela enkulu. Uhamba ukusuka esiswini ukuya entanyeni. Ngumbhobho othwala i-lymph kunye ne-chyle kwiithishu zomzimba wethu. Umbhobho ovela kwisiqingatha sasekhohlo nesasekunene somzimba wethu uhamba ngale mbhobho. Ngoko ke ukuba uyonakala, kukho ithuba elikhulu lokuvuza.
Zithini iimpawu zokuvuza kwe-chyle?
Ngexesha lotyando, ugqirha unokukwazi ukubona i-chyle . Elo linye uphawu. Kwakhona, emva kotyando, xa isigulana siqala ukutya, ingakumbi ukutya okunamafutha, oogqirha baya kujonga ukwanda kolwelo oluphuma kwimisele yotyando.
Iimpawu ezinokwenzeka emva kotyando zezi:
- I-Lymphedema: Oku kukudumba kweendawo ezifana namalungu ngenxa yokuvaleka kwemithambo ye-lymph.
- Ukubomvu kwesikhumba: Ulusu olujikeleze ukuvuza lunokuba bomvu.
- Ukudumba ngaphezu kwe-clavicle: Ukudumba kunokubonakala entanyeni, ngaphezulu kwe-collarbone. Olu luphawu olubonakala ngakumbi ukuba umbhobho wesifuba wonakele.
Uyibona njani i-chyle leak?
Ngexesha lotyando, oogqirha bajonga indawo ukuba ayinayo i-chyle na ngaphambi kokuba bavale inxeba. Nangona kunjalo, oku kuvuza akusoloko kubonakala. Ngamanye amaxesha kuhlolwa kuphela emva kotyando, xa isigulane siphila.
Uvavanyo lokuxilonga
- Ngexesha lotyando: Oogqirha badla ngokujika umzimba wesigulana ube kwiindawo ezithile baze bafake uxinzelelo esifubeni okanye esiswini ukuze bajonge ukuba akukho chyle evuzayo na. Oku kwenziwa ngaphambi kokuba kuvalwe inxeba.
- Emva kotyando: Njengoko isigulana sichacha, oogqirha baya kwenza uvavanyo lomzimba ukujonga iimpawu zokuvuza kwe-chyle. Baya kujonga nolwelo oluvela kwimibhobho yotyando.
- Uvavanyo lwesampuli yolwelo: Ukuba kukho ukudumba, oogqirha baza kuthatha isampuli yolwelo oluvela ekudumbeni baze baluvavanye ukuba lungakanani na amafutha, okanye ii-triglycerides, kulo. Ukuba amanqanaba e-triglyceride kulwelo aphezulu kakhulu, oko kuthetha ukuba i-chyle iyavuza.
Inyangwa njani i-chyle leak?
Kukho iindlela ezahlukeneyo zonyango, kuxhomekeke ekubeni ukuvuza kufunyenwe nini kwaye kungakanani na ubunzulu bako.
Unyango ngexesha lotyando
Ukuba kufunyenwe ukuvuza kwe-chyle ngexesha lotyando, oogqirha baya kuzama ukumisa ukuvuza ngokukhawuleza. Baza kusebenzisa ii-clip okanye ii-sutures ezikhethekileyo ukuvala i-lymph duct eyonakeleyo.
Ukhathalelo emva kotyando
Ukuba ukuvuza kufunyenwe emva kotyando, unyango luya kuxhomekeka kubungakanani bokuvuza (nokuba kuncinci, kuphakathi, okanye kuqatha) kunye nempilo iyonke yesigulana.
Amaxesha amaninzi, unyango olungelulo utyando luyazanywa kuqala. Olu lubizwa ngokuba lunyango olugcina ulwelo . Utyando luza kuqwalaselwa kwakhona kuphela xa lungakwazi ukulawula ukuvuza.
Unyango olungelulo utyando
Ukuthintela ukuvuza kwe-chyle, ugqirha wakho unokucebisa oku kulandelayo:
- Ukuphumla ebhedini: Ungaxelelwa ukuba uyeke ngokupheleleyo ukwenza umthambo kwaye uphumle. Oku kuya kunciphisa uxinzelelo kwinkqubo ye-lymphatic.
- Ukutya okutshintshiweyo: Oku kubaluleke kakhulu. Makhe sithethe ngale nto ngokweenkcukacha ezithe vetshe.
- Amayeza athintela ukufunxwa kwamafutha: Amayeza anokunikwa anciphisa ukufunxwa kwamafutha emzimbeni ekutyeni.
- Izithambisi zendle: Ezi zinikwa ukuthintela ukuxinana ngexesha lokuhamba kwamathumbu, njengoko ukuxinana kunokunyusa uxinzelelo esiswini kwaye kwandise ukuvuza.
Ithini indlela yokutya ekhethekileyo yomntu onesifo sokuvuza kwesisu?
Le yinxalenye ebaluleke kakhulu yonyango. Ugqirha uza kukuxelelaUya kucetyiswa ukuba ulandele ukutya okunamafutha aphantsi okanye okungenamafutha okwethutyana. Kubalulekile ukulandela oku kutya njengoko kuyalelwe ngugqirha wakho de i-leek iphole.
Khumbula, i-chyle lulwelo oluqulethe amafutha amaninzi. Ngoko ke xa sinciphisa amafutha ekutyeni kwethu, ubungakanani be-chyle eveliswayo nabo buyancipha. Oku kunciphisa ubungakanani bokuvuza, okunika inkqubo ye-lymphatic ithuba lokuphiliswa.
Ukutya okunamafutha aphantsi kungabandakanya:
- Ezinye iintlobo zeziqhamo (uninzi lweziqhamo lunamafutha amancinci).
- Isonka esingenamafutha, iinkozo zesidlo sakusasa, kunye neemveliso zobisi ezingenamafutha.
- Inyama engenamafutha njengenkukhu nentlanzi engenasikhumba.
- Imifuno ibilisiwe ngaphandle kweoyile.
Izinto ongazityiyo kwaye ongaziseliyo xa une-chyle leak
Ugqirha wakho uza kukuxelela ukuba uphephe ukutya neziselo ezinamafutha amaninzi neswekile . Abanye abantu banokufuna ukunikwa ulwelo kunye nezondlo ngendlela ye-IV (efakwa kwi-intravenous) ukuthintela ukuphelelwa ngamanzi emzimbeni kunye nokubonelela ngesondlo.
Ngawaphi amayeza okunyanga i-chyle leak?
Ugqirha wakho angakunika amayeza athile okunyanga ukuvuza kwe-chyle. La mayeza anikwa nge-catheter efakwe emthanjeni (IV). La mayeza aquka:
- I-Somatostatin
- I-Octreotide
La mayeza asebenza ngokunciphisa ukuveliswa kwe-chyle kunye nokuhamba kwegazi kwimithambo ye-lymphatic.
Ngamanye amaxesha, amayeza asetyenziswa endaweni yokuvuza angafakwa kwindawo evuzayo, nokuba ngexesha lotyando okanye emva kotyando, ukunceda ukuvala ukuvuza.
Kuthatha ixesha elingakanani ukuchacha emva konyango lweChyle Leak?
Ngokwesiqhelo, ukuvuza okuncinci kwe-chyle kunokuphola kwiveki okanye ngaphezulu , ingakumbi emva kokuba i-chyle iphumile kwaye ngokutya okufanelekileyo kunye nokuzilolonga. Nangona kunjalo, okunye ukuvuza akuphili, kwaye kunokufuna utyando olongezelelweyo ukuze kulungiswe.
Ngaba ukuvuza kwe-chyle kungathintelwa?
Akukho nto unokuyenza njengesigulana ukuthintela ukuvuza kwe-chyle. Oku kungenxa yokuba kwenzeka xa imithambo ye-lymphatic yonakele. Kunokwenzeka ngexesha lotyando okanye kwingozi. Oogqirha bazama konke okusemandleni abo ukunciphisa olu hlobo lomonakalo xa besenza utyando.
Yintoni onokuyilindela ukuba unesifo sokuvuza kwe-chyle?
Ugqirha wakho uza kukunika imiyalelo eneenkcukacha malunga nendlela yokulawula ukutya kwakho kunye nokunciphisa imisebenzi yakho yomzimba . Kubaluleke kakhulu ukulandela le miyalelo ngokuchanekileyo. Kwakhona, qiniseka ukuba uyayigcina imihlangano yakho yokulandelela.
"Ukuba ulandela imiyalelo kagqirha ngokufanelekileyo, ungaphila ngokukhawuleza kule meko. Ngoko ke eyona nto ibalulekileyo kukumamela oko ugqirha akuthethayo."
Uninzi lwexesha, le meko iyaphela kwisithuba seveki okanye ngaphezulu ngokutshintsha indlela yokuphila kunye nokutya.
Ngaba kukho ezinye iziphumo zokuvuza kwe-chyle?
Ewe, ukuvuza kwe-chyle kungayicothisa inkqubo yokuphiliswa kwenxeba emzimbeni wakho . Oku kungenxa yokuba xa i-chyle eyongezelelweyo iqokelelana kwizicwili ezikufutshane nenxeba, loo zicubu zinokudumba . Oku kuvutha kunokucothisa ukuphiliswa kwenxeba kwaye kwandise umngcipheko wosulelo.
Injani imeko ukuba une-chyle leak?
Ukuba ukuvuza kwe-chyle kuphola kakuhle, ungabuyela kwindlela yakho yokutya eqhelekileyo . Kwakhona, inkqubo yokuphiliswa kwenxeba iya kwenzeka ngokuqhelekileyo emva kokuba ukuvuza kupholile. Uninzi lokuvuza kwe-chyle luyaphola malunga neveki emva konyango.
Ngaba ukuvuza kwe-chyle kungenzeki ngaphezu kwesihlandlo esinye?
Ewe, nangona kunqabile, kunokwenzeka ukuba ukuvuza kwe-chyle kwenzeke ngaphezu kwesihlandlo esinye, ingakumbi ukuba umntu okhe wavuza ngaphambili kufuneka aphinde atyandwe.
Ndingazinyamekela njani xa ndine-chyle leak?
Eyona nto ibalulekileyo kukulandela imiyalelo kagqirha wakho ngokuchanekileyo . Oku kuya kukunceda uphilise ukuvuza kwe-chyle yakho ngokukhawuleza kwaye kuthintele iingxaki. Ukutya, ukuphumla, kunye nokusela amayeza akho ngokufanelekileyo konke kubalulekile.
Isishwankathelo: Izinto ekufuneka uzikhumbule
Ukuvuza kweChyle yimeko embi kakhulu enokwenzeka emva kotyando okanye ingozi ngenxa yomonakalo kwinkqubo ye-lymphatic. Kwimeko enjalo, ulwelo olunamafutha olubizwa ngokuba yi-chyle luvuza kwizicwili zomzimba ezingqongileyo. Oku kunokubangela iingxaki ezinje ngokuphelelwa ngamanzi emzimbeni kunye nokungabikho kokutya okunempilo.
Oogqirha banika umntu ukutya okukhethekileyo (amafutha aphantsi), ukunciphisa umthambo womzimba (ukuphumla), kunye namayeza ukuba kuyimfuneko. Ngokulandela imiyalelo kagqirha ngqo, le meko inokuphiliswa kwiveki nje enye. Ngoko ke, kubalulekile ukukwazi oku nokulandela oko kuthethwa ngugqirha.
👩🏽⚕️ Imibuzo eyongezelelweyo (Ii-FAQ)
💬 Ingaba iChyle Leak ifana nombhobho wamanzi oqhumayo ngaphakathi emzimbeni?
Kulungile oko! Ukongeza kwimithambo yegazi emzimbeni wethu, sinenkqubo 'yemithambo yegazi'. Amafutha nokutya esikutyayo kufunxwa emathunjini kwaye kuthwalwe kuwo wonke umzimba ngezi mithambo yegazi njengolwelo olufana nobisi (olubizwa ngokuba yi-chyle). Xa enye yezi payipi ziphambili (imibhobho yesifuba) ibhobozwa ngexesha lotyando okanye ingozi enkulu (ukwenzakala), oku kubizwa ngokuba 'kukuvuza' kolo lwelo lufana nobisi (chyle) lujikeleze imiphunga okanye isisu.
💬 Ngaba olu lwelo luza kubangela ingozi enkulu emzimbeni ukuba luvuza?
Ewe, oku kuyingozi kakhulu. Xa olu lwelo lujikeleze imiphunga luzalisa ukuya kuthi ga kwiilitha ezininzi (iChylothorax), kuba nzima ukuphefumla (Ukuphefumla kancinci). Ayipheleli apho, kodwa ngenxa yokuba olu lwelo luvuzayo luqulethe inani elikhulu leeproteni, iiseli zomzimba (iiLymphocytes) kunye neevithamini, ukuzikhusela komzimba kwesigulana kunokwehla ngequbuliso kuye kuthi shwaka (Ukungondleki), usulelo olukhulu lunokwenzeka kwaye ukufa kunokubakho.
💬 Ungawumisa njani lo mphunga?
Into yokuqala ekufuneka uyenze kukuyeka ngokupheleleyo ukutya (amafutha) kwaye endaweni yoko unike isisombululo esikhethekileyo se-saline (TPN) ngomthambo. Emva koko, ukufunxwa kokutya kuyayeka kwaye ulwelo oluvuzayo luyancipha, kwaye umngxuma uvaleka ngokuzenzekelayo. Ukuba oko akusebenzi, kufakwa ityhubhu yokususa ulwelo (iDrainage), kwaye njengesisombululo sokugqibela, umngxuma uyavalwa ngokuqinisekileyo ngotyando (Ligation/Embolization).
ukuvuza kwe - chyle, i-lymphatic duct, iingxaki emva kotyando, i-thoracic duct, i-chylothorax, ukutya okunamafutha aphantsi
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