Iyintoni iNkqubo kaHartmann? Ungakhathazeki, masithethe ngayo ngokulula.

Ngaba ugqirha wakho ukuxelele okanye umntu okwintsapho yakho ukuba kufuneka wenze inkqubo ebizwa ngokuba yi-"Hartmann's Procedure"? Usenokuba uzive usoyika kancinci xa usiva elo gama. Liqhelekile kakhulu. Kodwa olu lutyando olubaluleke kakhulu olwenziwayo ukusindisa ubomi. Ngoko ke namhlanje, masithethe ngalo ngokulula, ngendlela eya kususa yonke imibuzo kunye noloyiko onokuba nalo ngalo.

Ngamafutshane, yintoni iNkqubo kaHartmann?

Cinga ngenkqubo yethu yokugaya ukutya njengetyhubhu ende. Isiphelo sale tyhubhu yinto esiyibiza ngokuba yikholoni. Kwinkqubo kaHartmann, isiphelo sekholoni esigulayo nesonakeleyo (esibizwa ngokuba yikholoni yesigmoid) kwaye ngamanye amaxesha inxalenye yerectum, apho kugcinwa khona ilindle, ziyasuswa.

Ngamafutshane, olu lutyando olususa inxalenye yamathumbu amakhulu (i-colectomy). Nangona kunjalo, ingcali kukuba emva kokususwa kwecandelo, iindawo ezimbini eziseleyo zamathumbu aziphinde zihlangane ngoko nangoko.

Kunoko, ugqirha wenza into efana nale:

1. Isiphelo samathumbu esiqhagamshelwe kwi-rectum sithungwe sivaliwe.

2. Inxalenye ephilileyo yekholoni yakho ephuma phezulu iqhagamshelwe kumngxuma omncinci (obizwa ngokuba yi-stoma) owenziwe eluswini lwesisu sakho.

Emva koko, ingxowa ye-colostomy ibekwa ngaphandle kwale mbobo. Indle yakho iya kuphuma emzimbeni wakho iye kule ngxowa. Nangona oku kunokuvakala ngathi lutshintsho olukhulu, kudla ngokuba yinto yexeshana. Emva kokuba amathumbu akho epholile, malunga neenyanga ezi-6 ukuya kwezi-12 kamva, kunokwenziwa olunye utyando lokususa ingxowa kunye nokudibanisa kwakhona iindawo ezimbini zamathumbu akho.

Kutheni kuyimfuneko ukwenza olu hlobo lotyando?

Kukho izizathu ezibini eziphambili zokwenza utyando lweHartmann. Esinye kukususa inxalenye yamathumbu. Esinye kukubeka ingxowa ye-colostomy. Makhe sijonge izizathu zesinye nesinye kwezi.

Kutheni inxalenye yamathumbu inqunyulwa ize isuswe?

Umntu unokufuna ukuba inxalenye yekholoni yakhe isuswe ngenxa yezi zizathu zilandelayo:

• Ukuvaleka kwamathumbu: Ukuba inxalenye yamathumbu ivalekile ngokupheleleyo ngenxa yethumba, umhlaza, okanye esinye isizathu, loo nxalenye kuya kufuneka isuswe.
• Ukugqobhoka Kwamathumbu: Ukuba usulelo okanye ingozi ibangela umngxuma emathunjini, nto leyo ebangela ukuba indle ivuza ingene esiswini, ibeka ubomi esichengeni. Ngoko ke, inxalenye eyonakeleyo kufuneka isuswe ngoko nangoko.
• Usulelo okanye isifo esingalawulekiyo: Ukuze kuthintelwe ukusasazeka kwezinye izifo (umzekelo, i-diverticulitis enzima) okanye izifo ezifana nomhlaza, inxalenye enesifo kufuneka isuswe ngokupheleleyo.

Kutheni kufakwa ibhegi ye-colostomy?

Ukususa icandelo lamathumbu nokudibanisa kwakhona amacandelo amabini aseleyo kutyando olunye kubizwa ngokuba yi-"primary anastomosis." Nangona kunjalo, ukuze kwenzeke oku, imeko yesigulana kufuneka ibe ntle kakhulu, kwaye akufuneki kubekho mngcipheko wokosuleleka.

Kodwa inkqubo kaHartmann idla ngokwenziwa xa kukho imeko engxamisekileyo.Oko kukuthi, xa isigulana sinosulelo olukhulu okanye ukudumba ngaphakathi kwesisu. Kwimeko enobungozi kangaka, ukuba iindawo ezimbini zamathumbu zidibene, imithungo isenokungapholi kakuhle, kwaye indle ingaphinda ivuze, nto leyo eyenza imeko ibe mandundu nangakumbi.

Ziziphi izizathu eziphambili zokwenza utyando lukaHartmann?

Kukho iimeko ezininzi zempilo ezidla ngokufuna olu tyando.

Lwenziwa njani olu tyando?

Utyando lukaHartmann lunokwenziwa ngeendlela ezimbini.

1. Utyando Oluvulekileyo: Kule meko, utyando lwenziwa ngokwenza utyando olukhulu kancinci esiswini kunye nokuvula umngxuma wesisu.

2. Utyando lweLaparoscopic:Oku kukwabizwa ngokuba "lutyando lwe-keyhole." Olu tyando lwenziwa ngokusikwa okuncinci esiswini, kwaye kufakwa ikhamera (i-laparoscope) kunye nezixhobo ezikhethekileyo. Le ndlela ishiya amanxeba amancinci kwaye inexesha elifutshane lokuphola.

Nangona kunjalo, kuxhomekeke ekubeni imeko yakho imbi kangakanani na, ungaqala ngendlela ye-laparoscopic uze emva koko utshintshele kwindlela yotyando oluvulekileyo ngexesha lenkqubo. Oku kuya kugqitywa ngugqirha wakho.

Kwenzeka ntoni ngaphambi kotyando?

• Uza kucelwa ukuba uyeke ukutya nokusela iiyure ezi-6-12 ngaphambi kotyando.
• Ngokuxhomekeke kwimeko yakho, unganikwa isiselo esikhethekileyo sokucoca amathumbu akho.
• Xa ungeniswa esibhedlele, kufakwa i-IV catheter emthanjeni osengalweni yakho.
• Ugqirha uza kukuchazela amayeza okudambisa iintlungu kwangaphambili.

Kwenzeka ntoni ngexesha lotyando?

Uza kunikwa i-anesthesia eqhelekileyo, ngoko awuyi kuva nto. Utyando lungathatha malunga neeyure ezimbini ukuya kwezine. Ugqirha uza kususa inxalenye yamathumbu enesifo, enze i-colostomy njengoko besitshilo ngaphambili, aze athunge amanxeba.

Yintoni onokuyilindela emva kotyando?

Emva kotyando, uza kuqala usiwe kwigumbi lokuchacha. Xa imeko yakho izinzile, uza kudluliselwa kwigumbi lonyango.

• Ukuhlala esibhedlele: Ngokwesiqhelo, kuya kufuneka uhlale esibhedlele malunga neentsuku ezisi-7-10.
• Ukutya: Kunikwa ukutya okumanzi kuphela kwiintsuku zokuqala. Kancinci kancinci, baziswa ekutyeni okuqhelekileyo.
• Intlungu: Iipilisi zokunciphisa iintlungu ezifakwa emithanjeni zinikwa kwiintsuku zokuqala ezimbalwa, emva koko zitshintshelwe kwiipilisi.
• Ukusebenza kwamathumbu: Kungathatha iintsuku ezimbalwa ukuba amathumbu aqale ukusebenza kwakhona emva kotyando.
• Ingxowa yeColostomy: Umongikazi oqeqeshwe ngokukodwa (umongikazi westoma) uza kukubonisa indlela yokuyisebenzisa, ukuyicoca, kunye nokuyitshintsha. Ungakhathazeki, kuza kuthatha ixesha ukuqhela.

Ndingaya nini ekhaya?

• Xa izinto ezifana nesantya sentliziyo yakho kunye noxinzelelo lwegazi zibuyela esiqhelweni.
• Xa unokuvuka uhambe ngaphandle koncedo lomntu.
• Xa indle iqala ukuvuza kwingxowa ye-colostomy.
• Xa intlungu ingalawulwa ngeepilisi.
• Xa ungayitshintsha ngokwakho ingxowa ye-colostomy.

Ziziphi iingozi ezinokubakho kunye nemiphumo emibi?

Njengakwezinye iintlobo zotyando, kukho iingozi ezibandakanyekileyo, kwaye kubalulekile ukuxoxa ngazo nogqirha wakho.

• Iingxaki ezinokubakho: Usulelo lwenxeba, i-pneumonia, ukopha ngaphakathi, amahlwili egazi, ukwakheka kwe-hernia, njl.
• Imiphumela:
• Ukungasebenzi kakuhle kwamathumbu okwethutyana (Ileus): Emva kotyando, kusenokulibaziseka ukuba amathumbu asebenze. Kwezo ntsuku, ukutya kunikwa ngetyuwa.
• Ukuphuma kwamanzi empundu: Nokuba indle ayiphumi, ulwelo olufana ne-mucus lunokuphuma ngamanye amaxesha kwinxalenye eseleyo yempundu.
• Iziphumo ekusebenzeni ngokwesondo: Kunqabile kakhulu, ukonakala kwemithambo-luvo kwindawo yotyando kunokubangela utshintsho kwindlela ovakalelwa ngayo ngokwesondo okanye kwindlela osebenza ngayo. Ukuba unenkxalabo malunga noku, thetha nogqirha wakho ngokukhululekileyo.

Ngaba ingxowa ye-colostomy ingasuswa kwakhona? (Utyando Lokubuyisela Umva)

Le yeyona ngxaki inkulu abantu abaninzi abanayo. Ewe, abantu abaninzi banokubuyisela oku esiqhelweni.

Phakathi kweenyanga ezi-6 ukuya kwezili-12 emva kotyando lukaHartmann, ugqirha wakho uza kuphinda ahlolisise impilo yakho. Ukuba uyachacha kakuhle kwaye awunazo ezinye iingxaki zempilo ezinzulu, kunokwenziwa olunye utyando lokususa i-colostomy bag kunye nokudibanisa kwakhona iinxalenye ezimbini zamathumbu akho.

Nangona kunjalo, abanye abantu basenokungakwazi ukwenza olu tyando lwesibini. Umzekelo:

• Ukuba umhlaza usasazeke kwezinye iindawo zomzimba.
• Ukuba unezinye izifo ezinzulu ezifana nesifo sentliziyo okanye isifo semiphunga.
• Ukuba awukwazi ukuhlawula olunye utyando ngenxa yobudala okanye ukutyeba kakhulu.

Ugqirha wakho ngumntu ofanelekileyo ukwenza esi sigqibo.