Kuthekani ukuba unosulelo olukhulu, ukuvaleka, okanye umhlaza emathunjini akho kwaye udinga utyando olukhulu? Ngamanye amaxesha, oogqirha kufuneka benze utyando olusindisa ubomi ngokukhawuleza. Inkqubo ekhethekileyo esetyenziswa kwiimeko ezinjalo ibizwa ngokuba yiHartmann's Procedure. Eli gama lisenokuvakala liyoyikisa kancinci, kodwa masithethe ngokucacileyo nangokulula malunga nokuba kwenzeka ntoni ngokwenene, kutheni kwenziwa njalo, kunye nokuba kwenzeka ntoni emva kotyando.
Kalula nje, yintoni le nkqubo kaHartmann?
Inkqubo kaHartmann lutyando olwenziwa emathunjini ethu amakhulu (ikholoni). Ngokukodwa, ibandakanya ukusika nokususa inxalenye enesifo emathunjini ethu amakhulu, ingakumbi inxalenye yokugqibela apho kuphuma khona ilindle, eliyi -sigmoid colon, kwaye ngamanye amaxesha inxalenye ephezulu ye-rectum.
Ngoku khawucinge nje ukuba emva kokususa inxalenye yamathumbu enesifo, iindawo ezimbini ezisele ziphilile kufuneka ziphinde zihlanganiswe. Nangona kunjalo, kuyingozi kakhulu ukuphinda zidibanise ezi ndawo zimbini ngaxeshanye xa kukho usulelo olunzima, ukudumba, okanye ezinye iingxaki. Ukwenza njalo kunokubangela ukuba usulelo luphinde lusasazeke, nto leyo enokuba yingxaki enkulu.
Yiyo loo nto oogqirha benika amalungu amabini aseleyo ethunjini ixesha lokuphola.
1. Isiphelo samathumbu esiqhagamshelwe kwi-anus (i-rectal stump) sithungwe sivalwe okwethutyana.
2. Isiphelo esisempilweni samathumbu amakhulu, esingaphezulu, sinamathele kumngxuma omncinci (i-stoma) owenziwe eludongeni lwesisu.
Kulapho indle iphuma khona ngale mbobo intsha esiswini. Oku kubizwa ngokuba yi-colostomy . Ukuze kuqokelelwe le ndle, kufakwa ibhegi ekhethekileyo (ingxowa ye-colostomy) ngaphandle kwale mbobo.
Oku kunokuvakala ngathi lutshintsho olukhulu, kodwa khumbula, oku kudla ngokuba sisisombululo sexeshana . Nje ukuba amathumbu aphile kakuhle (malunga neenyanga ezi-6-12), kunokwenziwa olunye utyando lokudibanisa kwakhona iindawo ezimbini zamathumbu ezazivalekile, ukuvala i-colostomy.
Kutheni udinga olu tyando?
Kukho izizathu ezininzi eziphambili zokwenza utyando lweHartmann. Kukho izizathu ezahlukeneyo zokususa inxalenye yamathumbu kunye nokufaka i-colostomy.
Kutheni inxalenye yamathumbu isuswa?
- Ukuvaleka: Ukuba kukho ukuvaleka kwindawo ethile emathunjini okuthintela indle ukuba ingashukumi.
- Ukugqobhoka: Ukuba umngxuma uvela eludongeni lwamathumbu kwaye isitulo sivuza singene kwisisu, oku kunokusasaza usulelo kulo lonke isisu (i-peritonitis).
- Usulelo okanye isifo esingalawulekiyo: Ezinye izifo (umz., i-diverticulitis enzima) okanye izifo ezifana nomhlaza zinokufuna ukuba kususwe inxalenye enesifo ukuze kuthintelwe ukusasazeka okungakumbi.
Kutheni kusenziwa i-colostomy?
Njengoko kukhankanyiwe apha ngasentla, xa utyando lwenziwa kwimeko engxamisekileyo, umzimba wesigulana uba buthathaka kwaye umngcipheko wosulelo uphezulu kakhulu. Kwimeko enjalo, ukudibanisa iindawo ezimbini zamathumbu (i-anastomosis) kuyingozi kakhulu. Ke ngoko, injongo yokuqala yoogqirha kukusindisa ubomi besigulana. I-colostomy inika amathumbu ixesha lokuphiliswa, ize emva koko ivumele utyando olufanelekileyo nolungenabungozi kangako, ukubuyisela imeko eqhelekileyo.
| Iimeko eziphambili zonyango ezikhokelela kutyando lukaHartmann | |
|---|---|
| Ezona zizathu zixhaphakileyo |
|
| Ezinye izizathu | |
Indlela okwenziwa ngayo utyando kunye nenkqubo
Olu tyando lunokwenziwa ngeendlela ezimbini eziphambili:
1. Utyando Oluvulekileyo: Utyando lwenziwa ngokuvula umngxuma wesisu ngomngxuma omkhulu esiswini. Le ndlela isetyenziswa kakhulu kwiimeko ezingxamisekileyo nezintsonkothileyo.
2. Utyando lweLaparoscopic: Utyando lwenziwa ngokusikwa okuncinci okumbalwa esiswini, kusetyenziswa ikhamera kunye nezixhobo ezikhethekileyo. Nangona ukuchacha kukhawuleza, le ndlela ayifanelekanga kubo bonke abaguli.
Ngaphambi kotyando
Ukuba ulungiselela utyando, uza kucelwa ukuba uzile ukutya iiyure ezi-6-12. Unganikwa nolwelo olukhethekileyo (ukulungiselela amathumbu) ukuze ucoce amathumbu akho. Emva kokuba ungeniswe esibhedlele, i-saline cannula iza kufakwa emthanjeni osengalweni yakho kwaye uza kunikwa ulwelo kunye namayeza.
Ngexesha lotyando
Olu tyando lwenziwa phantsi kwe-anesthesia eqhelekileyo. Ugqirha ususa inxalenye yamathumbu enesifo, avale isiphelo se-rectum, aze ancamathisele elinye icala esiswini.I-stoma inamathele kwindawo evulekileyo. Ekugqibeleni, ingxowa ye-colostomy inamathele kwaye amanxeba otyando ayathungwa. Le nkqubo yonke ingathatha malunga neeyure ezimbini ukuya kwezine.
Emva kotyando
Emva kotyando, uza kuqala usiwe kwigumbi lokuchacha uze udluliselwe kwigumbi lokuhlala emva kokuba imeko yakho izinzile. Kuya kufuneka uhlale esibhedlele malunga neentsuku ezisi-7 ukuya kwezili-10.
- Kwiintsuku zokuqala, amayeza okudambisa iintlungu, amayeza okubulala iintsholongwane, kunye nolwelo ziya kunikwa nge-saline.
- Kungathatha iintsuku ezininzi ukuba amathumbu aphinde asebenze.
- Okokuqala, banikwa ukutya okumanzi baze bangeniswe kancinci kancinci kukutya okuqinileyo.
- Umongikazi oqeqeshwe ngokukodwa uza kufundisa wena nosapho lwakho indlela yokucoca nokutshintsha ingxowa ye-colostomy, kunye nendlela yokunyamekela i-stoma (ukhathalelo lwe-stoma).
Ziziphi iingozi ezinokubakho kunye nemiphumo emibi?
Njengakwezinye iindlela zotyando, kukho iingozi ezithile ezibandakanyekileyo, kodwa ithathwa njengenkqubo ekhuselekileyo.
- Iingozi ezinokubakho: usulelo lwenxeba, usulelo lwemiphunga (i-pneumonia), ukopha ngaphakathi, ukuvuza kwamathumbu, umonakalo kwizitho ezingqongileyo, ukwakheka kwe-hernia.
- Iziphumo ebezingalindelekanga ezinokubakho:
- I-ileus yexeshana: Kuthatha ixesha ukuba amathumbu aqale ukusebenza kwakhona emva kotyando.
- Ukuphuma kwamanzi empundu: Nokuba awuphumi, ulwelo olufana ne-mucus lunokuphuma ngamanye amaxesha kwinxalenye eseleyo ye-rectum. Oku kuqhelekile.
- Ukungasebenzi kakuhle ngokwesondo: Kunqabile kakhulu, utyando lunokonakalisa imithambo-luvo ebandakanyekayo ekusebenzeni ngokwesondo. Thetha nogqirha wakho ukuba unenkxalabo malunga noku.
Ukuchacha kunye nokuchacha
Kuthatha ixesha elithile ukuba umntu aphile ngokupheleleyo.
- Iiveki 4-6: Nciphisa ukusetyenziswa kwamayeza entlungu, buyela kwindlela eqhelekileyo yokutya, kwaye uqalise umthambo olula.
- Iinyanga ezi-3-6: Ukuqhela ubomi ngebhegi yokufakelwa i-colostomy, uzive uphilile ngokupheleleyo emzimbeni.
Ngaba i-colostomy ingatshintshwa? (Ukuguqulwa)
Le yeyona ngxaki inkulu kubantu abaninzi. Ewe, kwiimeko ezininzi inokuguqulwa.
Kwiinyanga ezimalunga nezi-6-12 emva kotyando lwakho lokuqala, ugqirha wakho uza kuphinda ahlolisise impilo yakho. Ukuba usempilweni entle, amathumbu akho aphilile kakuhle, kwaye unako ukunyamezela olunye utyando, ungakhetha ukwenza utyando lokubuyisela umva .
Nangona kunjalo, ukuba umhlaza usasazeke emzimbeni wonke, ukuba kukho isifo esinzima emzimbeni, okanye ukuba isigulana sibuthathaka kakhulu, ugqirha usenokungacebisi ukuba kwenziwe utyando lwesibini. Ungathetha ngokukhululekileyo nogqirha wakho ngazo zonke ezi zinto.
Umyalezo Wokuya Ekhaya
- Inkqubo kaHartmann lutyando olubaluleke kakhulu olusindisa ubomi , oludla ngokwenziwa kwiimeko ezingxamisekileyo.
- Olu tyando lubandakanya ukwenza umngxuma wesikhashana esiswini ukuze indle idlule. Oku kubizwa ngokuba yi-colostomy , kwaye kuya kufuneka ufunde ukuphila nayo.
- Kwizigulane ezininzi, olu hlobo lotyando lomlomo lungolwexeshana kwaye lunokubuyiselwa ngotyando olunye emva kweenyanga ezi-6-12.
- Inkqubo yokuphiliswa ithatha ixesha. Wena nosapho lwakho niza kufuna inkxaso ukuze nilungelelane nolu tshintsho, ngokwasemzimbeni nangokwengqondo.
- Kubaluleke kakhulu ukuthetha ngokukhululekileyo nogqirha wakho ngayo nayiphi na imibuzo okanye uloyiko onalo.
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