Ngaba uziva iqhuma emqaleni okanye esifubeni xa usitya okanye usela? Ngaba ngamanye amaxesha uziva usoyika ukutya kuba uziva ngathi ukutya kwakho akwehlanga? Oku kusenokuba ngenxa yesifo esingaqhelekanga esibizwa ngokuba yiAchalasia. Ukuphila nale meko akulula. Kunzima ukuginya ukutya, kwaye ukungatyi kakuhle kunokukhokelela ekusweleni kwesondlo. Ngoko ke namhlanje siza kuthetha ngotyando olubizwa ngokuba yiHeller Myotomy, olwenziwa njengonyango loku.
Yintoni utyando lweHeller Myotomy?
Ngamafutshane, iHeller Myotomy lutyando oluncinci lokusikwa ukuze kunyangwe iAchalasia . IAchalasia yimeko engaqhelekanga echaphazela i-esophagus yethu, okanye umbhobho wokutya. Oku kwenzeka xa inkqubo yokuthumela ukutya kunye nolwelo ukusuka kwi-esophagus ukuya esiswini ingasebenzi kakuhle.
Igama elithi "myotomy" lithetha ukusika umsipha. Kwi-Heller Myotomy, ugqirha wenza imicu embalwa emincinci kwisangqa semisipha esezantsi kwe-esophagus yakho, ebizwa ngokuba yi-Lower Esophageal Sphincter (LES) . I-LES ngumsipha oqinileyo ohlala phakathi kwenxalenye esezantsi ye-esophagus yakho kunye nenxalenye ephezulu yesisu sakho. Ifana nevalvu.
Ukuba une-achalasia, umsipha we-LES awuvuli kwaye awuvaleki kakuhle. Oku kuthintela ukutya ukuba kungadluli kwi-esophagus ukuya esiswini. Utyando lwe-Heller Myotomy lusebenza ngokuphumza umsipha we-LES uze uwuvule.
Olu tyando ludla ngokwenziwa kunye nenye inkqubo ebizwa ngokuba yi-fundoplication . Oku kubandakanya ukuba ugqirha athathe icandelo lesisu sakho alijikeleze umphimbo wakho. Oku kunciphisa umngcipheko wokuba i-asidi yesisu ibuyele kwi-esophagus yakho (i-reflux).
Into ebalulekileyo kukuba utyando lweHeller Myotomy alulonyango olupheleleyo lwe-Achalasia. Lunika isiqabu sexesha elide, nangona kunjalo, kusenokufuneka ukuba olu tyando luphindwe ngokuhamba kwexesha.
Uzilungiselela njani ngaphambi kotyando?
Ukuqinisekisa ukuba ufanelekile utyando, ugqirha wakho uza kuyalela iimvavanyo ezininzi ngaphambi kotyando. Umzekelo, uvavanyo lwegazi, i-X-ray yesifuba, kunye ne-ECG.
Ngaphambi kotyando, ingcali yokubulala iintlungu eza kukunika i-anesthesia iza kuthetha nawe. Baza kukubuza imibuzo efana nale:
- Ngaba wakha wayenza i-anesthesia ngaphambili kwaye yayinjani loo nto?
- Ngawaphi amayeza, amayeza, okanye iivithamini ozisebenzisayo?
- Ngaba usebenzisa icuba, utywala, okanye ezinye iziyobisi?
Kukho izinto ezimbalwa ekufuneka uzenze ukuze ulungiselele utyando. Ezi zinto kufuneka zixoxwe kwaye ziqinisekiswe nogqirha wakho.
| Kwenziwe ntoni | Kutheni oko kubalulekile? |
|---|---|
| Ukuyeka ukusebenzisa i-nicotine (naluphi na uhlobo, kuquka i-cigarettes kunye ne-e-cigarettes) | I-Nicotine ichaphazela ukujikeleza kwegazi lakho, nto leyo enokucothisa ukuphiliswa kwamanxeba emva kotyando. |
| Ukuzila ukutya. | Ugqirha wakho angakuxelela ukuba ungatyi nto iiyure ezi-6 nangaphezulu ngaphambi kotyando. Usenokukwazi ukusela ulwelo olucacileyo (njengamanzi) okwethutyana ngaphambi kotyando. Kodwa qiniseka ukuba ubuza ugqirha wakho ngale nto. |
| Ukucwangcisa ukuhlala esibhedlele. | Olu lutyando olukhulu, ngoko ke kuya kufuneka uhlale esibhedlele ubuncinane usuku olunye emva kotyando. Kwakhona, lungiselela ukuba umntu akuqhubele ekhaya aze ahlale nawe iiyure ezingama-24 zokuqala. |
| Ukucwangcisa ukubuyela esimeni. | Emva kotyando, ugqirha angakunika amayeza okuthomalalisa iintlungu. Awuyi kukwazi ukuqhuba ude uwasebenzise, ngoko ke fumana umntu oza kukunceda ngaloo misebenzi. |
Lwenziwa njani utyando?
Ngoku makhe sijonge okwenzekayo ngaphakathi kotyando. Oku kudla ngokwenziwa nge-laparoscopically . Oko kukuthi, ngoncedo lweteleskopu. Apha, ugqirha usebenzisa isixhobo esincinci esinekhamera eqhotyoshelwe kuso ukujonga ngaphakathi komphimbo wakho kunye nezixhobo ezincinci kakhulu zokwenza utyando.
- Okokuqala, ingcali yokubulala iintlungu iza kufaka umgca we-IV (njengetyhubhu enika i-saline) emthanjeni osengalweni yakho ize ikunike amayeza okukulalisa. Awuyi kuva nto ngexesha lotyando.
- Okulandelayo, ugqirha uza kwenza imingxunya emincinci emihlanu esiswini sakho (esiswini).
- Emva koko, isisu sakho sizaliswa yigesi yekhabhoni-dayoksayidi. Oku kwenzelwa ukwenza kube lula ukuhambisa izixhobo zotyando kunye nokubonelela ngembonakalo ecacileyo yomqala kunye nenxalenye ephezulu yesisu.
- Ngoku ugqirha ufaka ikhamera kunye nezixhobo ezincinci zotyando ngaloo mingxunya .
- Ngokusebenzisa ezi zixhobo, umaleko wemisipha esezantsi kwe-esophagus uyanqunyulwa ngobude kwaye i-LES iyavulwa.
- Emva koko, kwenziwa inkqubo ebizwa ngokuba yi-fundoplication. Oku kuquka ukuthatha inxalenye yenxalenye ephezulu yesisu uze uyisonge ujikeleze umphimbo. Oku kuthintela i-asidi yesisu ukuba ingaphumi.
- Ekugqibeleni, ikhamera kunye nezixhobo ziyasuswa, kwaye loo mingxunya mincinci iyathungwa.
Olu tyando luphela ludla ngokuthatha malunga neeyure ezimbini.
Kwenzeka ntoni emva kotyando?
Amava emva kotyando anokwahluka kancinci kumntu nomntu. Kodwa ngokwesiqhelo, uza kuhlala esibhedlele ubusuku bonke. Ngeli xesha, uza kunikwa ulwelo kunye nesondlo ngomgca we-IV. Emva koko, ixesha lokuchacha liqala.
Eyona nto ibalulekileyo kukuba umphimbo wakho unokudumba emva kotyando. Kungathatha malunga neenyanga ezimbini ukuba oku kudumba kuphele ngokupheleleyo. Ngoko ke kuya kufuneka utshintshe ukutya kwakho kancinci kancinci.
Iqela lakho lezonyango liza kukuchazela oku, kodwa isicwangciso sesiqhelo sokutya silandelayo.
| Ixesha | Ukutya kuyafumaneka |
|---|---|
| Usuku lokuqala nolwesibini | Ulwelo olucacileyo. Umzekelo: umhluzi wenkukhu/wenyama yenkomo (oxutyiweyo), ijeli, iipakethi zomkhenkce, amanzi. |
| Ukususela ngomhla wesithathu ukuya kumhla wesixhenxe | Ukutya kobisi. Umzekelo: i-ayisikhrim, isuphu ekhrim ehluziweyo, iiporridge ezifana neCream of Wheat okanye iCream of Rice. |
| Ukususela ngosuku lwesibhozo ukuya kutsho kuvavanyo lweeveki ezimbini | Ukutya okuthambileyo. Ugqirha wakho uza kukuxelela ukuba ungaqala nini ukongeza ukutya okuqinileyo. |
Ziziphi iingenelo kunye neengozi zalo tyando?
Iinzuzo
Abantu abaninzi abane-achalasia bakhetha ukusebenzisa i-Heller Myotomy xa ezinye iindlela zonyango ezingasebenzisi utyando zingaphumeleli. Eyona nzuzo iphambili yale nkqubo kukuba iimpawu ze-achalasia ziyanyamalala emva kotyando.
Uhlalutyo lwakutshanje lophando lubonise ukuba phakathi kwama-87% nama-92% abantu abaye bafumana olu nyango iimpawu zabo ziye zaphela. Nangona kunjalo, njengoko besitshilo ngaphambili, oku akunyanga ngokupheleleyo i-achalasia. Iimpawu ngamanye amaxesha zinokuphinda zibuye emva kweminyaka emi-5-10 emva kotyando.
Iingozi
Njengakwezinye iintlobo zotyando olukhulu, iHeller Myotomy ineengozi. Iingozi ngokubanzi ziquka ukopha kakhulu kunye nosulelo. Ukongeza, iingxaki ezithile ezinokubakho ziquka:
- Umphimbo kaBarrett
- Usulelo lwe-Esophageal
- I-GERD (isifo se-gastroesophageal reflux)
- Ukuqhekeka komlomo wesibeleko
Ufika nini kugqirha
Ukuba unezinye zezi mpawu zilandelayo emva kotyando, fowunela ugqirha wakho ngoko nangoko, okanye uye kwiSebe leNgxamiseko (ETU) lesibhedlele esikufutshane.
- Ukuba indawo yotyando ibomvu kwaye idumbile.
- Ukuba ubomvu buvela kwinxeba lotyando.
- Ukuba awukwazi nokuginya ulwelo.
- Ukuba amayeza okudambisa iintlungu anikwe ngugqirha awayithomalalisi intlungu.
Umahluko phakathi kotyando lwe-Heller Myotomy kunye ne-POEM
Usenokuba ukhe weva ngenkqubo ebizwa ngokuba yiPOEM. IPOEM sisishunqulelo sePeroral Endoscopic Myotomy . NjengeHeller Myotomy, olu lunyango lwemeko yeAchalasia.
Umahluko phakathi kwezi zimbini kukuba kutyando lwe-POEM, akukho mingxunya yenziwayo esiswini sakho. Endaweni yoko, ugqirha wakho ufaka i-endoscope (ityhubhu enekhamera eqhotyoshelweyo) ngomlomo wakho aze ehle emophagus. Emva koko umsipha we-LES uyasikwa uvulekile ngaphakathi. Kwi-Heller Myotomy, oku kwenziwa ngaphandle ngokusebenzisa imingxunya emincinci esiswini sakho.
Umyalezo Wokuya Ekhaya
- I-Heller Myotomy lutyando olwenziwa ukunyanga i-achalasia, imeko ebangela ubunzima bokuginya.
- Oku kudla ngokwenziwa nge-laparoscopically ngokusebenzisa imingxunya emincinci esiswini, apho i-sphincter esezantsi ye-esophageal iphumla khona.
- Nangona olu tyando lunika isiqabu sexesha elide kwiimpawu, alulonyango olupheleleyo lwe-Achalasia.
- Ngexesha lokuphola emva kotyando, kuya kufuneka ulandele ukutya okukhethekileyo kangangeeveki eziliqela.
- Kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho kanye njengoko inikwe ngaphambi nasemva kotyando.
- Funa uncedo lwezonyango ngokukhawuleza ukuba ufumana naziphi na iimpawu ezilumkisayo, ezinjengokudumba, ubomvu, okanye ukungakwazi ukuginya ulwelo kwindawo yotyando.
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