Ngenxa yeemeko ezithile zempilo, ingakumbi iingxaki zamathumbu amakhulu, kufuneka utyando ukuze kususwe loo ndawo. Emva koko, kwenziwa umngxuma omncinci eluswini lwesisu ukuvumela inkunkuma ukuba iphume emzimbeni. Ngoko ke, ilindle liqokelelwa kwingxowa eqhotyoshelwe kulo mngxuma. Ukuhlala nale ngxowa kunokuba yinto engathandekiyo kwabanye abantu. Ingavakala ngathi yingxaki xa udibana nabantu, unxibe impahla, kwaye wenza imisebenzi yemihla ngemihla. Kuthekani ke ukuba bekukho indlela yokuqokelela inkunkuma emzimbeni ngaphandle kwale ngxowa yangaphandle size siyikhuphe nanini na xa sifuna? Isisombululo saloo nto yingxowa yeKock esithetha ngayo namhlanje.
Ngamafutshane, yintoni le ngxowa yeKock (ingxowa yeK)?
Khawuthelekelele, endaweni yokuba nengxowa exhonywe ngaphandle komzimba wakho, kuthekani ukuba ubunokwenza ingxowa encinci enokuqokelela nokugcina inkunkuma emzimbeni wakho? Yiyo leyo ingxowa yeKock.
Emva kotyando lwe-colectomy, isiphelo samathumbu akho amancinci, i-ileum, siziswa kumphezulu wesikhumba esiswini sakho kwaye kwenziwa umngxuma omncinci. Oku kubizwa ngokuba yi-ileostomy. Lo mngxuma ubizwa ngokuba yi-stoma. Oku kudla ngokwenziwa ngokuncamathisela isikhwama sangaphandle kwi-stoma.
Kodwa kwinkqubo yesikhwama seKock, ugqirha usebenzisa inxalenye yamathumbu akho amancinci ukwenza isikhwama esincinci ngaphakathi emzimbeni wakho . Esi sikhwama siqhagamshelwe ngqo kwindawo evulekileyo (stoma) esiswini sakho. Ngoko ke awudingi sikhwama sangaphandle ukuze uqokelele indle yakho. Xa kuyimfuneko, ityhubhu encinci (i-catheter) ingafakwa ngale ndawo ivulekileyo kwaye inkunkuma eqokelelene kwisikhwama ingasuswa.
Oku kufana "ne-internal scrotum" ngaphakathi emzimbeni esinokuyikhupha nangaliphi na ixesha. Ithiywe ngegama likagqirha otyandayo uNils Kock.
Zithini iindlela zokusebenzisa isikhwama seKock?
Le ndlela isetyenziswa kakhulu kubantu abaphila ne-'ileostomy' esisigxina kodwa abafuni ukusebenzisa ibhegi yendle yangaphandle. Eyona nzuzo inkulu yoku kukuba bayakwazi ukulawula ukuhamba kwendle.
Kwi-ileostomy eqhelekileyo, indle ingaqokelelana kwingxowa nangaliphi na ixesha. Asinakukwazi ukuyilawula. Kodwa i-ileostomy enengxowa yeKock ibizwa ngokuba yi-continence ileostomy. Oko kuthetha "ukulawuleka." Kwimeko enjalo, indle iqokelelana kwingxowa engaphakathi, endaweni yokuvuza, ngoko unenkululeko yokuyikhupha nanini na xa ufuna.
- Ulwazi olongezelelekileyo: Isikhwama seKock ekuqaleni sasiyilwe njengesikhwama sangaphakathi sokuqokelela umchamo wezigulane ezisuswe izinyini zazo. Loo ndlela isasetyenziswa nanamhlanje, kodwa iindlela ezininzi ezintsha ngoku ziye zaphuhliswa.
Olu tyando lwenziwa njani?
Ugqirha wakho angenza isikhwama seKock ngexesha elinye ne-ileostomy yakho, okanye angayenza ngotyando olwahlukileyo ngomhla olandelayo. Oku kuthetha ukuba ukuba sele une-ileostomy, usenokutshintshela kwisikhwama seKock ngomhla olandelayo.
Ngamazwi alula, utyando lwenziwa ngolu hlobo lulandelayo:
1. Ukudala isikhwama: Ugqirha uza kuthatha malunga nee-intshi ezili-18 zesiphelo samathumbu akho amancinci aze asisonge sibe yi-"U". Emva koko, amathumbu aza kuvulwa embindini wale ngubo kwaye imiphetho iya kuthungwa kunye. Oku kuya kudala isikhwama.
2. Ukwenza iValve: Le yeyona nxalenye ibalulekileyo. Kusetyenziswa amathumbu aseleyo ekupheleni kwebhegi, kwenziwa ivalve ekhethekileyo (`ivalve yendlela enye`). Ifana nocango oluvuleka kwicala elinye kuphela. Xa inkunkuma izaliswe ngaphakathi, le valve ivala ngokuzenzekelayo. Ngale ndlela, ilindle, ulwelo, nomoya aziphumi.
3. Uqhagamshelo: Ekugqibeleni, isiphelo esinevalvu sinamathele kwindawo evulekileyo (`stoma`) eyenziwe esiswini sakho. Ugqirha uza kujonga ukuqinisekisa ukuba yonke into isebenza kakuhle kwaye akukho kuvuza.
Kwenzeka ntoni emva kotyando? Kuthatha ixesha elingakanani ukuze umntu aphile?
Emva kotyando, kuya kufuneka uhlale esibhedlele kangangeentsuku ezintathu ukuya kwezintlanu. Ngeli xesha, iityhubhu ezahlukeneyo ziya kudityaniswa emzimbeni wakho ukuze zikuncede uphile ngokukhawuleza.
- Ityhubhu ye-`IV` yokunika i-saline
- `Isondlo se-IV` sesondlo
- Iipayipi zokukhupha inkunkuma enxebeni
- I-catheter yomchamo
- `Impompo yentlungu` yokulawula iintlungu
Musa ukukhathazeka ngezi zinto, zonke zezexeshana.
I-catheter efakwe kwi-stoma yakho iya kushiywa endaweni yayo kangangeeveki eziliqela. Oku kuya kuvumela inkunkuma ukuba iphume kwisingxobo esitsha esidaliweyo de inxeba liphole. Umongikazi uya kukufundisa indlela yokunyamekela i-catheter.
Emva kokuba ubuyele ekhaya uze uphumle iiveki ezimbalwa, ugqirha wakho uza kuyisusa le tube. Emva koko, umongikazi uza kukufundisa indlela yokukhupha ibhegi ngokwakho usebenzisa ityhubhu eqhelekileyo (catheter).
Ekuqaleni, kusenokufuneka ukhuphe isinyi sakho malunga nezihlandlo ezisi-8 ngemini. Kodwa ungakhathazeki, kwiinyanga ezimbalwa ezizayo, esi sikhwama sitsha emzimbeni wakho siya kuba sikhulu kancinci kancinci. Emva koko, kusenokufuneka usikhuphe izihlandlo ezi-2-4 kuphela ngemini.
Iingenelo kunye neengxaki ezinokubakho zesikhwama seKock
Njengayo nayiphi na inkqubo yezonyango, kukho iingenelo kunye neengozi. Makhe sizijonge.
| Iinzuzo | Iingxaki ezinokubakho |
|---|---|
| Akukho mfuneko yengxowa yangaphandle: Akunyanzelekanga ukuba unxibe okanye uphathe ingxowa yangaphandle ye-ileostomy. | Iingxaki zevalvu: Ngamanye amaxesha ivalvu isenokukhululeka ize ibangele ukuba indle ivuza. Okanye ivalvu isenokuvaleka kwaye ityhubhu isenokungakwazi ukufakwa. Ukuvaleka kwamathumbu ngokupheleleyo yingxamiseko. Ukuba oku kuyenzeka, kufuneka uye kwi-ETU (iYunithi yoNyango oluNgxamisekileyo) ngoko nangoko. |
| Inkululeko engakumbi kunye nobumfihlo: I-stoma ingagqunywa ngento encinci, njenge-gauze pad. Oku akuyi kubonakala ngaphandle. | I-Fistula: Iitonela ezingafanelekanga zinokwenzeka ukusuka kwisingxobo ukuya eluswini okanye kwamanye amalungu omzimba. Oku kunokubangela intlungu kunye nosulelo. |
| Ulawulo: Ungayikhupha i-bladder yakho nanini na naphi na apho ufuna khona, ngaphandle kokuvuza indle imini yonke. | I-Pouchitis: Ukudumba okanye usulelo lwengxowa. Le yimeko eqhelekileyo. Ihlala inyangwa ngokukhawuleza ngamayeza okubulala iintsholongwane. |
| Ukulala kamnandi: Kulula kakhulu ukulala ebusuku. Akuyi kufuneka uvuke phakathi kobusuku ukuze ukhuphe yonke into ebhegini yakho. | Ukuncitshiswa komngxuma (Stricture/stenosis): Ukuvaleka kungenza i-stoma ibe mxinwa kwaye kube nzima ukufaka umbhobho. |
| I-Parastomal hernia: Inxalenye yamathumbu iphuma nge-stoma. Oku kunokubangela ukuvaleka. |
Ukuba ezi ngxaki zenzeka, kukho amaxesha apho kunokufuneka olunye utyando (`utyando lokuhlaziya`) ukuze lulungiswe. Kwimeko yesikhwama seKock, ingakumbi ngenxa yeengxaki zevalvu, izinga lotyando lokuhlaziya liphezulu kancinci kunezinye iindlela (malunga ne-30%). Kodwa ugqirha wakho uza kukuchazela konke oku ngokupheleleyo.
Yintoni umahluko phakathi kwesikhwama seKock kunye nesikhwama seJ?
Nangona zombini ezi ziintlobo zeengxowa ezenziwe ngaphakathi emzimbeni, indlela ezisebenza ngayo yahlukile ngokupheleleyo.
- Isikhwama seKock (isikhwama seK): Esi senziwe nge-'ileostomy', engumngxuma ('stoma') esiswini. Indle ikhutshwa ngetyhubhu ('catheter') efakwe ngomngxuma esiswini.
- I-J-Pouch: Le yindlela eyahlukileyo endaweni ye-ileostomy. Apha, kwenziwa isikhwama esisuka esiphelweni samathumbu amancinci size sidityaniswe ngqo ne-anus (umjelo wempundu). Oku kuphelisa isidingo se-stoma (ukuvulwa kwesisu). Isigulana sinokuya kwindlu yangasese size sikhuphe inkunkuma ngokuqhelekileyo.
Kwiimeko ezininzi, izigulana ezifuna ukususwa kwamathumbu amakhulu kunye ne-rectum zikhetha inkqubo ye-J-pouch. Nangona kunjalo, ukuze i-J-pouch iphumelele, izihlunu ezikwi-rectum kufuneka zisebenze kakuhle. Kwabo bangenako ukuba ne-J-pouch ngesizathu esithile, okanye kwabo baye baba ne-J-pouch engasebenziyo, i-Kock pouch lukhetho oluhle.
Ngaba ufuna ukwenza utshintsho kwindlela otya ngayo?
Ewe, ukutya ukutya okunesondlo nokulinganiselayo kubaluleke kakhulu ukuze ukhawulezise ukuchacha kwakho. Ukuba indle yakho ityebile kakhulu okanye imanzi kakhulu, ungenza utshintsho oluncinci kwindlela otya ngayo. Kunganceda kakhulu ukufuna ingcebiso kugqirha wezondlo. Ugqirha wakho angakuthumela kumntu ofanelekileyo.
Umyalezo Wokuya Ekhaya
- Isikhwama seKock siyindlela entle kwabo bangafuniyo ukuhlala nesikhwama se-ileostomy sangaphandle.
- Oku kuya kukunceda ukulawula ukuhamba kwakho kwamathumbu kwaye kukunike inkululeko engakumbi kunye nentuthuzelo xa uncokola nabantu.
- Nangona kunjalo, njengakuzo zonke iintlobo zotyando, kukho iingozi kunye neengxaki, ingakumbi iingxaki zevalvu.
- Ngaphambi kokuba uthathe isigqibo sokuba le ndlela ikulungele na, kubaluleke kakhulu ukuthetha nogqirha wakho kwaye uqonde ngokucacileyo zonke izinto ezilungileyo nezingalunganga.
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