Isisombululo samatye amakhulu ezintso: Inkcazo elula yotyando lwe-PCNL (i-Percutaneous Nephrolithotomy)

Amatye ezintso yingxaki abantu abaninzi abanayo, kwaye ngamanye amaxesha abangela iintlungu ezinganyamezelekiyo. Amatye amancinci adla ngokudlula emchameni emva kokusela amanzi amaninzi nokusela amayeza anikwe ngugqirha. Kodwa amanye amatye makhulu kakhulu. Namhlanje siza kuthetha ngotyando olukhethekileyo noluphumelele kakhulu olucetywayo ngoogqirha xa lungenakususwa ngezinye iindlela.

Kalula nje, yintoni i-PCNL?

Igama elipheleleyo le-PCNL yi- Percutaneous Nephrolithotomy . Nangona igama lisenokuvakala linzima kancinci, intsingiselo yalo ilula kakhulu.

• "I-Percutaneous" ithetha "ngolusu."
• Igama elithi "Nephrolithotomy" lithetha "ukususwa kwelitye kwizintso ngotyando."

Ngamafutshane, i-PCNL yinkqubo apho kwenziwa khona umngxuma omncinci kakhulu emqolo wakho kwaye kususwa ilitye elikhulu kwizintso. Isetyenziswa kakhulu ukususa amatye amakhulu angakhange anyangwe ngempumelelo ngezinye iindlela zonyango, ezifana namayeza, i-shock wave lithotripsy, okanye ezinye iindlela.

Ngaba i-PCNL lutyando olukhulu?

Ewe, i-PCNL ithathwa njengotyando olukhulu. Kodwa ungakhathazeki. Ayifani notyando oluvulekileyo lwendabuko. Utyando oluvulekileyo lubandakanya ukusikwa okukhulu, oko kuthetha ukuba kuthatha ixesha elide ukuphola kwaye kubuhlungu ngakumbi.

Kodwa i-PCNL lutyando "olungenabungozi kangako" . Oko kuthetha ukuba ngenxa yokuba lwenziwa ngomsikelo omncinci kakhulu, akukho mpembelelo ingako emzimbeni wakho, kukho iingxaki ezimbalwa, kwaye ungaphila ngokukhawuleza. Kodwa ngenxa yokuba lutyando olukhulu, lwenziwa liqela loogqirha abaziingcali esibhedlele.

Ngubani ngokwenene odinga olu tyando?

Uninzi lwexesha, amatye ezintso ayaphuma kunye nomchamo. Ngaphandle koko, ugqirha uza kukuthumela kwezinye iindlela zonyango ezilula. Utyando lwe-PCNL lwenziwa kwezi meko zilandelayo:

• Ukuba ilitye lezintso likhulu kakhulu: Le ndlela idla ngokuba yeyona ilungileyo yokususa amatye amakhulu kuneesentimitha ezi-2.
• Ukuba ezinye iindlela zonyango aziphumelelanga: Ukuba ilitye alinakukwazi ukususwa ngonyango olufana ne-shock wave lithotripsy okanye i-laser ureteroscopy, equka ukudlulisa ikhamera kwi-urethra nokususa ilitye nge-laser.
• Ukuba ilitye likwindawo enzima: Ukuba ilitye likwindawo enzima ukulisusa ngaphakathi kwezintso.

Masifunde inyathelo ngenyathelo indlela olu tyando olwenziwa ngayo.

Kuya kuba luncedo kakhulu ukuba nolwazi olupheleleyo malunga nolu hlobo lotyando ngaphambi kokuba ulwenze. Makhe sijonge indlela olusebenza ngayo olu tyando.

1. Yintoni endifanele ndiyenze ngaphambi kotyando?

Kuya kufuneka ubone ugqirha kwiintsuku ezimbalwa ngaphambi kotyando. Apho:

• Imeko yakho yempilo iyajongwa: izinto ezifana noxinzelelo lwegazi kunye nesantya sentliziyo ziyalinganiswa.
• Lumka ngamayeza akho: Ufanele uxelele ugqirha wakho ngawo onke amayeza owasebenzisayo, kuquka iivithamini kunye namayeza esintu. Ukuba uthatha amayeza okunciphisa igazi (umz., i-aspirin) , unokufuna ukuyeka ukuwasebenzisa ngaphambi kotyando. Kodwa ungaze uyeke ukuthatha naliphi na iyeza ngaphandle kokubuza ugqirha wakho kuqala.
• Sixelele nge-allergies zakho: Qiniseka ukuba usazisa ukuba unayo nayiphi na i-allergies kumayeza, ukutya, okanye nantoni na efana ne-plaster.
• Ukuzila Ukutya: Uya kucetyiswa ukuba ungatyi okanye ungaseli nto emva kweentsuku ezinzulwini zobusuku ngaphambi kotyando. Ukuba kufuneka usele naluphi na unyango oluyimfuneko, ungalusela ngamanzi nje ambalwa.
• Uvavanyo: Usenokucelwa ukuba wenze i -'CT (computed tomography) scan', i-'Ultrasound scan', okanye i-'X-ray' ukuze ubone indawo echanekileyo kunye nobukhulu belitye lezintso.

2. Kwenzeka ntoni ngexesha lotyando?

Olu tyando lwenziwa liqela loogqirha abaziingcali, ingcali yokubulala iintlungu, kunye nabasebenzi bomongikazi.

• I-Anesthesia: Okokuqala, uza kufakwa phantsi kwe-anesthesia eqhelekileyo. Ngoko awuyi kuva ntlungu ngexesha lotyando, kwaye uza kube ulele ngokupheleleyo.
• Indawo: Utyando ludla ngokwenziwa ulele ngesisu (indawo ethambileyo) ebhedini. Oku kwenza kube lula ukufikelela kwizintso ungasemva.
• Ukusikwa okuncinci: Ingcali iza kwenza ukusikwa okuncinci, malunga ne-1 sentimitha, emqolo wakho, apho kukho izintso zakho.
• Ukufakwa kwesixhobo: Ngomsikelo, kufakwa ityhubhu yokukhusela (isheya) kwizintso. Emva koko, kufakwa ikhamera encinci (i-nephroscope) ngetyhubhu kwaye ilitye elingaphakathi kwizintso lijongwa kwiscreen.
• Ukususwa kwelitye: Ukuba ilitye lincinci, likhutshwa ngesixhobo esifanayo. Ukuba ilitye likhulu, umqadi welaser okanye isixhobo esikhethekileyo sokungcangcazela ``lithotripter`` sisetyenziselwa ukuqhekeza ilitye libe ziingceba ezincinci nokususa ezo zingceba.
• Ukufakwa kombhobho: Emva kokuba ilitye lisusiwe ngokupheleleyo, umbhobho omncinci (umbhobho wokukhupha amanzi) okanye i- ureteral stent inokufakwa kwisinyi ukuvumela umchamo negazi ukuba ziphume kwizintso. Oku kunceda inxeba liphole.
• Ukuthungwa: Ekugqibeleni, umngxuma omncinci owenziwe ngasemva uvalwa ngezitishi.

Le nkqubo yonke idla ngokubaKungathatha malunga neeyure ezimbini ukuya kwezine.

3. Kwenzeka ntoni emva kotyando?

Emva kokuba utyando luphelile, ingcali yokubulala iintlungu iya kuyeka ukunika i-anesthesia. Uya kubuyela engqondweni kancinci kancinci kwimizuzu embalwa.

• Igumbi Lokuchacha: Uza kuqala usiwe kwigumbi lokuchacha, apho impilo yakho iza kuhlolwa ngokusondeleyo.
• Ulawulo lweentlungu: Usenokuziva iintlungu emva kokuba ubuyele ezingqondweni. Abasebenzi bonyango baza kukunika iintlungu zokukunceda kule nto.
• Ukuhlala esibhedlele: Kuya kufuneka uhlale esibhedlele malunga nosuku. Ngelo xesha, oogqirha baya kujonga indlela ochacha ngayo.
• Igazi kumchamo: Kuqhelekile ukuba negazi elincinci kumchamo wakho kangangeveki okanye ezimbini emva kotyando. Musa ukukhathazeka ngaloo nto.

Ziziphi iingenelo kunye neengozi zotyando lwe-PCNL?

Njengazo zonke iindlela zonyango, le ineenzuzo kunye neengozi ezincinci.

Iingenelo:

• Amandla okususa phantse ngokupheleleyo amatye amakhulu ezintso angenakususwa ngezinye iindlela.
• Olu lutyando olunezinga eliphezulu kakhulu lempumelelo eliphakathi kwe-75% - 98%.
• Inxeba lincinci kunakwityando elivulekileyo, ngoko ke inxeba liphola ngokukhawuleza.
• Ixesha lokuchitha esibhedlele lincinci.

Iingozi:

Nangona ezi zizinto ezingaqhelekanga kakhulu, kubalulekile ukuba uzazi.

• Iingozi ezinxulumene ne-anesthesia.
• Usulelo kwindawo yotyando.
• Ukopha kakhulu.
• Ukwakheka kwehlwili legazi `(hematoma)`.
• Umonakalo othile kwizintso.
• Ngamanye amaxesha akunakwenzeka ukususa ilitye lonke.
• Usulelo olubi kakhulu kwindlela yomchamo (iSepsis).

Kuza kuthatha ixesha elingakanani ukuchacha? Ngawaphi amanyathelo okhuseleko ekufuneka athathwe ekhaya?

Kudla ngokuthatha malunga neeveki ezimbini ukuya kwezine ukuze umzimba wakho uphile ngokupheleleyo. Kubaluleke kakhulu ukuba umzimba wakho uphumle ngeli xesha.

• Kuphephe ukuphakamisa izinto ezisindayo: Musa ukuphakamisa nantoni na enzima ngaphezu kobunzima belitha yobisi (malunga ne-4 kg) kangangeeveki ezimbini .
• Ukuzilolonga: Zigcine kude nokuzilolonga okunzima okwethutyana.
• Ukubuyela emsebenzini: Ukuba unomsebenzi waseofisini, ungabuyela emsebenzini emva kweveki. Nangona kunjalo, ukuba umsebenzi wakho ufuna ukuzilolonga, kungcono ukuthatha ikhefu ubuncinane iiveki ezimbini.

Xa kufuneka ubone ugqirha ngokukhawuleza!

Ukuba ufumana naziphi na iimpawu ezingaqhelekanga emva kotyando, musa ukuzityeshela. Ukuba unezinye zezi mpawu zilandelayo, fowunela ugqirha wakho ngoko nangoko okanye uye kwiSebe leNgxamiseko (ETU) lesibhedlele esikufutshane.

Qiniseka ukuba ubona ugqirha wakho kwakhona emva kweeveki ezine ukuya kwezintandathu emva kotyando ukuze ahlolwe.