Mhlawumbi wena okanye umntu omaziyo uxelelwe ngugqirha ukuba kufuneka benze utyando olubizwa ngokuba yi-'proctocolectomy'. Kuqhelekile ukuba uzive usoyika kwaye unexhala xa usiva eli gama. Mhlawumbi unemibuzo emininzi engqondweni yakho, efana nokuthi "Luyintoni olu tyando? Kutheni ndiludinga olu? Buza kuba njani ubomi bam emva koku?" Ungakhathazeki. Masithethe ngako konke oku ngendlela elula kakhulu, inyathelo ngenyathelo, njengokuba ubuya kuthetha nomhlobo.
Ngamafutshane, yintoni iProctocolectomy?
I-proctocolectomy yinkqubo yotyando esusa inxalenye okanye yonke ithumbu lakho elikhulu (ikholoni) kunye ne-rectum.
Ngoku masicacise oku ngakumbi. Inkqubo yethu yokwetyisa inenxalenye ebizwa ngokuba yi-large intestine. Iquka iindawo ezintathu: i-colon, i-rectum, kunye ne-anus. Cinga ngayo njengetyhubhu ende.
- Ikholoni: Le yeyona nxalenye inkulu yale tube. Kulapho ke inkunkuma eshiyekileyo emva kokuba sityile ukutya esikutyayo ifunxwa khona ize iguqulwe ibe yimo eqinileyo, ebizwa ngokuba yindle.
- I-Rectum: Le yinxalenye emfutshane yamathumbu amakhulu egcina indle okwethutyana ngaphambi kokuba iphume emzimbeni.
- Impundu: Le yindawo apho ilindle liphuma khona emzimbeni.
Kwi-proctocolectomy, igama elithi "procto" libhekisa kwi-rectum kwaye elithi "colectomy" libhekisa ekususweni kwe-colon. Ngoko ke , i-proctocolectomy lutyando olususa zombini i-colon kunye ne-rectum. Ngamanye amaxesha, ukuba i-colon kuphela isusiwe, ibizwa ngokuba yi-colectomy. Ukuba i-rectum kuphela isusiwe, ibizwa ngokuba yi-proctectomy. Ngaba uyayiqonda umahluko?
Kutheni kufuneka wenze olu hlobo lotyando?
Oogqirha bacebisa utyando olukhulu olufana nolu kuphela xa kukho isizathu esibalulekileyo. Olu tyando ludla ngokwenziwa ukuba imeko kwi-colon okanye i-rectum ithintela i-colon okanye i-rectum ekusebenzeni kakuhle, okanye ukuba imeko ibeka ubomi esichengeni.
Nazi ezinye zezizathu eziphambili:
- Izifo Zamathumbu Ezivuthayo (IBD): Ezi ziimeko ezibangela ukudumba okuhlala ixesha elide kunye nezilonda emathunjini. I-Ulcerative Colitis kunye neSifo sikaCrohn zezona mizekelo iphambili. Abanye abantu kufuneka basuswe iindawo ezigulayo zamathumbu abo xa bengenakukwazi ukulawulwa ngamayeza.
- Umhlaza we-Coloral Ectopic kunye neemeko ezingaphambi komhlaza: Xa iiseli zomhlaza zikhula kwi-colon okanye i-rectum, okanye xa kuvela ii-polyps ezinokuba ngumhlaza (iimeko ezifana ne -Familial Adenomatous Polyposis ), unyango olungcono kukususa ngokupheleleyo iindawo ezinesifo.
- Ezinye izizathu:
- I-Ischemia yenzeka xa igazi liphuma emathunjini kwaye izicubu ziyafa.
- Iimeko zeDiverticulitis ezinzima.
- Ukulimala kwamathumbu ngenxa yengozi enkulu.
- Ukuqhinwa okunzulu okungenakunyangwa ngamayeza.
Eyona nto ibalulekileyo kukuba olu tyando lwenziwa ukuze kusindiswe ubomi bakho kwaye kukunike ubomi obungcono nobukhululekileyo.
Uphuma njani ebhedini emva kotyando?
Lo ngumbuzo omkhulu engqondweni yomntu wonke. Emva kokuba kususwe ikholoni kunye ne-rectum, indlela eqhelekileyo yokuphuma kwendle ayisekho. Uzikhupha njani ke ngoko izinto zokulahla indle?
Impendulo yoku ixhomekeke kuhlobo lwe-proctocolectomy oyenzayo. Ugqirha wakho uya kugqiba uhlobo lotyando olukulungeleyo ngokusekwe kwimeko yakho yempilo kunye nesizathu sotyando. Makhe sijonge iintlobo.
Ziziphi iintlobo zotyando lwe-proctocolectomy?
Zininzi iindlela zokwenza olu tyando. Ugqirha wakho uza kukhetha indlela efanelekileyo kuwe.
| Uhlobo lotyando | Ingcaciso elula yoko kwenzekayo |
|---|---|
| I-Proctocolectomy ene-Ileostomy (nge-ileostomy) | Kule nkqubo, ikholoni kunye ne-rectum zisuswa ngokupheleleyo. Emva koko, inxalenye yokugqibela yamathumbu amancinci, ebizwa ngokuba yi-ileum , ikhutshwa ngesikhumba sesisu kwaye kudalwe umngxuma (stoma). Indle iphuma ngale mngxuma. Ingxowa incamatheliswa ngaphandle kwayo. Abanye abantu kufuneka bayinxibe ngokusisigxina, ngelixa abanye benxiba okwethutyana kuphela. |
| I-Proctocolectomy yokubuyisela umva nge-Ileoanal Pouch (Utyando lokutshintsha) | Kule nkqubo, i-colon kunye ne-rectum nazo ziyasuswa, kodwa i-anus ishiywa injalo. Okulandelayo, kwenziwa i-packet yangaphakathi ukusuka esiphelweni samathumbu amancinci (ileum). Le ngxowa, njenge-rectum yokuqala, inceda ukubamba indle okwethutyana. Le ngxowa idityaniswa ne-anus (ileoanal anastomosis).Oku kukuvumela ukuba ukhuphe indle ngokuqhelekileyo. Oku kungenziwa ngotyando olunye okanye ezimbini. |
| I-Proctocolectomy engaphantsi (ukususa inxalenye) | Oku kuquka ukushiya inxalenye yekholoni okanye i-rectum. Umzekelo, inkqubo kaHartmann isusa kuphela inxalenye yokugqibela yekholoni (i-sigmoid colon) kunye ne-rectum. Ukuba oku kwenziwe, iindawo eziseleyo eziphilileyo zekholoni zinokuphinda ziqhagamshelwe kwakhona (i-anastomosis) , ukuze ube nokuhamba kwamathumbu okuqhelekileyo. Ngamanye amaxesha i -colostomy yexeshana (ukuvulwa kwekholoni) inokufakwa de inxeba liphole. |
Yintoni omele uyenze ngaphambi kotyando?
Ukuba ayilotyando olungxamisekileyo, uya kuba nexesha elaneleyo lokulungiselela.
- Kwiiveki ezimbalwa ngaphambili: Thetha nogqirha wakho malunga notyando, iintlobo zalo, iingozi, kunye neenzuzo. Buza nayiphi na imibuzo onayo.
- Iiveki ezimbini ngaphambi: Ukuba uthatha amayeza okunciphisa igazi, ugqirha wakho uya kukucebisa ukuba uyeke okanye unciphise amayeza lawo. Kwakhona, zama ukugcina amathumbu akho esempilweni ngokutya ifayibha eninzi nokusela amanzi amaninzi ngeli xesha.
- Iiyure ezingama-24 ngaphambi: Ngosuku olungaphambi kotyando, uza kunikwa isicoci samathumbu ukuze ucoce amathumbu akho ngokupheleleyo. Uza kuvunyelwa kuphela ukusela ulwelo olucacileyo, olufana namanzi kunye nesuphu, ngaloo mini. Usenokunikwa nee-antibiotics ukuthintela usulelo emva kotyando.
Kwenzeka ntoni ngexesha lotyando?
Xa usiya esibhedlele, uza kufakwa ilokhwe yotyando. I-catheter ye-IV iza kufakwa emthanjeni wakho kwaye uza kunikwa i-saline kunye nayo nayiphi na imithi efunekayo. Emva koko uza kuthathwa usiwe kwigumbi lotyando.
Ingcali yokubulala iintlungu iza kukufaka phantsi kwe-anesthesia eqhelekileyo. Awuyi kuva nto ngexesha lotyando. Uza kuqhagamshelwa kumatshini (i-ventilator) ukuze ukuncede uphefumle.
Utyando Oluvulekileyo? Utyando lweLaparoscopic?
Kule mihla, uninzi lotyando lwe-proctocolectomy lwenziwa nge-laparoscopically . Oku kuthetha ukuba endaweni yokwenza umngxuma omkhulu esiswini, utyando lwenziwa ngemingxunya embalwa emincinci, apho kufakwa khona ikhamera kunye nezixhobo zotyando ezincinci kakhulu. Le ndlela ivumela ukuchacha ngokukhawuleza, iintlungu ezincinci, kunye namanxeba amancinci. Nangona kunjalo, le ndlela ayifanelekanga kuye wonke umntu. Kwiimeko ezinzima okanye ezingxamisekileyo, utyando oluvulekileyo lwendabuko luyafuneka.
Ngexesha lotyando, ugqirha ususa ngononophelo ikholoni enesifo kunye ne-rectum. Emva koko, njengoko bekutshiwo ngaphambili, kwenziwa i-ileostomy/colostomy okanye amathumbu adityaniswe kwakhona (i-anastomosis).
Kwenzeka ntoni emva kotyando?
Emva kotyando, kuya kufuneka uhlale esibhedlele kangangeveki. Ngeli xesha, uya kwaziswa kancinci kancinci ngokutya okumanzi uze emva koko ufundiswe kancinci kancinci ngokutya okuqinileyo.
Ukuba une-ostomy (ileostomy/colostomy), i-Wound Ostomy Continence Nurse (WOCN) iya kukunceda. Baza kukufundisa yonke into ekufuneka uyazi malunga nokusebenzisa i-ostomy bag kunye nokugcina i-stoma yakho (ukuvula esiswini sakho) icocekile. Nangona iyi-ostomy yexeshana, kuya kuthatha iinyanga ezininzi ngaphambi kokuba uxoxe ngamanyathelo alandelayo (ukuyisusa okanye ukwenza i-inside pack) nogqirha wakho.
Ziziphi iingozi kunye neengxaki ezinxulumene nolu tyando?
Njengakwezinye iintlobo zotyando, kukho iingozi ezithile ezibandakanyekileyo, kodwa ezi azixhaphakanga kakhulu.
| Uhlobo lwengxaki | Izinto ezinokwenzeka |
|---|---|
| Iingozi eziqhelekileyo zotyando | Iimpendulo xa umntu ephathwa yi-anesthesia, umonakalo kwizitho ezingqongileyo, ukopha kakhulu, kunye nosulelo. |
| Iingxaki eziphathelele utyando | - Ukuvaleka kwamathumbu: Izicwili ezivalwe ngenxa yotyando zinokubangela ukuba amathumbu avaleke. - Ukonakala kwemithambo-luvo: Utyando lwempundu lunokonakalisa imithambo-luvo ebandakanyekayo ekusebenzeni ngokwesondo okanye ekuchameni. Ezi zihlala ziphola ngokuhamba kwexesha. |
| Iingxaki ezinxulumene ne-Ostomy (Ileostomy/Colostomy) | - Ukunganyamezelani nolusu: Ulusu olujikeleze i-stoma lunokuba bomvu kwaye lube buhlungu ngenxa yokudibana nendle. - Utshintsho kwi-stoma: I-stoma ingatshona ngaphakathi ukusuka kwinqanaba lesikhumba (ukurhoxa) okanye iphume kakhulu (ukurhoxa). - I-Phantom Rectum: Nokuba i-rectum isusiwe, abanye abantu basenokuziva befuna ukuya ngasese. Oku kuya kuncipha ngokuhamba kwexesha. |
| Iingxaki Ezinxulumene Nesingxobo Sangaphakathi | - I-Pouchitis: Ukudumba kwangaphakathi kwesingxobo esisandula ukwenziwa. Oku kunyangwa ngamayeza okubulala iintsholongwane. - Ukuvuza kwe-anastomotic: Ukuvuza kwindawo apho uqhagamshelwano lwamathumbu lukhona. Le yimeko engaqhelekanga kodwa imbi kakhulu. - Ubunzima bexeshana bokulawula ukuhamba kwamathumbu: Kwinqanaba lokuqala, kunokuba nzima ukulawula ukuhamba kwamathumbu ngenxa yemisipha ebuthathaka yempundu. Oku kuya kuphucuka ngokuzilolonga nexesha. |
Injani imeko yokhathalelo emva kotyando?
Kungathatha iinyanga ezininzi ukuba uphile ngokupheleleyo. Ngeli xesha, kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngononophelo.
- Ukhathalelo lwenxeba: Ugqirha okanye umongikazi uza kukufundisa indlela yokucoca inxeba nokutshintsha ibhandeji.
- Ukhathalelo lwe-Ostomy: Uza kufunda indlela yokukhupha i-ostomy bag izihlandlo ezininzi ngemini kwaye ugcine ulusu olujikeleze i-stoma lucocekile.
- Ukutya: Emva kokuba ufikile ekhaya uvela esibhedlele, kancinci kancinci qala ukutya okuqinileyo. Endaweni yokutya isidlo esikhulu ngaxeshanye, yitya kancinci amaxesha amaninzi ngemini. Hlafuna ukutya kwakho kakuhle.
- Ukufunxa amanzi emzimbeni: Oku kubaluleke kakhulu. Ekubeni inxalenye enkulu yekholoni yakho isusiwe, umzimba wakho uya kufunxa amanzi amancinci. Ngoko ke kubalulekile ukusela amanzi amaninzi kunye nolwelo imini yonke.
Ufika nini kugqirha
Emva kokubuya ekhaya emva kotyando, ukuba unezinye zezi mpawu zilandelayo , fowunela ugqirha wakho ngoko nangoko okanye uye kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele esikufutshane.
- Iimpawu zokuvaleka kwamathumbu ziquka ukuqhina, iintlungu zesisu, ukudumba, kunye nokucaphuka.
- Iimpawu zesifo esosulelayo ezifana nentlungu eqatha yesisu, ukudumba, ukuphuma kobofu enxebeni, kunye nomkhuhlane.
Utyando lwe-proctocolectomy lutyando olukhulu. Kodwa lunokukunceda ufumane isiqabu kwimeko yexesha elide kwaye luphucule umgangatho wobomi bakho. Ngobuchwepheshe banamhlanje, iibhegi ze-ostomy zinokwenziwa zingabonakali kwaye zikhululekile kakhulu. Thetha nogqirha wakho malunga neendlela onokukhetha kuzo kwaye wenze isigqibo esifanelekileyo kuwe.
Umyalezo Wokuya Ekhaya
- I-proctocolectomy lutyando olusindisa ubomi olususa i-colon kunye ne-rectum. Ihlala isenziwa kwiimeko ezinzima ezifana ne-IBD kunye nomhlaza.
- Indlela yokukhupha amathumbu emva kotyando iyahluka. Kukho iindlela ezifana ne-ileostomy (ingxowa yangaphandle) okanye ingxowa yangaphakathi (ingxowa yangaphakathi).
- Thetha ngokukhululekileyo nogqirha wakho malunga nohlobo lotyando olulungele wena kwaye ufumane iimpendulo kuyo yonke imibuzo yakho.
- Kuthatha ixesha ukuchacha emva kotyando. Ngeli xesha, landela imiyalelo kagqirha wakho ngononophelo, ingakumbi malunga nokutya kunye nolwelo olusetyenziswayo.
- Nangona ukuhlala ne-ostomy ekuqaleni kunokubonakala kunzima, ngoqeqesho olufanelekileyo kunye nenkxaso, kunokuba yinxalenye yobomi obuqhelekileyo.
- Ukuba ufumana naziphi na iimpawu ezingaqhelekanga (intlungu enzima, umkhuhlane, isicaphucaphu) emva kotyando, funa ingcebiso kagqirha ngokukhawuleza.
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