Xa ugqirha wakho ekuxelela ukuba kufuneka wenze utyando lwamathumbu amakhulu, kuyinto eqhelekileyo ukuziva uloyiko olukhulu kunye nexhala. Xa usiva igama elifana nelithi "proctocolectomy," linokubonakala linzima nangakumbi. Kodwa ungakhathazeki. Olu lutyando olusindisa ubomi olunokukunceda uphile ubomi obungcono ngokunciphisa iimpawu zakho zangoku. Siza kuthetha ngayo yonke into ngendlela elula onokuyiqonda.
Yintoni kanye kanye iProctocolectomy?
Ngamafutshane, i-proctocolectomy kukususwa kwekholoni yakho kunye nenxalenye yokugqibela ye-rectum yakho ngotyando.
Masiyicacise ngakumbi le nto. Amathumbu amakhulu yinxalenye ende efana nombhobho wenkqubo yethu yokugaya ukutya. Anamacandelo amathathu aphambili:
1. Ikholoni: Le yeyona nxalenye inkulu. Ifunxa amanzi kwinkunkuma eseleyo ekutyeni esikutyayo ize iwaguqule abe yimo eqinileyo, ebizwa ngokuba yindle.
2. I-Rectum: Le yinxalenye emfutshane ye-rectum elandela i-colon. Kulapho indle igcinwa khona okwethutyana ngaphambi kokuba ikhutshwe.
3. Impundu: Ngumngxuma apho ilindle liphuma khona emzimbeni.
Ngoko ke, kwi-proctocolectomy, zombini i-colon kunye ne-rectum ziyasuswa, okanye inxalenye yazo. Igama elithi "Procto" lithetha i-rectum. Igama elithi "Colectomy" lithetha ukususwa kwe-colon.
Kutheni kufuneka wenze olu hlobo lotyando?
Kukho izizathu ezininzi zokuba utyando olukhulu kangaka lunokwenziwa. Isizathu esiphambili kukuba isifo esisemathunjini sithintela loo nxalenye yomzimba ukuba isebenze kakuhle okanye eso sifo sibeka ubomi esichengeni.
| Imeko yezonyango | Ingcaciso elula |
|---|---|
| Izifo Zamathumbu Ezivuthayo | Ukuba ingaphakathi lamathumbu lihlala lisenzakele kwaye livuvukala ngenxa yeemeko ezifana ne -Ulcerative Colitis kunye nesifo sikaCrohn , utyando lunokufuneka ukuba imeko ayinakulawulwa ngamayeza. |
| Umhlaza we-Coloral kunye neemeko ezingaphambi komhlaza | Ukuthintela ukusasazeka kweeseli zomhlaza wamathumbu amakhulu okanye kwiimeko ezifana neFamilial Adenomatous Polyposis (FAP) , imeko yelifa ebangela amakhulu ee-polyps ezinokuthi zibe ngumhlaza. |
| Ezinye izizathu | Iingxaki ezinje ngokufa kwezicubu zamathumbu ngenxa yokulahlekelwa yigazi (ischemia), ukuqhina okukhulu, ukwenzakala okukhulu kwamathumbu, okanye i-diverticulitis . |
Uzikhupha njani inkunkuma emva kotyando?
Lo ngumbuzo omkhulu abantu abaninzi abanawo. Xa ikholoni kunye ne-rectum zisusiwe, indlela eqhelekileyo yokuphuma kwendle iyalahleka. Uzikhupha njani ke ngoko izinto zokulahla indle? Impendulo yoku ixhomekeke kuhlobo lwe-proctocolectomy oyenzayo. Ugqirha wakho uya kumisela eyona ndlela ifanelekileyo ngokusekelwe kwimeko yakho yempilo.
Kukho iindlela ezininzi eziphambili:
1. Inkqubo ye-Ileostomy
Oku kuquka ukudibanisa inxalenye yokugqibela yamathumbu akho amancinci, ebizwa ngokuba yi-ileum, nomngxuma omncinci (stoma) owenziwe eluswini lwesisu sakho. Emva koko ibhegi ye-ostomy incamathiselwa kumngxuma ukuze kuqokelelwe indle. Oku kunokuba yinto engunaphakade okanye yexeshana . Okwexeshana kwenziwa kuphela de umzimba wakho uphole. Oku kunokutshintshwa kamva ngotyando olunye.
2. Isikhwama se-Ileoanal (ukwenziwa kwesikhwama sangaphakathi)
Le yinkqubo enomdla kakhulu. Ikwabizwa ngokuba yiRestorative Proctocolectomy. Kuthathwa inxalenye yamathumbu akho amancinci (ileum) kwaye kwenziwa ingxowa encinci kuyo. Cinga ngayo njengenxalenye entsha yomzimba wakho enokubamba indle yakho okwethutyana, njengerectum yakho. Emva koko, ingxowa ibuyiselwa kwimpundu yakho. Emva kwale nkqubo, uya kukwazi ukuya kwindlu yangasese kwaye ukhululeke ngokuqhelekileyo emva kwexesha elithile. Eyona nkqubo ixhaphakileyo koku ibizwa ngokuba yi-J-pouch .
3. I-Proctocolectomy engaphantsi kwexabiso elipheleleyo (ukugcina inxalenye)
Kule meko, inxalenye yamathumbu amakhulu iyashiywa. Ukuba kunokwenzeka ukwenza njalo, inxalenye eseleyo yamathumbu inokuphinda idityaniswe kwi-anus okanye kwi-rectum (anastomosis). Nangona kunjalo, ngamanye amaxesha, kunokufuneka kwenziwe umngxuma wesikhashana esiswini kwaye kufakwe ibhegi yendle (colostomy) de indawo yokudibanisa iphole.
Eyona nto ibalulekileyo kukuba ugqirha wakho uza kuxoxa nawe ukuba zeziphi kwezi ndlela ezikulungeleyo. Ngoko ke, xoxa nogqirha wakho ngayo nayiphi na imibuzo okanye iinkxalabo onazo.
Kwenzeka ntoni ngaphambi, ngexesha, nasemva kotyando
Ngaphambi kotyando
Ukuba ayilotyando olungxamisekileyo, uya kuba nexesha lokulungiselela.
- Kwiiveki ezimbalwa ngaphambi: Ugqirha wakho uza kukuchazela ngolu tyando, iingozi zalo, kunye neendlela onokukhetha kuzo.
- Kwiiveki ezimbini ngaphambi: Ukuba uthatha amayeza okunciphisa igazi, uza kuxelelwa ukuba uyeke okanye unciphise. Uza kucetyiswa ukuba utye ukutya okunefayibha eninzi kwaye usele amanzi amaninzi.
- Iiyure ezingama-24 ngaphambi: Uza kunikwa isitofu sokucoca amathumbu ngokupheleleyo. Uza kuxelelwa nokuba utye ulwelo kuphela ngaloo mini. Usenokunikwa nee-antibiotics ukuthintela usulelo emva kotyando.
Ngexesha lotyando
Uza kulaliswa phantsi kwe-anesthesia, ngoko awuyi kuva nto. Olu tyando lungenziwa ngeendlela ezimbini eziphambili:
- Utyando Oluvulekileyo: Indlela yendabuko, eyenziwa ngokusikwa okukhulu esiswini.
- Utyando lweLaparoscopic: Olukwaziwa ngokuba lutyando lwe "keyhole", olu lwenziwa ngokwenza imingxunya embalwa esiswini kunye nokufaka ikhamera kunye nezixhobo ezithambileyo kuzo. Le ndlela ikhokelela ekupholeni ngokukhawuleza kunye nentlungu encinci.
Emva koko ugqirha uyayisusa ngononophelo inxalenye yamathumbu enesifo aze enze iinkqubo ezifunekayo (ileostomy, pouch, okanye re-connection) njengoko bekuxoxiwe ngaphambili.
Emva kotyando
Kuya kufuneka uhlale esibhedlele kangangeveki. Ngeli xesha, uya kutshintsha kancinci kancinci ukusuka kulwelo ukuya kukutya okuqinileyo. Ukuba une-ostomy (ibhegi), umongikazi oqeqeshwe ngokukodwa (WOCN - Wound Ostomy Continence Nurse) uya kukufundisa indlela yokuyisebenzisa kwaye agcine ulusu lwakho lucocekile.
Ziziphi iingxaki ezinokubakho?
Njengakwezinye iintlobo zotyando, kukho iingozi kunye neengxaki ezinokubakho, kodwa uninzi lwexesha ezi zezokwexeshana.
| Uhlobo lwengxaki | Inkcazo |
|---|---|
| Iingxaki eziqhelekileyo zotyando | Iimpendulo kwi-anesthesia, ukopha ngaphakathi, usulelo, ukuvaleka kwamathumbu, njl. |
| Iingxaki ezinxulumene ne-ostomy (ibhegi) | Usulelo lolusu olujikeleze istoma, oluhlaselayo okanye oluphumayo kwistoma.Imeko ebizwa ngokuba yi -phantom rectum nayo inokubakho. Le yimvakalelo yokuba kufuneka ukhuphe indle nangona i-rectum isusiwe. Oku kuya kuncipha ngokuhamba kwexesha. |
| Iingxaki ezinxulumene ne-Ileoanal Pouch (ingxowa yangaphakathi) | I-Pouchitis , ukuvuza kwe-anastomotic, kunye nokungakwazi ukuzibamba kwangethuba. Uninzi lwazo ziyanyangeka. |
Ziziphi iimeko ezingxamisekileyo ezifuna utyelelo lukagqirha?
Ukuba ufumana naziphi na kwezi mpawu zilandelayo emva kotyando lwakho, fowunela ugqirha wakho ngoko nangoko okanye uye kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele.
- Ukudumba, iintlungu zesisu, isicaphucaphu, kunye nokuqhina (ezi zisenokuba ziimpawu zokuvaleka kwamathumbu).
- Intlungu ebuhlungu yesisu, umkhuhlane, ukuphuma kobofu kwindawo etyumkileyo (ezi ziimpawu zosulelo).
Ungalibali, ukuba uziva into engaqhelekanga, ungayityesheli. Kungcono ukufuna ingcebiso kagqirha.
Umyalezo Wokuya Ekhaya
- Nangona i-proctocolectomy ilutyando olukhulu, inokunyanga izifo ezisongela ubomi kwaye ikuvumele ukuba uphile ubomi obutofotofo ngakumbi.
- Kukho iindlela ezahlukeneyo zokukhupha indle emva kotyando. Abanye abantu kufuneka baphile nebhegi ye-ostomy, ngelixa abanye banezinye iindlela ezibavumela ukuba bakhuphe indle ngokuqhelekileyo. Ugqirha wakho uya kugqiba ukuba yintoni ekulungeleyo.
- Kuthatha ixesha ukuphiliswa. Ungabuyela kubomi obuqhelekileyo kwiinyanga ezimbalwa. Kubaluleke kakhulu ukuba nomonde nokulandela imiyalelo kagqirha wakho ngeli xesha.
- Zive ukhululekile ukuxoxa nogqirha wakho ngazo zonke izinto ozicingayo, amathandabuzo akho, kunye nemibuzo yakho. Oku kuya kukunika amandla amakhulu engqondo.
- Nangona ukuhlala nebhegi ye-ostomy kunokuba ngumceli mngeni ekuqaleni, wakuba uyiqhelile, ungaqhubeka nokusebenza ngendlela eqhelekileyo. Kukho izixhobo ezininzi kunye neendlela ezikhoyo namhlanje zokunceda ngale nto.
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