Ngaba ukhe wenziwa utyando lokususa inyongo yakho? Ngaba usenentlungu enzima ngamanye amaxesha kwicala eliphezulu lasekunene lesisu sakho? Ngaba ifana nentlungu oyifumanayo ngenxa yamatye enyongo? Abantu abaninzi bacinga ukuba emva kokuba inyongo yabo isusiwe, iintlungu zesisu zabo ziphela ngokupheleleyo. Kodwa ngamanye amaxesha unobangela wale ntlungu ayikuko oko sikucingayo, kodwa yinto eyahlukileyo. Yiloo nto siza kuthetha ngayo namhlanje.
Ngamafutshane, yintoni iSphincter yase-Oddi?
Ukuze sikuqonde oku, masiqale sijonge inkqubo yokwetyisa emzimbeni wethu. Yinto entsonkothileyo kakhulu nemangalisayo. Amalungu amaninzi, njengesibindi sethu kunye nepancreas, asebenzisana ukuguqula ukutya esikutyayo kube ngamandla.
- Isibindi: Kulapho kuveliswa khona ikhemikhali ebizwa ngokuba yi-bile. Igcinwa okwethutyana kwi-gallbladder.
- I-Pancreas: Le gland ivelisa ii-enzymes ezinceda ekugayeni ukutya.
Inyongo evela esibindini kunye nee-enzymes ezivela kwi-pancreas kufuneka zihambe kunye ziye emathunjini ethu amancinci. Imisipha emincinci elawula olo hambo, esebenza njengesango, ibizwa ngokuba yiSphincter of Oddi .
Xa isebenza kakuhle, esi sihlunu, esibizwa ngokuba yiSphincter of Oddi, sivuleka ngexesha elifanelekileyo, sivumela inyongo kunye nee-enzymes ukuba zidlulele emathunjini amancinci. Emva koko siyavaleka kwakhona.
Ngoko ke yintoni iSphincter of Oddi Dysfunction (SOD)?
Ngamafutshane, i-Sphincter of Oddi Dysfunction kuxa elo sango sithethe ngalo, umsipha obizwa ngokuba yi-Sphincter of Oddi, ungavuli kakuhle xa kufanele. Kwenzeka ntoni ke ngoko? Ukuba ii-enzymes ze-bile kunye ne-pancreatic azikwazi ukungena emathunjini amancinci zize zibambeke kuloo mbhobho. Xa ibambeke ngolu hlobo, ibangela iintlungu zesisu eziqatha, ezifana nezo zenzekayo xa une-gallstones.
Le meko idla ngokubonakala kubantu abasuswe inyongo yabo (cholecystectomy). Ngenxa yesi sizathu, ngamanye amaxesha ibizwa ngokuba yi-"post-cholecystectomy syndrome."
Ziziphi iintlobo eziphambili kunye neendidi zale meko?
Le meko inokwahlulwahlulwa ibe ziintlobo ezimbini eziphambili kunye neendidi ezintathu. Kubalulekile ukwazi oku, kuba unyango luxhomekeke kolu hlobo.
| Uhlobo / Udidi | Icacisiwe ngokulula |
|---|---|
| Iindidi ezimbini eziphambili | |
| I-Biliary Dyskinesia | Oku kwenzeka xa imibhobho yenyongo ivalekile, nto leyo ethintela inyongo ukuba ingangeni emathunjini amancinci. |
| I-Pancreatitis | Kwimeko enjalo, ukuvaleka kwenzeka kwi-pancreas, okubangela ukudumba kwe-pancreas. |
| Iindidi ezintathu eziphambili | |
| Iindidi I kunye ne-II | Kwezi ndidi zimbini, oogqirha banokufumana ubungqina obucacileyo bengxaki ngokuvavanya. Umzekelo, uvavanyo lwegazi olungaqhelekanga okanye iskeni ye-ultrasound ebonisa imibhobho yenyongo evulekileyo okanye imibhobho yepancreatic. |
| Udidi III | Olu lolona hlobo kunzima ukulubona. Kuba akukho bungqina bucacileyo boku kwiingxelo zegazi, kwiiskeni, njl. Ubungqina bodwa besi sifo yintlungu yesisu yomguli. Ke ngoko, ukunyanga oku nako kunzima kancinci. |
Zithini iimpawu zesi sifo?
Uphawu oluphambili noluqhelekileyo lwale meko ziintlungu zesisu eziqatha, ezifana nentlungu eyenzeka xa kuvela amatye enyongo.
- Apho intlungu ivela khona: Intlungu evuthayo iqala kwicala eliphezulu lasekunene lesisu.
- Ukusasaza iintlungu: Ngamanye amaxesha le ntlungu ingavakala ngathi iya egxalabeni lasekunene okanye emqolo.
- Ubude bexesha lentlungu: Intlungu idla ngokuphela emva kwemizuzu engama-30 ukuya kwiyure. Nangona kunjalo, ingabuya ngenye imini.
Ukongeza kule ntlungu iphambili, ezinye iimpawu ezininzi zinokubonwa:
- Isicaphucaphu nokuhlanza
- Ifiva
- Ukugodola
- Urhudo
Into ebalulekileyo kukuba ezi mpawu azifani rhoqo. Ngezinye iintsuku ziyafika zidlule, ngelixa kwezinye iintsuku zinganyamezeleki.
Kutheni oku kusenzeka? Zithini izinto ezibangela umngcipheko?
Akukho sizathu sinye sale nto. Ngamanye amaxesha amanxeba okanye ukudumba kwemibhobho yenyongo kunokuthintela ukuhamba kwenyongo. Ngamanye amaxesha, ngaphandle kokuvaleka, kunokubangelwa yingxaki ye-sphincter yemisipha ye-Oddi ngokwayo.
Kodwa kukho amaqela aliqela asengozini enkulu yokuba nale meko.
- Eyona ixhaphakileyo: Abafazi abaphakathi kweminyaka engama-20-50 ubudala abaye basuswa inyongo yabo ngotyando.
- Ezinye izinto ezinobungozi:
- Abantu abaye benza utyando lokunciphisa umzimba (Gastric bypass surgery).
- Abantu abafumana i-pancreatitis ephindaphindayo.
- Abantu ababenamatye enyongo.
- Abantu abaye bafakelwa isibindi.
- Abantu abane-thyroid engasebenzi kakuhle (i-Hypothyroidism).
- Abantu abane-Irritable Bowel Syndrome (IBS).
- Abantu abasela utywala kakhulu.
- Abantu abasebenzisa iintlungu ezithile (ingakumbi ii-opiates).
Ngaba kunokuba yingozi ukuba ayinyangwa?
Le ayisiyongxaki isongela ubomi, kwaye iingxaki ezinkulu azixhaphakanga. Nangona kunjalo, iintlungu eziqatha ezibangelwa yiyo zinokuba ngumqobo omkhulu ekusebenzeni kwakho ngokuqhelekileyo.
Kodwa ukuba iyaqhubeka ngaphandle konyango, ezi meko zilandelayo zisenokungenzeki rhoqo:
- I-pancreatitis engapheliyo: Umonakalo ongenakuguqulwa kwi-pancreas obangelwa kukudumba okuqhubekayo.
- I-Jaundice: Ukutyheli kolusu kunye namhlophe emehlweni okubangelwa kukuqokelelana kwe-bilirubin, inxalenye yenyongo, emzimbeni.
Ugqirha usifumanisa njani esi sifo?
Ukuba unale mpawu, into yokuqala ugqirha wakho aza kuyenza kukujonga ezinye iimeko ezinokubangela iintlungu zesisu sakho, kuba olu hlobo lwentlungu lunokubangelwa zezinye iimeko ezininzi.
Umzekelo, kufuneka uqinisekise ukuba akukho zimo zinzima ezifana nesifo sesilonda sesisu, i-choledocholithiasis, okanye umhlaza we-pancreatic okanye we-bile duct. Okumangalisayo kukuba, iintlungu zezinye izifo zentliziyo (ezifana ne-angina) zinokuvakala njengeentlungu zesisu.
Emva kokuba ugqibe ukuba zonke ezi zinto azikho, ugqirha wakho angakucela ukuba wenze ezi mvavanyo:
- Uvavanyo lwegazi: Jonga amanqanaba aphezulu esibindi kunye neeenzyme zepancreas.
- Uvavanyo lomfanekiso:Jonga naziphi na iingxaki kwi-sphincter yemisipha okanye imibhobho ye-Oddi. Oku kungabandakanya iimvavanyo ezifana ne-Abdominal Ultrasound, i-CT scan, i-Endoscopic Ultrasound (EUS), i-Upper Endoscopy, kunye ne-Magnetic Resonance Cholangiopancreatography (MRCP).
Uvavanyo olukhethekileyo: i-ERCP eneManometry
Ngamanye amaxesha, ukuba zonke ezi mvavanyo aziphelelanga, ugqirha unokukuthumela kuvavanyo olukhethekileyo olubizwa ngokuba yi -Endoscopic Retrograde Cholangiopancreatography (ERCP) nge-manometry .
Oku kuquka ukuya kwiSphincter yase-Oddi ngoncedo lwe-endoscope, ukufaka ityhubhu encinci yeplastiki, nokulinganisa uxinzelelo ukuze ubone ukuba loo msipha uyaqina kwaye wande kangakanani.
Kodwa olu vavanyo lwe-ERCP luza nomngcipheko omncinci. Abanye abantu, malunga ne-15 ukuya kwi-30 kwi-100, banokuba ne-pancreatitis emva kolu vavanyo. Ke ngoko, oogqirha benza oku kuphela emva kokucingisisa ngononophelo kwaye kuphela xa kuyimfuneko.
Zithini iindlela zonyango zoku?
Indlela yonyango ixhomekeke kubukhali beempawu zakho kunye nodidi okulo.
1. Ukuba intlungu ayinzima kakhulu (ingakumbi kudidi lwesithathu):
Ugqirha uza kukunika amayeza okuthomalalisa iintlungu (angengo-opioid) kunye namayeza okuthomalalisa imisipha.
2. Ukuba intlungu inzima (kwiindidi I kunye ne-II):
Ukuba kunzima ukulawula ngamayeza, ugqirha angakuthumela kunyango olubizwa ngokuba yi -ERCP nge-sphincterotomy . Oku kwenziwa phantsi kwe-anesthesia okanye phantsi kwe-anesthesia. Ugqirha usebenzisa i-endoscope ukuya kwi-Sphincter yase-Oddi, asike isixa esincinci semisipha ebambekileyo, aze ayikhulule. Kwangaxeshanye, bajonga amatye kwimibhobho yenyongo.
Iingozi zonyango lwe-sphincterotomy
Olu nyango lunceda ekunciphiseni iintlungu kwizigulane ezininzi ezineendidi I kunye ne-II. Nangona kunjalo, ikwayinkqubo enzima enemingcipheko ethile.
- Malunga ne -10% - 15% yezigulana zinokuba neengxaki ezifana ne-pancreatitis.
- Nangona oku kurhawuzelela kudla ngokuba kuncinci, ngamanye amaxesha kunokuba nzima kwaye kube yingozi ebomini.
- Kwiimeko ezinjalo, kusenokufuneka uhlale esibhedlele ixesha elide ukuze ufumane unyango.
Ngoko ke, oogqirha basebenzisa olu nyango kuphela ukuba alunakulawulwa ngolunye unyango.
Umyalezo Wokuya Ekhaya
- Ukuba uyaqhubeka nokuba nentlungu esiswini emva kokususwa kwenyongo yakho, musa ukuyityeshela. Ngokuqinisekileyo bonana nogqirha.
- Le ntlungu isenokuba ibangelwa yiSphincter of Oddi Dysfunction (SOD), imeko enokwenzeka nokuba inyongo ayikho.
- Kukho iintlobo ezahlukeneyo zesi sifo. Ezinye zifumaneka lula ngovavanyo, kodwa ezinye (ingakumbi uhlobo lwesithathu) kunzima ukuzibona.
- Kukho unyango olufana neepilisi kunye ne-ERCP ene-sphincterotomy, ezenziwa kuphela xa kuyimfuneko. Nangona kunjalo, khumbula ukuba ezi ndlela zinemingcipheko ethile.
- Thetha nogqirha wakho malunga neempawu zakho, indlela eziqala ngayo, kunye nohlobo lwentlungu yakho. Oku kuya kukunceda ukhethe unyango olufanelekileyo nolukhuselekileyo kuwe.
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