Ngaba ubusoloko uziva iintlungu zesisu kunye nokungakhululeki kangangeentsuku? Ugqirha wakho usenokuba ukuxelele ukuba unesifo samathumbu esibangela ukudumba (IBD) esifana nesifo sikaCrohn. Xa unesi sifo ixesha elide, ezinye iindawo ngaphakathi kwamathumbu akho ziqala ukucutheka kancinci kancinci. Kufana nombhobho wamanzi obhajwa embindini. Ngoko ke, sibiza olu tyando lukhethekileyo ukwandisa ezi ndawo zicuthekileyo ngokuthi 'Strictureplasty'. Namhlanje, siza kuthetha ngayo yonke into ngokulula.
Yintoni kanye kanye iStrictureplasty?
Ngamafutshane, i-strictureplasty yinkqubo yotyando eyandisa indawo enciphileyo okanye evalekileyo emathunjini akho (ebizwa ngokuba yi-stricture). Oku kudla ngokubangelwa kukudumba okungapheliyo, okubangelwa zizifo zamathumbu ezivuthayo (IBD) ezifana nesifo sikaCrohn kunye ne-Ulcerative Colitis. Oku kudumba kubangela amanxeba kwiindonga zamathumbu, nto leyo ebangela ukuba ziqine kwaye zinciphe.
Ezi ntlobo ze-strictures zixhaphake kakhulu kwi:
- Inxalenye esezantsi yamathumbu amancinci (ileum)
- Ngokuphathelele ivalvu edibanisa amathumbu amancinci kunye namathumbu amakhulu (ivalvu ye-ileocecal).
Nangona kunjalo, le meko inokwenzeka nakwi-colon, rectum, kunye ne-anus. Injongo ephambili yolu tyando kukwandisa inxalenye encinci yamathumbu kunye nokubuyisela intshukumo eqhelekileyo yokutya, ngaphandle kokususa nayiphi na inxalenye yamathumbu.
Kutheni udinga olu tyando?
Xa inxalenye yamathumbu akho incipha ngolu hlobo, ukutya akukwazi ukuhamba kakuhle. Oku kunokubangela iimpawu ezininzi ezingathandekiyo nezibuhlungu.
| Uphawu | Ingcaciso elula |
|---|---|
| Intlungu ebuhlungu yesisu kunye nokuqhwalela | Le ntlungu yenzeka kuba amathumbu ayafinyela njengoko ezama ukudlulisa ukutya kuloo nto ivalekileyo. |
| Ukudumba kwesisu kunye nokurhawuzelela | Isisu siyadumba kuba ukutya nomoya azikwazi ukwehla kakuhle zize zibambeke kwindawo enye. |
| Isicaphucaphu nokuhlanza | Ukuba ukuvaleka kukhulu, ukutya kusenokungakwazi ukwehla kwaye kunokubuya kwakhona. |
| Ukuqhinwa | Ukuzithuma kuba nzima ngenxa yenkqubo yokucotha kokugaya ukutya. |
| Ukulahlekelwa ngumdla wokutya kunye nokunciphisa umzimba | Ngenxa yentlungu nokungonwabi, umnqweno wokutya uyaphela, kwaye umzimba awukwazi ukufunxa izondlo ngokufanelekileyo. |
| Ukudinwa kunye ne-Anemia | Amaxesha amaninzi, izilonda zenzeka kwezi ndawo zixineneyo. Ezi zilonda zopha kancinci, nto leyo ekhokelela ekubeni kubekho i-anemia ekuhambeni kwexesha. Le meko iyaphela emva kotyando. |
Eyona nto ibalulekileyo: Ukuba oku kuncipha kuyaqhubeka nokwanda, amathumbu anokuvaleka ngokupheleleyo (ukuvaleka kwamathumbu). Le yimeko eyingozi kakhulu kwaye isongela ubomi. Ke ngoko, ukuba uneempawu, kubalulekile ukubona ugqirha ngokukhawuleza.
Ngubani olu tyando lufanelekileyo kwaye alufanelekanga kuye?
Utyando lweStrictureplasty alulungelanga wonke umntu. Ugqirha wakho uza kwenza isigqibo esifanelekileyo ngokwemeko yakho.
| Abo bafanelekileyo utyando | Amatyala apho utyando lungakhuthazwa |
|---|---|
| Ukuba kukho ukuxinana okuliqela kwiindawo ezikufutshane nenxalenye ende yamathumbu. | Ukuba kukho ukuxinana okuliqela kwicandelo elifutshane lamathumbu, vala kunye. |
| Ukuba ukhe wahlinzwa amathumbu ngaphambili. | Ukuba kukho ukwenzakala, ukudumba, i-fistula, okanye ukukhula okungaqhelekanga kwindawo enciphileyo. |
| Ukuba unesifo sofuba esifutshane. | Ukuncitshiswa kukufutshane nendawo yotyando yangaphambili (i-anastomosis). |
| Ukuba kukho ukuncitshiswa kuphela, ngaphandle kokudumba okanye ukwenzakala kwindawo encitshisiweyo. | Ukuba unesithumbu esineembobo. |
| Ukuba uneempawu ezixhaphakileyo zesifo sikaCrohn. | Ukuba unengxaki yokungondleki kakuhle. |
Uzilungiselela njani ngaphambi kotyando?
Ngenxa yokuba olu lutyando olucwangcisiweyo, ugqirha wakho uza kwenza uvavanyo oluninzi kwangaphambili.
- Uvavanyo lweMifanekiso: Uvavanyo olufana ne-CT scan okanye iMagnetic Resonance Enterography (MRE) luya kwenziwa ukuze kubonwe ukuba ukuncitshiswa kwamathumbu akho kukuphi na kwaye bude kangakanani.
- Uvavanyo lweGazi: Uvavanyo lwegazi luya kwenziwa ukujonga imeko yakho yesondlo. Ukuba awondlekanga, unokunikwa izongezo zesondlo ngemithambo yegazi (`IV`) kangangeentsuku ezimbalwa ngaphambi kotyando. Oku kuya kukunceda ukuba uphile ngokukhawuleza emva kotyando.
- I-Stoma (ibhegi ye-Ostomy): Kwezinye iimeko, emva kotyando, kunokufuneka kwenziwe umngxuma wesikhashana (`stoma`) phezu kolusu lwesisu ukuze kungene ilindle, kwaye kunokufuneka kufakwe ibhegi (`ibhegi ye-ostomy`) kuyo de ithumbu liphole. Musa ukukhathazeka ngale nto. Ukuba oku kuyimfuneko, ugqirha wakho uya kukuchazela kakuhle ngaphambi kotyando.
Lwenziwa njani utyando?
I-Strictureplasty lutyando olukhulu olwenziwa phantsi kwe-anesthesia eqhelekileyo. Kuya kufuneka uhlale esibhedlele iintsuku ezimbalwa. Ngaphambi kokuba utyando luqale, uya kunikwa i-anesthesia eqhelekileyo, ukuze ungaziva ntlungu okanye ukhumbule naluphi na utyando.
Ngexesha lotyando, ugqirha wenza utyando ecaleni kwenxalenye encinci yamathumbu aze ayithunge. Cinga ngako njengokusika umbhobho ovalekileyo ngobude, wahlukanise iziphelo ezibini zomngxunya, aze azithunge kunye. Xa amathumbu ebanzi, ukutya kunokuhamba kuwo ngokulula kwakhona. Ukuba unezithintelo ezininzi, unokuzinyanga zonke ngotyando olunye.
Kukho iintlobo ezahlukeneyo zeStrictureplasty ngokuxhomekeke kubude bokuncitshiswa:
Heineke-Mikulicz Strictureplasty
Le yeyona ndlela isetyenziswa kakhulu. Yenzelwa ukuncitshiswa okungaphantsi kweesentimitha ezili-10 (malunga neesentimitha ezi-4).
UFinney okanye uJaboulay Strictureplasty
Ezi zisetyenziselwa ukuncitshiswa phakathi kweesentimitha ezili-10-20 (malunga neesentimitha ezi-8) ubude. Kolu tyando, amathumbu asongwa abe yimo 'U'.
I-Michelassi Strictureplasty
Le yinkqubo ekhethekileyo yokunciphisa ii-strictures ezinde ngaphezu kweesentimitha ezingama-20. Kule nkqubo, inxalenye encinci yamathumbu igoqwa kabini, amacala omabini adityaniswe, kwenziwa umsike omde, kwaye omabini athungelwa kunye.
Kuthatha ixesha elingakanani ukuphola emva kotyando?
Olu lutyando olukhulu, ngoko ke kuya kuthatha ixesha ukuba uphile. Kusenokufuneka uhlale esibhedlele kangangeveki . Ukuba kukho iingxaki, kunokufuneka uhlale ixesha elide.
- Intlungu: Usenokuba neentlungu zesisu kwiintsuku zokuqala emva kotyando. Ugqirha uza kukunika amayeza okudambisa iintlungu ngenxa yoku.
- Imida: Awuyi kukwazi ukwenza izinto ezifana nokuphakamisa iintsimbi okanye ukuqhuba kangangeeveki ezimbalwa.
- Lumka kwiintsholongwane: Kufuneka ulumke kakhulu malunga nokukhula kwesifo emva kotyando. Ukuba uneempawu ezifana nentlungu eqatha, umkhuhlane, ukubomvu okanye ukudumba kwindawo yotyando, okanye ukuphuma okungaqhelekanga kwinxeba, kufuneka wazise ugqirha wakho ngoko nangoko .
- Ukutya: Ngokuxhomekeke kwimeko yakho, ugqirha wakho okanye ingcali yesondlo ingacebisa ukutya okukhethekileyo (`ukutya okuthambileyo kwe-GI`).
- Unyango lwe-IBD: Into ebalulekileyo ekufuneka uyikhumbule kukuba olu tyando luyandisa kuphela ukuncitshiswa. Aluyinyangi i-IBD esisiseko (njenge-Crohn's). Ke ngoko, kuya kufuneka uqhubeke nokusebenzisa amanye amayeza emeko yakho.
Yintoni umahluko phakathi kwe-'Strictureplasty' kunye ne-'Bowel Resection'?
Lo ngumbuzo obuzwa ngabantu abaninzi. Kukho umahluko omkhulu phakathi kwezi ntlobo zotyando zimbini.
| Uphawu | Ukwandisa i-Strictureplasty (ukwandisa) | Ukususwa Kwamathumbu |
|---|---|---|
| Kwenziwe ntoni | Inxalenye enciphileyo yamathumbu ibanzi . | Inxalenye encinci yamathumbu iyasikwa kwaye ezinye iindawo ezimbini eziseleyo ziyadityaniswa. |
| Inzuzo ephambili | Ubude bonke bamathumbu buyagcinwa, nto leyo enciphisa umngcipheko we-'Short Bowel Syndrome' (iingxaki zokufunxwa kokutya) . | Umngcipheko wokuba ingxaki iphinde yenzeke kwindawo enye unokuncipha kancinci. |
| Umngcipheko wexesha elizayo | Kukho ithuba elikhulu lokuba utyando luza kufuneka kwakhona kwixesha elizayo. | Kukho amathuba amancinci okudinga utyando kwakhona kwixesha elizayo. |
Oogqirha badla ngokuzama i-strictureplasty kuqala, kuba ukugcina ubude bamathumbu kubaluleke kakhulu kwisondlo.
Umyalezo Wokuya Ekhaya
- I-Strictureplasty lutyando lokwandisa iindawo ezinciphileyo zamathumbu ngenxa yezifo ezifana ne-Crohn's. Ayibandakanyi ukusika iindawo ezithile zamathumbu.
- Olu tyando lunokuphelisa iimpawu ezifana neentlungu zesisu kunye nokudumba, kwaye lunciphise umngcipheko oyingozi wokuvaleka kwamathumbu ngokupheleleyo.
- Olu tyando alufanelekanga kuye wonke umntu. Ugqirha wakho uya kumisela unyango olufanelekileyo ngokusekelwe kwimeko yakho.
- Olu lutyando olukhulu, ngoko ke kuthatha ixesha ukuphola. Kukho iingozi ezifana nosulelo kunye nokopha.
- Olu tyando luza kuphelisa kuphela ukuxinana. Isifo esisisiseko (IBD) kufuneka sinyangwe.
- Ukuba unemibuzo malunga noku, ungoyiki ukuthetha nogqirha wakho ukuze ufumane yonke into echanekileyo.
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