'Ukuvuza' kwangaphakathi ngemva kokuhlinzwa? (Ukuvuza kwe-Anastomotic) Ake sifunde ngakho kalula!

Wake wacabanga ukuthi ngemva kokuhlinzwa okukhulu, kungavela izinkinga ngaphakathi emzimbeni esingazicabangi nhlobo? Njengoba nje uhlanganisa amapayipi amabili amanzi, ngezinye izikhathi kuvuza amanzi amancane avela ejoyintini, into efanayo ingenzeka lapho imithambo yegazi emibili emzimbeni wethu ixhunywe ngokuhlinzwa. Kwezokwelapha, lokhu sikubiza ngokuthi ukuvuza kwe-anastomotic . Njengoba lokhu kungaba kubi kakhulu, kubaluleke kakhulu ukuthi wena nabathandekayo bakho nazi ngakho.

Kuyini ngempela ukuvuza kwe-anastomotic?

Kalula nje, i-anastomosis inqubo yokuhlinzwa lapho iziphetho zamapayipi amabili omzimba zixhunywe khona ndawonye. Cabanga ukuthi bekufanele ususe ingxenye yamathumbu akho. Ngemuva kwalokho kufanele uphinde uxhume izingcezu ezimbili zamathumbu ezisikiwe. Lokho kuxhumana kubizwa ngokuthi i-anastomosis.

Manje, lokhu kuvuza kwe-anastomotic kwenzeka lapho uxhumano lungavaleki kahle, futhi okuqukethwe yilelo payipi kuphuma. Lokhu kungaba yingozi, ngoba akukuhle ukuthi okuqukethwe yizimbobo zomzimba wethu kuye kwezinye izindawo. Isibonelo, kunamabhaktheriya kokuqukethwe kwesistimu yakho yokugaya ukudla. Uma lokhu kufinyelela kwezinye izindawo esiswini sakho, kungabangela izifo.

Kwenzekani uma kukhona ukuvuza ngemva kokuhlinzwa kwamathumbu?

Ukususwa kwamathumbu kuyindlela evamile lapho kwenziwa khona i-anastomosis, futhi kungenzeka kube nokuvuza kwe-anastomotic. Uma okuqukethwe kwamathumbu kuvuza kungene emgodini wesisu, ulwelwesi lwesisu (i-peritoneum) lungatheleleka futhi luvuvuke. Lokhu kubizwa ngokuthi i-peritonitis . Lokhu kutheleleka kungasakazekela kwezinye izitho esiswini nasegazini. Uma kuba kubi kakhulu, kungaholela esimweni esisongela ukuphila esibizwa ngokuthi i-sepsis . I-Sepsis ukusabela ngokweqile komzimba ekuthelelekeni. Lokhu kungaholela ekushaqekeni , ukwehluleka kwezitho, noma ngisho nokufa.

Cabanga ukuthi bekuzokwenzekani uma izinto ezisezibindini zethu zasekhishini zingachithekela egumbini lokuphumula. Bekuzokwenzeka into efanayo uma izinto ezisezibilinini zethu zingachithekela esiswini sethu. Yingakho lokhu kuyingozi kangaka.

Enye into engavuza emgodini wesisu yindlela yakho yomchamo. Isibonelo, ngesikhathi sokufakelwa izinso noma ukuhlinzwa kwe-prostate, kungadingeka ukuthi wenze i-anastomosis. Uma lokhu kuvuza, umchamo ungaqoqana ngaphakathi emgodini wesisu. Lokhu kubizwa ngokuthi i-urinoma . Kukhona futhi ingozi yokutheleleka kanye ne-sepsis ngaphandle komgodi wesisu. Isibonelo, uma unokuvuza kwe-anastomotic emhubheni wakho, okuyingxenye yombhobho wakho wokudla, kungaholela ekuthelelekeni emgodini wesifuba sakho.

Kwenzeka nini ukuvuza kwe-anastomotic?

Ngezinye izikhathi lokhu kuvuza kungaba khona ngesikhathi sokuhlinzwa. Kodwa odokotela abahlinzayo bayakuhlola ngaleso sikhathi. Ngokuvamile, lokhu kwenzeka ngesikhathi senqubo yokuphulukiswa. Ukuvuza okuningi kuvela phakathi nesonto lokuqala ngemva kokuhlinzwa , kodwa okunye kungabambezeleka. Odokotela bazokuqapha lokhu amasonto ambalwa ngemva kokuhlinzwa. Ukuvuza okuncane, okuncane kungathatha isikhathi eside ukukhombisa imiphumela yako. Ukuvuza okwenzeka ngemva kwezinsuku ezingu-30 (`(Delayed Anastomotic Leak)`) akuvamile kakhulu.

Sivame kangakanani lesi simo?

Kubikwa ukuthi ukuvuza kwe-anastomotic kwenzeka cishe ku-5% wokuhlinzwa kwe-anastomosis. Kulokhu, ama-75% ahlotshaniswa nokuhlinzwa kwe-colectomy. Le ngozi iphezulu kakhulu ekuhlinzweni okwenziwa ekugcineni kwekholoni, i-rectum noma i-sigmoid colon. Lokhu kungenxa yokuthi indawo incane futhi kunzima ukuyihlinza, ikakhulukazi kwabesilisa.

Ubani okungenzeka kakhulu ukuthi athole ukuvuza kwe-anastomotic?

Eqinisweni, noma ubani oke wabhekana ne-anastomosis angathola le nkinga. Kodwa-ke, kunezici ezithile eziyingozi ezandisa amathuba okuba lokhu kwenzeke.

Izici zengozi yilezi:

• Ukubhema.
• Ukungondleki kahle noma i-anemia.
• Ukusetshenziswa kwemithi yokucindezela amasosha omzimba.
• Ukuba nezimila ezisezingeni eliphansi.
• Njengoba ngithole ukwelashwa ngemisebe.
• Usuvele unesifo esibizwa ngokuthi ``Sepsis`` noma ``Septic Shock`` emzimbeni.
• Ukumpontshelwa igazi ngesikhathi sokuhlinzwa (`(Ukumpontshelwa Igazi Ngesikhathi Sokuhlinzwa)`).
• Ukukhuluphala ngokweqile noma isifo sikashukela (`(Diabetes Mellitus)`).
• Ukuhlinzwa Okuphuthumayo.
• Ukuhlinzwa kuthatha isikhathi eside kakhulu.
• I-Anastomosis Yesinqe.
• Ukuba yindoda ekuzalweni (`(Ubulili Besilisa Obunikezwe)`).

Yini ebangela lokhu kuvuza?

Ukuvuza kwe-anastomosis kuvame ukubangelwa ukwehluleka kwenqubo yokuphola kwenxeba . Kunzima ukukhomba imbangela eyodwa, kodwa kunezici eziningana ezingaba nomthelela. Isibonelo:

• Ukucindezeleka okukhulu endaweni yokuhlinzwa: Yilokhu odokotela abahlinzayo abazama ukukugwema ngokuyinhloko ukuvimbela ukuvuza. Lokhu kuxhumana kungadonseka noma kuqiniswe ngesikhathi sokunyakaza. Le ngozi inkulu uma indawo yokuhlinzwa incane noma kunzima ukuyifinyelela.
• Ukutheleleka kwangaphambilini emzimbeni: Uma kukhona ukutheleleka kwangaphambilini, kungabangela ukuthi izicubu zivuvuke futhi zivuvuke. Ukuvuvukala kwesikhathi eside kungabangela nokwehla kwe-collagen . Odokotela abahlinzayo bazogeza indawo ngezixazululo ze-antiseptic bese benikeza ama-antibiotic.Ngisho noma uzama ukulawula ukutheleleka ngama-antibiotic, izicubu zingase zibe buthaka ngesikhathi sokuhlinzwa.
• Ukwehla kokugeleza kwegazi kuya emthanjeni oxhumanisayo (`(Ischemia)`): `(Ischemia)` kungaba yisimo esivele sikhona noma kungenzeka njengempendulo yokuhlinzwa.
• Ukuzivikela komzimba okubuthakathaka: Ezinye izimo zempilo, ukubhema, ukudla okunomsoco okungenampilo, noma ukusebenzisa `(Immunosuppressants)` kungenza buthaka isimiso somzimba sokuzivikela komzimba. Ukwelashwa ngemisebe nakho kulimaza izicubu futhi kubuthakathaka isimiso somzimba sokuzivikela komzimba. Lokhu kungenxa yokuthi abantu abaningi abahlinzwa `(Anastomosis)` bangabantu abanomdlavuza.

Ziyini izimpawu zokuvuza kwe-anastomotic?

Izimpawu zokuqala nezivame kakhulu ezibonakala kulesi simo yilezi:

• Ubuhlungu Besisu (`(Ubuhlungu Besisu)`) .
• Umkhuhlane (`(Umkhuhlane)`) .
• Ukuvuvukala kwesisu (kungenzeka ukuthi kungenxa ye-Peritonitis).
• I-ileus ekhubazekile engapheli (ukungasebenzi kahle kwamathumbu) ngemva kokuhlinzwa .

Uma isimo siba sibi kancane, izimpawu ezinjengalezi zingase zivele:

• Inhliziyo esheshayo (i-Tachycardia) .
• Ukuhlanya (`(Ukuhlanya)`) .
• I-Sepsis `(Sepsis)` .
• Ukushaqeka .

Ukubona kanjani lokhu ngqo?

Uma uya kudokotela wakho ngemva kokuhlinzwa, uzohlola isimo sakho ngokucophelela. Izimpawu zakho ezibalulekile (njengokushaya kwenhliziyo, izinga lokuphefumula, izinga lokushisa, kanye nomfutho wegazi), ukuhlolwa kwegazi, kanye nokusebenza kwamathumbu kuzohlolwa njalo. Uma unezimpawu zokutheleleka noma amathumbu akho engasebenzi kahle ngemva kokuhlinzwa kwamathumbu amakhulu, udokotela wakho angase asole ukuvuza kwe-anastomotic. Bazosebenzisa izivivinyo ze-imaging (ezifana nezikena) ukuqinisekisa lokhu - ngokuvamile i-CT scan , esebenzisa idayi yokuhlukanisa .

Iphathwa kanjani?

Uma kutholakala ukuthi unalolu hlobo lokuvuza, uzokwelashwa ngama -antibiotic ukulawula ukutheleleka. Ukwelashwa kuzoncika kubukhulu bokuvuza kanye nobunzima besimo sakho. Lokhu kungafaka:

• Ukumunca amanzi: Umzimba udinga ukukhipha uketshezi kanye/noma ukuvuvukala okuqongeleleke ngenxa yokutheleleka. Uma kungenzeka, udokotela uzokwenza lokhu ngenaliti engenalutho efakwe ngembobo encane esikhumbeni.
• Ukuphumula Kwamathumbu: Uma ukuvuza kusemathumbu, kuzodingeka uyeke ukudla noma ukuphuza ngomlomo ngesikhathi sokwelashwa. Udokotela wakho angakunika uketshezi olufakwa emthanjeni.uzonikezwa, futhi uma kudingeka, uzonikezwa ukudla okunomsoco ngemithambo yegazi.
• Ukuhlinzwa Okuphindaphindiwe: Udokotela ohlinzayo angadinga ukuhlola kabusha i-anastomosis bese enza olunye ukuhlinzwa. Uma kungenzeka, bazosebenzisa inqubo engangenisi kakhulu, njenge -laparoscopy . Lokhu kuhilela ukufaka ikhamera nge-incision encane ukuhlola umgodi wesisu. Bangase basebenzise nezinsimbi ezincane ukukhipha ithumba noma ukugeza umgodi ngezixazululo ze-antiseptic. Uma lokhu kungasebenzi, umgodi wesisu ungadinga ukuvulwa futhi ukuze kufike lapho kuvuza khona. I-anastomosis ingadinga ukuqinisa noma entsha ingadinga ukwenziwa endaweni ehlukile enezicubu ezinempilo. Ngezinye izikhathi, umzimba udinga ukunikezwa isikhathi esengeziwe sokuphulukiswa ngaphambi kokuba i-anastomosis iphinde yenziwe. Ngesikhathi sokuhlinzwa kwamathumbu, udokotela ohlinzayo angadinga ukuguqula ingxenye yamathumbu okwesikhashana iye ku- ostomy (umgodi omusha odlula i-anastomosis futhi uvumele isikhathi esengeziwe sokuphulukiswa).

Kuthatha isikhathi esingakanani ukuphulukiswa?

Ukuvuza kwe-anastomotic kungabangela ukuhlala esibhedlela amasonto amane noma ngaphezulu.

Ingabe lokhu kuvuza akukwazi ukuvinjelwa?

Kunezici eziningi ezingaba nomthelela ekwandeni kokuvuza kwe-anastomotic, eziningi zazo ezingenakuguqulwa. Isibonelo, impilo yesiguli, ubunzima bokuhlinzwa, nezinye izinto ezenzeka ngesikhathi senqubo yokuphulukiswa. Kodwa-ke, odokotela abahlinzayo bangahlola ukuvuza ngesikhathi sokuhlinzwa.

Ukuhlola

Ukuhlolwa okwenziwa ukuhlola ukuvuza ngemva kokuthola i-anastomosis yilezi:

• Ukuhlolwa Komoya: Umgodi womzimba ugcwele isixazululo sikasawoti bese umoya ufakwa epayipini lomzimba. Uma kubonakala amabhamuza esixazululweni, kuba nokuvuza lapho kuxhumanwa khona. Ngokuvamile, lokhu kuvuza kulungiswa ngokunamathisela kabusha uxhumano noma ukuluthunga.
• Ukuhlolwa Koketshezi: Isixazululo sokubulala amagciwane sifakwa epayipini lomzimba bese sihlolwa ukuthi asivuzi yini.
• Ukuhlolwa Kokuqhathanisa: Uma kwenzeka ukuhlinzwa kwamathumbu, udokotela ohlinzayo angasebenzisa i-CT scan kanye nedayi yokuhlukanisa ukuze abone ukuthi kukhona yini ukuvuza. Idayi yokuhlukanisa idluliselwa nge-anus iye ku-anastomosis ukuze kubonakale ukuthi kukhona yini ukuvuza.

Nakuba lezi zivivinyo ezenziwa ngesikhathi sokuhlinzwa zingenakukuvimbela konke ukuvuza, zinganciphisa inani lazo futhi zibone labo abasengozini enkulu yokuvuza okuphindaphindiwe.

I-Stoma Yokuvimbela (`(I-Stoma Yokuvimbela)`)

Ngesikhathi sokuhlinzwa kwamathumbu, odokotela abahlinzayo bangasusa indle emathunjini ngesikhathi sokuphulukiswa, bavimbele imiphumela emibi kakhulu yamathumbu avuzayo. Lokhu bakwenza ngokudala i -colostomy yesikhashana noma i-ileostomy.Kwenziwa eyodwa, okuqukethwe emathunjini kususwa endaweni yokuxhuma bese kuqondiswa esikhwameni. Nakuba lokhu kungavimbeli ukuvuza kwe-anastomotic, kuvimbela okuqukethwe emathunjini ukuthi kungangeni emgodini wesisu uma kwenzeka ukuvuza.

I-ostomy idala umgodi omusha, owenziwe ngokwenziwa ukuze indle idlule, obizwa ngokuthi i-stoma . Lokhu kuvumela amathumbu ukuthi aphole ngaphandle kokungakhululeki kokudlula kwendle. Ngezinye izikhathi, odokotela abahlinzayo bakha i-ostomy yesikhashana, yokuvimbela. I-ostomy yesikhashana iyanconywa njengendlela yokuvimbela abantu abasengozini enkulu yokuthola ukuvuza kwe-anastomotic.

Iyini ikusasa lalabo abaye baba nokuvuza kwe-anastomotic?

Ukuvuza okutholakalayo ngokuvamile kungalungiswa. Kodwa-ke, ukuxilongwa kusenesikhathi kanye nokwelashwa kubalulekile ukulawula ukutheleleka nokuvimbela i-sepsis. Ngokuvamile, abantu abanokuvuza kwe-anastomotic basengozini enkulu yezinkinga zempilo kanye nokufa esikhathini esizayo. Akucaci ukuthi le miphumela ibangelwa kangakanani ukuvuza kwe-anastomotic uqobo, noma ukuthi ukuvuza kuyisibonakaliso senkinga yempilo ejwayelekile.

Kufanele ngimbone nini udokotela wami?

Uma ululama ekuhlukunyezweni, hlala usondelene nodokotela wakho futhi ubike noma yiziphi izimpawu ezingalindelekile. Funa usizo lwezokwelapha ngokushesha uma unezimpawu zokutheleleka. Isibonelo:

• Imfiva.
• Isisu esibuhlungu.
• Ukuvuvukala (ubomvu, ukuvuvukala).

Yimiphi imibuzo okufanele ngiyibuze udokotela wami ngaphambi kokuhlinzwa kwe-anastomosis?

Uma une-anastomosis futhi ukhathazekile ngokuvuza kwe-anastomotic, ungabuza udokotela wakho ngezinto ezikubangela ubungozi, ukuthi yiziphi izinyathelo zokuvimbela abangazithatha, nokuthi yiziphi izindlela zokungenelela abancomayo kuwe. Isibonelo:

• Ingabe ukuhlinzwa kwami ​​​​kusengozini enkulu yokuvuza kwe-anastomotic?
• Ingabe mina ngokwami ​​ngisengozini enkulu?
• Ulawula kanjani `(Ukuvuza kwe-Anastomotic)`?
• Uyahlola yini ukuvuza ngesikhathi sokuhlinzwa?
• Ngingahlola kanjani ukuvuza ngemva kokuhlinzwa?
• Kwenzekani uma ngivuza ngemva kokuhlinzwa?

Uma udinga ukuhlinzwa kwe-anastomosis, mhlawumbe kuyindlela esindisa impilo. Ngesikhathi esinjengalesi, kunzima ngisho nokucabanga ngenkinga esongela impilo evela ekuhlinzweni ngokwako. Nakuba odokotela besaba, ukuvuza kwe-anastomotic kuhlale kungenzeka. Kodwa ngokuvamile, ingozi iphansi. Futhi, ngokuqwashisa kanye nokungenelela kusenesikhathi, amacala amaningi angaphathwa.

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

• Ukuvuza kwe-anastomotic ukuvuza kokuqukethwe okuvela emapayipini amabili axhunyiwe ngemuva kokuhlinzwa.
• Lokhu kungenzeka noma kuphi, njengasemathunjini noma emgudwini womchamo.
• Uma uzwa izimpawu ezifana nomkhuhlane, ubuhlungu besisu, noma ukuqunjelwa, xhumana nodokotela ngokushesha.
• Le ngozi ingandiswa yizinto ezifana nokubhema, isifo sikashukela kanye nokungondleki kahle.
• Uma sitholakale futhi selashwa kusenesikhathi, singelapheka kaningi. Kodwa-ke, uma singelashwa, singaba yingozi.
• Uma uzohlinzwa, khuluma nodokotela wakho ngakho ngokukhululekile. Cacisa ngezingozi zakho, ukuthi yini okufanele uyenze ukuze uzivimbele, nokuthi yini okufanele uyenze uma kuvela ukuvuza. Ukuqwashisa kuyindlela engcono kakhulu yokuzivikela!

Ukuvuza Kwe- Anastomotic, Izinkinga Zokuhlinzwa, Ukuhlinzwa Kwamathumbu, I-Peritonitis, I-Sepsis, Ukunakekelwa Ngemva Kokuhlinzwa, Izingozi Zokuhlinzwa