Ingabe amehlo akho nesikhumba sakho kuzwakala kuphuzi? Noma ingabe unesifo sokulunywa esingabekezeleleki emzimbeni wakho wonke? Lokhu kungaba ngezinye izikhathi izimpawu ezenzeka lapho imigudu ethwala uketshezi olubizwa ngokuthi 'i-bile' oluvela esibindini sethu ivalekile. Lolu ketshezi olubizwa ngokuthi 'i-bile' lubalulekile enqubweni yokugaya ukudla emzimbeni wethu. Ngakho-ke uma le migudu ye-bile ivalekile, ingabuyela esibindini futhi ibangele izinkinga eziningi. Namuhla, sikhuluma ngokwelashwa okukhethekile okwenziwa odokotela ezimweni ezinjalo. Kubizwa ngokuthi i-Biliary Drainage.
Kalula nje, iyini le Biliary Drain?
Umsele wenyongo uyipayipi elincane neliguquguqukayo. Leli payipi lisetshenziselwa ukugwema ukuvinjelwa komsele wenyongo oxhumanisa isibindi sethu namathumbu amancane bese kususwa inyongo emzimbeni noma ukuyibuyisela emathunjini amancane.
Cabanga ngengcezu kadoti ebhajwe phakathi kwepayipi lamanzi. Bese amanzi egcwala endaweni eyodwa, umfutho uyanda, futhi ipayipi lingalimala, akunjalo? Yileyo ndlela imisele yenyongo evaleka ngayo. Inyongo iqoqana esibindini. Ngokwezokwelapha lesi simo sisibiza ngokuthi i-cholestasis . Uma lokhu kwenzeka, isimo se- jaundice, esiphenduka sibe phuzi emehlweni nasesikhumbeni, siyenzeka, njengoba kushiwo ngaphambili. Kanye nalokhu, kungaba nokulunywa okukhulu emzimbeni wonke.
Ngakho-ke, lokho okwenziwa yileli payipi lenyongo ukugwema ukuvaleka bese kudala indlela yokuthi inyongo ibuye igeleze ngayo. Ngezinye izikhathi, lenyongo iqoqwa esikhwameni esingaphandle komzimba.
Yiziphi lezi zindlela zokufaka amapayipi? (Izinhlobo Zokukhipha Amanzi E-Biliary)
Kunezindlela ezimbili eziyinhloko zalokhu kwelashwa. Kuye ngesimo sakho, udokotela wakho uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe.
1. Ukukhipha Amanzi E-Biliary Ehamba Ngesinqe Esingena Esibindini (PTBD)
Lokhu kuhilela ukufaka ipayipi elincane (i-catheter) esikhumbeni ngakwesokudla kwesisu sakho, esibindini sakho, nasemzimbeni wakho we-bile. Lokhu kwenziwa kusetshenziswa i-fluoroscopy, inqubo ekhethekile ye-X-ray. Ipayipi lifakwa ngemva kokuthola indawo eqondile yokuvaleka. Bese, elinye icala lale payipi lixhunywe esikhwameni esingaphandle komzimba. I-bile ibe isiqoqwa kuleso sikhwama.
2. I-Endoscopic Biliary Drainage (EBD)
Okwenzekayo lapha ukuthi ithubhu elincane elinekhamera enamathiselwe, elibizwa ngokuthi i-endoscope , lifakwa ngomlomo wakho bese lehla ngepayipi lakho lokudla liye emhubheni we-bile duct (ukuqala kwamathumbu amancane). Bese, elinye ithubhu elincane lidluliselwa nge-endoscope bese lifakwa emhubheni we-bile ovalekile ukuze kukhishwe i-bile.
Le ndlela ingenziwa ngezindlela ezahlukene.
- Ukukhipha Amanzi E-Endoscopic Nasobiliary (ENBD):Lapha, indle ihamba ngepayipi elifakwe ngekhala bese iqoqana esikhwameni ngaphandle komzimba.
- Ukufaka I-Stent Yangaphakathi: Lokhu kuhilela ukufaka i -stent encane efana ne-stent ngaphakathi kwendawo evinjiwe nokuvumela i-bile ukuthi igeleze kuyo. Lokhu kuvumela i-bile ukuthi igeleze ngqo emathunjini amancane, kunokuphuma emzimbeni. Lena yindlela evame kakhulu.
Kungani umuntu angafuna ukufaka ipayipi elinje?
Kunezizathu eziningi zokuthi kungani umsele wenyongo ungavaleka noma uvaleke. Lokhu kwelashwa kuyadingeka ngenxa yesimo esibizwa ngokuthi i-cholestasis esenzeka uma lokhu kwenzeka. Ake sibheke izimbangela eziyinhloko.
| Isizathu sokuvinjelwa | Incazelo elula |
|---|---|
| Amatshe enyongo noma emisele yenyongo (i-choledocholithiasis) | Amatshe enyongo akheka enyongweni futhi avimbe umsele wenyongo yiwona avame kakhulu. |
| I-Pancreatitis | Umsele wenyongo ungacindezelwa ngaphandle ngenxa yokuvuvukala kwe-pancreas. |
| Izimo zomdlavuza | Umsele ungavinjelwa yizimila ku-pancreas, i-bile duct, i-gallbladder, noma isibindi. |
| Ukulimala kwemigudu yenyongo | Amapayipi enyongo angonakala, ikakhulukazi ngesikhathi sokuhlinzwa njengokususwa kwenyongo. |
| Ezinye izifo ezibangelwa yizinambuzane | Nakuba kungavamile eSri Lanka, ezinye izinhlobo zezibungu zingabangela ukuvaleka kwemisele yenyongo. |
| I-Sclerosing Eyinhloko I-Cholangitis | Lesi yisimo esingapheli lapho imisele yenyongo iba nezibazi futhi ivaleke kancane kancane. |
Kufanele uzilungiselele kanjani ngaphambi kokwelashwa?
Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngaphambi kokuthola lokhu kwelashwa. Ngokuvamile, kufanele uqaphele ngalezi zinto.
- Kufanele uyeke ukudla, ukuphuza, nokubhema okungenani amahora ayisithupha ngaphambi kokwelashwa . Ungase uvunyelwe ukuphuza amanzi, kodwa udokotela wakho uzokutshela ngqo ukuthi wenzeni.
- Tshela udokotela wakho nganoma yikuphi ukungezwani komzimba onakho kusengaphambili, ikakhulukazi kuma-anesthetics, idayi yokuhlukanisa esetshenziswa kuma-X-ray, amapulasitiki, noma izinsimbi.
- Yazisa udokotela wakho ngayo yonke imithi namavithamini owasebenzisayo njengamanje .
- Uma uthatha imithi evimbela ukujiya kwegazi (isib., imithi yokuvimbela ukujiya kwegazi efana ne-Aspirin ne-Warfarin), khuluma nodokotela wakho bese uthola iseluleko sokuthi ungayiyeka yini futhi kanjani ngaphambi kokwelashwa.
- Uma ukhulelwe noma ungase ukhulelwe, qiniseka ukuthi uyasazisa.
- Njengoba ungeke ukwazi ukushayela ngemuva kokwelashwa ngenxa yokubulala izinzwa, kubalulekile ukuhlela ukuthi othile akushayele ekhaya kusenesikhathi.
Kwenzekani ngesikhathi sokwelashwa?
Kungase kube nomehluko omncane kulokho okwenzekayo kuye ngenqubo ozoyenza, kodwa udokotela uzokuchazela konke kusengaphambili.
Indlela yokwenza i-percutaneous method (PTBD) yenziwa ngayo
1. Okokuqala, udokotela uzohlanza isikhumba esiswini sakho ngesisombululo se-antiseptic bese evala indawo.
2. Ngemuva kwalokho, kufakwa inaliti encane esikhumbeni iye emgudwini we-bile esibindini.
3. Kufakwa uketshezi olukhethekile olubizwa ngokuthi idayi yokungafani ukuze lubone ngokucacile uhlelo lwe-bile duct ku-X-ray.
4. Ngemva kokuthola indawo eqondile lapho kuvimbeke khona, kufakwa ipayipi lokukhipha inyongo ngalo bese inyongo ivunyelwa ukuphuma.
5. Ingxenye engaphandle yepayipi ikhishwa esikhumbeni sesisu bese ixhunywa esikhwameni. Indle iqoqana kuleso sikhwama. Lesi sikhwama sidinga ukuthululwa izikhathi eziningana ngosuku.
Indlela inqubo ye-endoscopic (EBD) eyenziwa ngayo
1. Uzolaliswa ngokuphelele noma ulale ubuthongo obukhulu.
2. Ngaphambi kokufaka i-endoscope ngomlomo, kufakwa umuthi wokufutha emphinjeni ukuze kuncishiswe umphimbo.
3. Udokotela ube esefaka i-endoscope ngomlomo, ayidlulisele emgudwini wokudla, bese engena engxenyeni engenhla yamathumbu amancane.
4. Ukusuka lapho, kufakwa elinye ipayipi elincane (i-catheter) nge-endoscope emgudwini we-bile ovalekile.
5. Ukuvaleka kuyasuswa bese inyongo ivunyelwa ukuphuma. Uma kufakwa i-stent ngaphakathi, lokhu kwenziwa ngalesi sikhathi. Uma kukhishwa ipayipi, ipayipi liyakhishwa ekhaleni bese lixhunywa esikhwameni.
Ingabe zikhona izingozi ezihilelekile?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezingozi nezinkinga ezingase zivele. Udokotela wakho uzokwazisa ngakho konke lokhu.
Khumbula, amathuba okuba lezi zinkinga zenzeke mancane kakhulu. Futhi ingozi yokuthi i-bile duct ivaleke iphakeme kakhulu.
| Ingozi/Inkinga | Incazelo |
|---|---|
| Izingozi ezivamile | |
| Ukutheleleka | Amagciwane angangena endaweni lapho kufakwe khona ithubhu. Ama-antibiotic anikezwa ukuvimbela lokhu. |
| Ukopha | Kuyinto engavamile kakhulu, futhi kungadinga ngisho nokunikela ngegazi. |
| Ubuhlungu | Kungase kube nokungakhululeki noma ubuhlungu lapho kufakwe khona ipayipi. |
| Ipayipi elivuzayo noma elivalekile | Izinkinga zingavela ngokudonsa ipayipi ngengozi noma ukuvaleka kwangaphakathi. |
| Izingozi ezihlobene nezindlela ezithile | |
| Ukuvuza kwenyongo (PTBD) | Uketshezi lungavuza emzimbeni luvela eduze kwepayipi. |
| I-Pneumothorax (PTBD) | Akuvamile kakhulu ukuthi amaphaphu alimale futhi umoya ungaqoqana nxazonke zawo. |
| I-Pancreatitis (EBD) | Ngemva kokwelashwa kwe-EBD, kungase kube nokuvuvukala kwesikhashana kwe-pancreas. |
Uyinakekela kanjani ipayipi uma ufika ekhaya?
Uma unepayipi nesikhwama esifakwe ngaphandle komzimba wakho, umhlengikazi uzokunikeza imiyalelo eningiliziwe yokuthi ungayinakekela kanjani. Landela leyo miyalelo ngokucophelela.
- Phuza inani leziphuzo ze-electrolyte elilingana nenani le-bile elifakwa esikhwameni. Udokotela wakho uzokutshela ukuthi uphuze ini nokuthi uphuze malini.
- Phumula ngokwanele ngemva kokwelashwa. Kungumqondo omuhle ukuba nomuntu ozokusiza ngobusuku bokuqala.
- Ungalali unesisindo sakho eceleni lapho kukhona khona ithubhu . Ngaleyo ndlela, mancane amathuba okuthi ithubhu lijike.
- Ngokuvamile ungaqhubeka nemisebenzi yakho evamile ngemva kwamahora angu-24, kodwa ungaphakamisi lutho olusinda ngaphezu kwama-5 kg .
- Thatha yonke imithi ebhalwe udokotela njengoba eyalelwe .
- Ungageza ngemva kwamahora angu-48. Kodwa-ke, gwema ukubhukuda emachibini, olwandle, noma emifuleni ngokuphelele kuze kube yilapho ipayipi selikhona.
Kufanele ubonane nodokotela ngokushesha nini?
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, kungaba uphawu lokutheleleka. Ngakho-ke shayela udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
- Uma ubuhlungu, ukuvuvukala, noma ukubomvu endaweni yokufaka ithubhu kukhuphuka .
- Uma ubomvu noma olunye uketshezi luvuza endaweni yepayipi.
- Uma uthola umkhuhlane .
Futhi qaphela lezi zici:
- Uma kukhona ukuphuzi okusha noma okubi kakhulu kwesikhumba noma amehlo.
- Uma umbala noma iphunga lendle eqoqwe esikhwameni lishintsha ngokuzumayo .
- Uma ipayipi libonakala sengathi liyakhululeka lapho libekwe khona.
- Uma unesifo esisha sesisu noma uma ubuhlungu obukhona buba bubi kakhulu.
- Uma ukuhlanza kuqhubeka.
- Uma isisu singaphumi noma umoya ungaphumi .
Kuvamile ukuzizwa wesaba kancane uma uzwa ngalolu hlobo lokwelashwa. Kodwa khumbula, lokhu kwenzelwa ukusiza umzimba wakho uqede ukungakhululeki okubangelayo bese uwubuyisela esimweni esinempilo. Khuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho. Uzokuchazela konke.
Umlayezo Wokuya Nawe Ekhaya
- Ukugeleza Kwendle kuyindlela ebaluleke kakhulu yokwelapha esetshenziselwa ukuvumela indle ukuthi igeleze ngepayipi lendle elivalekile.
- Lokhu kungenziwa ikakhulukazi ngesikhumba (PTBD) noma nge-endoscope (EBD).
- Kubalulekile ukulandela imiyalelo kadokotela ngokucophelela (ukuzila ukudla, ulwazi ngemithi) ngaphambi kokwelashwa.
- Uma unepayipi elibekwe ngaphandle komzimba wakho, funda ukuthi ungalinakekela kanjani kahle futhi wenze ngendlela efanele.
- Uma uba nezimpawu zokutheleleka njengomkhuhlane, ubuhlungu noma ukuvuvukala endaweni yokufaka, noma ubomvu, funa iseluleko sezokwelapha ngokushesha.
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