Ukugeleza Kwendle Egazini: Kungani Futhi Kwenziwa Kanjani?

Ingabe amehlo akho nesikhumba sakho kuyashintsha kube phuzi futhi umzimba wakho wonke uyaluma ngendlela engabekezeleleki? Lezi yizimpawu zalokho sonke esikwaziyo ngokuthi i-jaundice. Esikhathini esiningi, imbangela yalokhu ukuvaleka komsele we-bile, okuwuketshezi oluvela esibindini sethu futhi olusiza ekugayeni ukudla. Uma lokhu kuvinjiwe, lolo ketshezi lubuyela esibindini, okubangela ukuba kube phuzi nokulunywa . Ngakho-ke, indlela ekhethekile yokwelapha esetshenziswa odokotela ezimweni ezinjalo ibizwa ngokuthi i-Biliary Drainage. Kalula nje, lokhu kuhilela ukufaka ithubhu elincane emseleni we-bile ovinjiwe nokuvumela i-bile ukuba iphume. Ake sixoxe ngalokhu ngokuningiliziwe namuhla.

Kuyini Ukugeleza Kwendle Kwe-Biliary? Ingabe zikhona izinhlobo?

Ukukhipha Amanzi Enyongo kuyindlela esebenzisa ipayipi elincane neliguquguqukayo (i-catheter) ukuvumela inyongo ukuthi igeleze ngokuvaleka komsele wenyongo, osuka esibindini uye emathunjini amancane. Kufana nokudala indlela entsha yomzila wamanzi ovalekile. Lokhu kwenziwa ngezindlela ezimbili eziyinhloko. Udokotela wakho uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe ngokusekelwe esimweni sakho.

Kuyini ukufakwa kwe-stent?

Kwezinye izimo, ikakhulukazi uma ukuvaleka kungunaphakade (isibonelo, ngenxa yomdlavuza), udokotela wakho angase afake unomphela ithubhu elincane elifana ne-mesh, elibizwa ngokuthi i-stent, ngaphakathi kwe-bile duct yakho ukuze lihlale livulekile. Lokhu kuvame ukwenziwa ezinsukwini ezimbalwa ngemva kokufakwa kwethubhu lokuqala.

Kungani umuntu angadinga lolu hlobo lokwelashwa?

Isizathu esiyinhloko sokudinga lokhu kwelashwa ukuvaleka noma ukuncishiswa komsele we-bile (`stricture`). Lokhu kubangela uketshezi lwe-bile ukuthi luqoqeke esibindini (`cholestasis`). Cabanga nje, into efana nalapho ipayipi lokukhipha amanzi endlini yethu livaleka, amanzi ayaqoqeka lapha. Kungaba nezizathu eziningana zokuvaleka komsele we-bile:

• Amatshe enyongweni noma emigudwini yenyongo (i-choledocholithiasis).
• I-pancreatitis noma umdlavuza we-pancreatic.
• Umdlavuza we-bile duct (i-Cholangiocarcinoma).
• Umdlavuza wesibindi noma umdlavuza we-gallbladder .
• Ukuvuvukala kwama -lymph node eduze kwesibindi noma i-pancreas ngenxa yomdlavuza.
• Ezinye izifo ezibangelwa yizinambuzane .
• Ukulimala kwemigudu yenyongo ngesikhathi sokuhlinzwa okunye.
• Izimo zokuvuvukala zesikhathi eside zemibhobho ye-bile, njenge-'primary sclerosing cholangitis'.

Uzilungiselela kanjani ngaphambi kokwelashwa?

Kunezinto ezimbalwa okudingeka uzenze ngaphambi kwalokhu kwelashwa. Udokotela wakho uzokunikeza imiyalelo ecacile ngalokhu. Kubaluleke kakhulu ukulandela leyo miyalelo ngqo. 1. Ukudla Nokuphuza: Kufanele uyeke ukudla, ukuphuza, nokubhema okungenani amahora ayisithupha ngaphambi kokwelashwa. Udokotela wakho angakutshela ukuthi ungaphuza nini uketshezi, njengamanzi. 2. Ukungezwani komzimba: Qiniseka ukuthi utshela udokotela wakho nganoma yikuphi ukungezwani komzimba onakho, ikakhulukazi kuma-anesthetics, udayi wokungafani komzimba osetshenziswa kuma-X-ray, noma kumapulasitiki noma ezinsimbi. 3. Imithi:Tshela udokotela wakho ngayo yonke imithi oyithathayo njengamanje (kufaka phakathi amavithamini). Ikakhulukazi uma uthatha imithi yokunciphisa igazi (ama-anticoagulant) njenge-aspirin ne-warfarin, buza ukuthi udinga ukuyeka yini ukuyithatha nokuthi nini. 4. Ukukhulelwa: Qiniseka ukuthi utshela udokotela wakho ukuthi ukhulelwe noma ungase ukhulelwe. 5. Ukushayela: Ngeke ukwazi ukushayela ngemuva kokwelashwa ngoba uzobe ungaphansi kwe-anesthesia. Ngakho-ke hlela ukuletha othile ozokuthatha akuyise ekhaya.

Kwenzekani ngesikhathi sokwelashwa?

Izinyathelo zalokhu zizohluka kancane kuye ngenqubo oyenzayo (i-PTBD noma i-EBD). Kodwa ungakhathazeki, udokotela wakho uzokuchazela konke kusengaphambili.

Indlela yokwenza i-percutaneous method (PTBD) yenziwa ngayo:

• Okokuqala, isikhumba esiswini sakho siyahlanzwa futhi indawo ayisebenzi kahle.
• Udokotela ube esefaka inalithi encane esikhumbeni iye emgudwini wenyongo esibindini.
• Kufakwa uketshezi olukhethekile (udayi ohlukile) ukuze kubonakale ama-X-ray.
• Uma indawo eqondile yokuvaleka isitholakele, ipayipi lokukhipha amanzi lifakwa kuleyo ndawo bese uketshezi lwenyongo luvunyelwa ukuphuma.
• Esinye isiphetho sale tube siphuma esikhumbeni sakho futhi sixhunywe esikhwameni ngaphandle. Uketshezi lwenyongo luyaqoqana kulesi sikhwama. (Lesi sikhwama sidinga ukuthululwa izikhathi eziningana ngosuku.)

Indlela inqubo ye-endoscopic (EBD) eyenziwa ngayo:

• Kulokhu, uzonikezwa i-anesthesia ejwayelekile noma i-anesthesia elula, ngakho ngeke uzwe lutho.
• Umphimbo wakho uyathuthumela.
• Udokotela ufaka ipayipi elinekhamera (i-endoscope) ngomlomo, alidlulisele emgudwini wokudla, bese eliqondisa endaweni yomsele wenyongo.
• Bese kuthi elinye ithubhu (i-catheter) lidlule kulelo thubhu bese lidlula emgudwini ovalekile ukuze kuvunyelwe inyongo ukuthi igeleze.
• Uma i-phlegm ikhishwa ngaphandle, kufakwa ipayipi ngekhala bese linamathiselwa esikhwameni. Uma ikhishwa ngaphakathi, kufakwa i-stent ngaphakathi.

Izingozi nokunakekelwa ngemva kokwelashwa

Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezingozi nezinkinga ezingaba khona.

• Izinkinga ezingaba khona:
• Ukukhululeka, ukusonta, noma ukuvaleka kwepayipi elifakiwe ngengozi.
• Ubuhlungu noma ukungakhululeki.
• Ukutheleleka (udokotela uzokunikeza ama-antibiotic ukuvimbela lokhu).
• Ukopha.
• Izinguquko ekwakhekeni kwama-electrolyte emzimbeni (`ukukhubazeka kwe-Electrolyte`).
• Akuvamile kakhulu ukuthi kube nezinkinga zamaphaphu (`i-Pneumothorax`).

Udokotela uzochaza ngokucacile lezi zingozi kuwe futhi akunikeze iseluleko ngalokho okufanele ukwenze uma kuvela izinkinga.

Ungazinakekela kanjani ekhaya?

Uma unepayipi nesikhwama esifakwe ngaphandle komzimba wakho, abasebenzi bobuhlengikazi bazokufundisa ukuthi ungayinakekela kanjani.

• Ungalali unesisindo sakho ohlangothini lapho kukhona khona ipayipi. Lokhu kungabangela ukuthi ipayipi lijike.
• Uma udokotela wakho ekweluleka ukuthi ugeze ipayipi ngesisombululo esincane se-saline nsuku zonke, yenza kanjalo.
• Phuza iziphuzo ze-electrolyte ukuze zilingane noketshezi oluphuma esikhwameni. Buza udokotela wakho ukuthi uphuze ini nokuthi uphuze malini.
• Ungageza ngemva kwamahora angu-48 ngemva kokwelashwa. Kodwa-ke, ungabhukudi emachibini noma olwandle/emfuleni ngenkathi ipayipi likhona.
• Gwema ukuphakamisa izinsimbi kuze kube yilapho udokotela wakho ekuyala.

Kunini lapho kufanele ufune khona usizo lwezokwelapha ngokushesha?

Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, shayela udokotela wakho ngokushesha, noma uye eMnyangweni Wezimo Eziphuthumayo (i-ETU) wesibhedlela esiseduze.

• Imfiva .
• Uma kukhona ubuhlungu obandayo, ukuvuvukala, noma ukubomvu endaweni yokufaka ithubhu.
• Uma ubomvu noma olunye uketshezi luphuma endaweni yepayipi.
• Uma ubuhlungu besisu bukhula noma buphinde buvela.
• Uma isikhumba noma amehlo ephenduka aphuzi futhi.
• Uma uhlanza.
• Uma ipayipi libonakala sengathi liyakhululeka.
• Uma indle ingaphumi noma umoya ungaphumi.

Ukugeleza kwendle kuyindlela ephumelela kakhulu yokwelapha ukuvaleka kwendle. Ithimba lakho lezokwelapha lizokusiza ukhethe inketho engcono kakhulu yesimo sakho. Zizwe ukhululekile ukubabuza noma yimiphi imibuzo noma ukukhathazeka ongase ube nakho. Ukugeleza Kwendle Yenyongo, Ukuvaleka Kwemisele Yenyongo, I-Jaundice, I-PTBD, I-EBD, Izifo Zesibindi, Amatshe Enyongo, Isihloko Sezokwelapha saseSinhala