Ungacabanga ngobuhlungu obungabekezeleleki obubangelwa ukutheleleka okukhulu, ukuvuvukala, noma amatshe enyongo enyongweni yakho? Ngezinye izikhathi, esimweni esinjalo, isimo sesiguli singaba sibi kakhulu kangangokuthi ukuhlinzwa kokususa ngokuphelele inyongo akunakwenzeka. Ezimweni ezinjalo, sizokhuluma ngendlela yokwelapha ekhethekile, engangenisi kakhulu esetshenziswa odokotela ukusindisa impilo yesiguli, ukunciphisa ubuhlungu, nokulawula ukutheleleka.
Kuyini i-cholecystostomy?
Kalula nje, i-cholecystostomy inqubo encane yezokwelapha lapho kwenziwa khona imbobo encane enyongweni yakho bese kufakwa ipayipi (i-catheter) ngayo. Njengoba igama lisho, elithi "cholecyst-" lisho inyongo, kanti elithi "-ostomy" lisho ukuvulwa okwenziwe ngokuhlinzwa. Inyongo iyisitho esincane esifana nesikhwama esigcina inyongo, esidingekayo ohlelweni lwethu lokugaya ukudla.
Le ndlela ivame ukubizwa ngokuthi "i-percutaneous cholecystostomy." Igama elithi "Percutaneous" lisho into eyenziwa ngesikhumba. Lokho kusho ukuthi udokotela wenza imbobo encane ngesikhumba sesisu sakho bese efaka leli payipi enyongweni.
Umgomo oyinhloko walokhu kwelashwa ukususa uketshezi oluthelelekile (i-bile kanye nobomvu) oluqongeleleke ngaphakathi kwenyongo, ukunciphisa ingcindezi yangaphakathi, nokulawula ubuhlungu kanye nokutheleleka.
Kungani lolu hlobo lokwelashwa ludingeka?
Lokhu kwelashwa kuvame ukudingeka esimweni esibizwa ngokuthi i-acute cholecystitis. Lokhu kwenzeka lapho into efana namatshe enyongo ivimba umgudu wenyongo, okubangela ukuthi inyongo ihlangane futhi itheleleke ngamagciwane. Lokhu kubangela ukuthi inyongo ivuvuke futhi ibe buhlungu kakhulu.
Ngokuvamile, ukwelashwa okungcono kakhulu kwalesi simo ukuhlinzwa kokususa ngokuphelele inyongo (i-cholecystectomy). Kodwa-ke, uma isiguli sihlushwa ezinye izifo ezinkulu njengesifo senhliziyo, isifo sikashukela, isifo sezinso, noma sesikhulile kakhulu, singase singakwazi ukumelana nokuhlinzwa okukhulu ngaleso sikhathi. Ezimweni ezinjalo, esikhundleni sokuhlinzwa okukhulu, lokhu kwelashwa okubizwa ngokuthi i-Cholecystostomy kwenziwa ukuze kuqiniswe isimo sesiguli.
Uyini umehluko phakathi kwe-Cholecystectomy ne-Cholecystectomy?
La magama amabili angase afane kancane, ngakho-ke ungase udideke. Kodwa lezi izindlela ezimbili zokwelapha ezihlukene. Ake siqonde ngokucacile umehluko phakathi kwala magama amabili.
| Isici | I-Cholecystostomy (ukubekwa kwepayipi) | Ukususwa kwe-Cholecystectomy (ukususwa kokuhlinzwa) |
|---|---|---|
| Uhlobo lokwelashwa | Isixazululo sesikhashana. Kwenziwe okuthile ukulawula izimpawu. | Isixazululo esihlala njalo. Inyongo isusiwe ngokuphelele. |
| Ulaka | Incane. Yenza umgodi omncane kuphela. | Kuningi kakhulu. Ukuhlinzwa okukhulu (okuvuliwe noma okwenziwa nge-laparoscopic). |
| Amacala okusetshenziswa | Kulabo abagula kakhulu futhi abangakwazi ukumelana nokuhlinzwa okukhulu. | Iziguli eziningi ezinempilo enhle zingahlinzwa. |
| Umphumela | Kubekwa ipayipi lokukhipha amanzi ukuze kukhishwe uketshezi oluvela enyongweni. | Inyongo isuswa emzimbeni. |
Lokhu kwelashwa kwenziwa kanjani?
Lokhu kuvame ukwenziwa yi- Interventional Radiologist . Okusho ukuthi, uchwepheshe osebenzisa ubuchwepheshe bokuthwebula izithombe njenge-ultrasound kanye ne-CT scan ukuze abheke izitho zomzimba ngaphakathi komzimba futhi enze izimbobo ezincane ezinembile kakhulu ukuze elashwe.
Ukulungiselela ngaphambi kokwelashwa
- Udokotela uzokuchazela izingozi nezinzuzo zalokhu kwelashwa futhi athole imvume yakho enolwazi.
- Uyalulekwa ukuthi ungadli noma uphuze amahora ambalwa.
- Kuhlolwa igazi ukuze kuhlolwe ikhono legazi lokujiya. Uma kudingeka, kunikezwa ukwelashwa.
- Umugqa we-IV uzofakwa emthanjeni ongalweni yakho ukuze ukunikeze ama-antibiotic, i-saline, futhi, uma kudingeka, umuthi wokudambisa ubuhlungu.
Kwenzekani ngesikhathi sokwelashwa
1. Isilinganiso senhliziyo yakho kanye nomfutho wegazi kubhekwa njalo.
2. Hlanza indawo lapho kuzofakwa khona ipayipi lesisu,Ngithatha umuthi wokuqeda izinhlungu.
3. Kuzosetshenziswa i-ultrasound noma i-CT scan ukuthola indlela engcono kakhulu nephephile yokufaka ipayipi (le ndlela ingase idlule esibindini (transhepatic) noma idlule odongeni lwesisu (transperitoneal).
4. Ngemuva kwalokho, ngaphansi kwesiqondiso se-X-ray, ithubhu lifakwa enyongweni kusetshenziswa inalithi encane kakhulu kanye nocingo oluqondisayo.
5. Uma ithubhu selikhona, liboshelwe esikhumbeni nge-suture , bese kuthi elinye icala lethubhu lixhunywe esikhwameni sokukhipha amanzi.
Le nqubo yonke ingathatha imizuzu engama-30 nehora.
Uyinakekela kanjani ithubhu ngemva kokwelashwa?
Lena yingxenye ebaluleke kakhulu. Le payipi yokukhipha amanzi ngokuvamile izohlala emzimbeni wakho amasonto amane kuya kwayisithupha . Kuzodingeka uyinakekele kahle uma usuya ekhaya.
- Ukunakekelwa kwenxeba: Indwangu ebhodleleni kufanele ishintshwe nsuku zonke. Gcina indawo ihlanzekile futhi yomile. Gqoka isembozo sepulasitiki esingangeni manzi uma ugeza.
- Ukuhlanzwa kwepayipi: Ukuze uvimbele inyongo ukuthi ingabhajwa epayipini, udinga ukuhlanza ipayipi nge -saline ehlanzekile cishe kanye ngosuku. Udokotela wakho noma umhlengikazi uzokukhombisa ukuthi ungakwenza kanjani lokhu.
- Ukukhipha uketshezi esikhwameni: Isikhwama esiqoqa uketshezi kufanele sikhishwe ngokushesha nje lapho sigcwala. Udokotela wakho angakutshela nokuthi ulandelele ukuthi uqoqa uketshezi olungakanani usuku ngalunye. Uma uketshezi lukhula ngokuzumayo noma luyeka ukuphuma, lokho kuyisibonakaliso esibalulekile.
Ngaphambi kokuba ipayipi likhishwe, kwenziwa ukuhlolwa okukhethekile kwe-X-ray okubizwa ngokuthi i-cholangiogram ukuze kubonakale ukuthi ukugeleza kwenyongo enyongweni sekujwayelekile yini futhi akukho ukuvaleka noma kuphi. Ipayipi lisuswa kuphela ngemva kokuqinisekiswa ukuthi konke kuhamba kahle.
Yiziphi izinzuzo nezingozi zalokhu kwelashwa?
Ngakolunye uhlangothi, lokhu kuyindlela yokwelapha ephephile kakhulu futhi esebenza kahle. Izinga lempumelelo ekulawuleni i-acute cholecystitis liphezulu ngamaphesenti angama-95. Kunganikeza ukululama okusheshayo ngengozi encane kakhulu esigulini esingakwazi ukubekezelela ukuhlinzwa okukhulu.
Izingozi nezinkinga azivamile, kodwa kufanele siziqaphele.
| Uhlobo lwenkinga | Izinto ezingenzeka |
|---|---|
| Izinto ezingase zenzeke ngesikhathi sokwelashwa | Ukopha ngokweqile, ukuvuza kwenyongo esiswini, kanye nokuqongelela kwamagciwane egazini (i-septicemia). |
| Yini engenzeka kamuva ngepayipi? | Ukuvaleka kwamapayipi, ukuphuma kwamapayipi, ukutheleleka okuzungeze ipayipi. |
Kufanele ngimshayele nini udokotela?
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo ngesikhathi ululama, yazisa udokotela wakho noma isibhedlela lapho uthole khona ukwelashwa.
- Umkhuhlane: Umkhuhlane ongaphezu kuka-38.3 Celsius (101 Fahrenheit).
- Ubuhlungu: Ubuhlungu obukhulu, obungachazeki esiswini noma lapho ipayipi lifakwe khona.
- Izimpawu zokutheleleka: ukubomvu kwesikhumba esizungeze ipayipi, ukuvuvukala, noma uketshezi olunuka kabi.
- Izinkinga zamapayipi: ukungakwazi ukuhlanza ipayipi, ipayipi eliphuma esikhumbeni, inyongo ephuma epayipini.
- Ushintsho kumthamo woketshezi: Ukwanda okungazelelwe noma ukuyeka ngokuphelele inani loketshezi olufakwe esikhwameni.
Esimweni esinjalo, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha.
Umlayezo Wokuya Nawe Ekhaya
- I-Cholecystostomy iyindlela yokwelapha engangenisi kakhulu futhi ephephile yeziguli ezinokuvuvukala kwenyongo okubukhali ezingebona abantu abazohlinzwa.
- Lokhu kuhilela ukufaka ipayipi esikhumbeni liye enyongweni bese kususwa uketshezi oluthelelekile.
- Leli payipi kuzodingeka lishiywe emzimbeni amasonto amaningana, futhi kubaluleke kakhulu ukulinakekela kahle ekhaya.
- Ngemva kwalokhu kwelashwa, lapho isimo sesiguli sithuthuka, udokotela uzonquma ukuthi kuyadingeka yini ukuhlinzwa kokususwa kwenyongo (i-cholecystectomy).
- Uma uhlangabezana nanoma yiziphi izimpawu ezingavamile ngesikhathi sokululama kwakho, yazisa udokotela wakho ngokushesha.
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