Ingabe udokotela wakho ukutshelile noma othile emndenini wakho ukuthi udinga ukwenza inqubo ebizwa ngokuthi "i-Hartmann's Procedure"? Kungenzeka ukuthi uzizwe wesaba kancane lapho uzwa lelo gama. Kuvamile kakhulu. Kodwa lokhu kuyindlela ebaluleke kakhulu yokuhlinzwa eyenziwa ukusindisa izimpilo. Ngakho-ke namuhla, ake sixoxe ngakho kalula, ngendlela ezosusa yonke imibuzo nokwesaba ongase ube nakho ngakho.
Kalula nje, iyini inqubo kaHartmann?
Cabanga ngohlelo lwethu lokugaya ukudla njengepayipi elide. Isiphetho saleli payipi yilokho esikubiza ngokuthi ikholoni. Enqubweni kaHartmann, isiphetho sekholoni esigulayo nesonakele (esibizwa ngokuthi ikholoni ye-sigmoid) kanye nengxenye ye-rectum, lapho kugcinwa khona indle, siyasuswa.
Kalula nje, lokhu ukuhlinzwa okususa ingxenye yamathumbu amakhulu (i-colectomy). Kodwa-ke, okukhethekile ukuthi ngemva kokususwa kwengxenye, izingxenye ezimbili ezisele zamathumbu azixhunyaniswe ngokushesha.
Kunalokho, udokotela ohlinzayo wenza into efana nale:
1. Isiphetho samathumbu esixhunywe ku-rectum sithungwe sivaliwe.
2. Ingxenye enempilo yekholoni yakho ephuma phezulu ixhunywe embotsheni encane (ebizwa ngokuthi i-stoma) eyenziwe esikhumbeni sesisu sakho.
Ngemuva kwalokho, isikhwama se-colostomy sibekwa ngaphandle kwalesi simbobo. Indle yakho izophuma emzimbeni wakho ingene kulesi sikhwama. Nakuba lokhu kungase kuzwakale njengoshintsho olukhulu, ngokuvamile kuba okwesikhashana. Ngemva kokuba ithumbu lakho selipholile, cishe ezinyangeni eziyi-6 kuya kweziyi-12 kamuva, kungenziwa olunye ukuhlinzwa ukuze kususwe isikhwama futhi kuxhunywe kabusha izingxenye ezimbili zamathumbu akho.
Kungani kudingeka ukuba nohlobo olunjalo lokuhlinzwa?
Kunezizathu ezimbili eziyinhloko zokwenza inqubo kaHartmann. Esinye ukususa ingxenye yamathumbu. Esinye ukubeka isikhwama se-colostomy. Ake sibheke izizathu zalokhu ngakunye.
Kungani ingxenye yamathumbu inqunywa futhi isuswe?
Umuntu angadinga ukususwa ingxenye yekholoni lakhe ngenxa yezizathu ezilandelayo:
- Ukuvaleka kwamathumbu: Uma ingxenye yamathumbu ivalekile ngokuphelele ngenxa yesimila, umdlavuza, noma esinye isizathu, leyo ngxenye kuzodingeka isuswe.
- Ukubhoboka Kwamathumbu: Uma ukutheleleka noma ingozi kubangela imbobo emathunjini, okubangela ukuba indle ivuza ingene esiswini, kusongela ukuphila. Ngakho-ke, ingxenye eyonakele kumele isuswe ngokushesha.
- Ukutheleleka noma isifo esingalawuleki: Ukuze kumiswe ukusabalala kwezinye izifo (isibonelo, i-diverticulitis enzima) noma izifo ezifana nomdlavuza, ingxenye egulayo kumele isuswe ngokuphelele.
Kungani kufakwa isikhwama se-colostomy?
Ukususa ingxenye yamathumbu nokuxhumanisa kabusha izingxenye ezimbili ezisele ekuhlinzeni okufanayo kubizwa ngokuthi "i-primary anastomosis." Kodwa-ke, ukuze kwenziwe lokhu, isimo sesiguli kumele sibe sihle kakhulu, futhi akumelwe kube khona ingozi yokutheleleka.
Kodwa inqubo kaHartmann ivame ukwenziwa uma kunesimo esiphuthumayo.Okusho ukuthi, lapho isiguli sinesifo esibi kakhulu noma ukuvuvukala ngaphakathi kwesisu. Esimweni esiyingozi kangaka, uma izingxenye ezimbili zamathumbu zixhumene, imithungo ingase ingapholi kahle, futhi indle ingavuza futhi, okwenza isimo sibe sibi nakakhulu.
Ngakho-ke, okwenziwa udokotela ohlinzayo kuqala ukulungisa inkinga esheshayo (ukususa ingxenye egulayo) bese enika amathumbu isikhathi sokuphulukiswa. Yilokho okwenziwa yisikhwama se-colostomy. Ngemuva kwalokho, lapho konke sekupholile, kuba nethuba lokwenza okunye ukuhlinzwa ukuze kubuyiselwe esimweni esijwayelekile ngesikhathi esifanele.
Yiziphi izizathu eziyinhloko zokwenza ukuhlinzwa kukaHartmann?
Kunezimo eziningana zezokwelapha ezivame ukudinga lokhu kuhlinzwa.
| Isimo sezokwelapha | Incazelo elula |
|---|---|
| I-Diverticulitis Eyinkimbinkimbi | Amasaka amancane odongeni lwamathumbu amakhulu ayatheleleka futhi aqhume, asakaze ukutheleleka kulo lonke ithumbu (i-peritonitis). Lesi yisimo esibi kakhulu. |
| Umdlavuza we-Colorectal | Lokhu kuhlinzwa kungenziwa ezimweni eziphuthumayo, njengalapho isimila somdlavuza sibangela ukuvaleka kwamathumbu, ukubhoboka, noma ukopha ngokweqile. |
| Ezinye izizathu | Ezimweni ezifana nokuvaleka kwamathumbu ngenxa yezibazi zokuhlinzwa kwangaphambilini, ukulahlekelwa igazi eliya emathunjini, ingozi enkulu, noma ukuthungwa kokuhlinzwa kwangaphambilini okuvuzayo. |
Ukuhlinzwa kwenziwa kanjani?
Ukuhlinzwa kukaHartmann kungenziwa ngezindlela ezimbili.
1. Ukuhlinzwa Okuvulekile: Kulokhu, ukuhlinzwa kwenziwa ngokwenza ukusika okukhulu kancane esiswini bese kuvulwa umgodi wesisu.
2. Ukuhlinzwa kwe-Laparoscopic:Lokhu kubizwa nangokuthi "ukuhlinzwa kwe-keyhole." Ukuhlinzwa kwenziwa ngokusikwa okuncane esiswini, bese kufakwa ikhamera (i-laparoscope) kanye nezinsimbi ezikhethekile. Le ndlela ishiya izibazi ezimbalwa futhi inesikhathi esifushane sokululama.
Kodwa-ke, kuye ngokuthi isimo sakho sibucayi kangakanani, ungaqala ngendlela ye-laparoscopic bese ushintshela ekuhlinzeni okuvulekile ngesikhathi senqubo. Lokhu kuzonqunywa udokotela wakho ohlinzayo.
Kwenzekani ngaphambi kokuhlinzwa?
- Uzocelwa ukuthi uyeke ukudla nokuphuza amahora angu-6-12 ngaphambi kokuhlinzwa.
- Kuye ngesimo sakho, ungase unikezwe isiphuzo esikhethekile sokuhlanza amathumbu akho.
- Uma ungeniswa esibhedlela, kufakwa i-catheter ye-IV emthanjeni osengalweni yakho.
- Udokotela uzokuchazela kusengaphambili ngemithi yokwelapha izinhlungu.
Kwenzekani ngesikhathi sokuhlinzwa?
Uzonikezwa i-anesthesia ejwayelekile, ngakho ngeke uzwe lutho. Ukuhlinzwa kungathatha cishe amahora amabili kuya kwamane. Udokotela ohlinzayo uzosusa ingxenye yamathumbu egulayo, enze i-colostomy njengoba sixoxile ngaphambili, bese ethunga izimbobo.
Yini ongayilindela ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, uzoqala uyiswe egumbini lokululama. Uma isimo sakho sesizinzile, uzodluliselwa ewadini.
- Ukuhlala esibhedlela: Ngokuvamile, kuzodingeka uhlale esibhedlela cishe izinsuku eziyi-7-10.
- Ukudla: Ukudla okumanzi kuphela okunikezwa ezinsukwini zokuqala. Kancane kancane, baqala ukudla okuvamile.
- Ubuhlungu: Kunikezwa imithi yobuhlungu efakwa emthanjeni ezinsukwini ezimbalwa zokuqala, bese ishintshelwa kumaphilisi.
- Ukusebenza kwamathumbu: Kungathatha izinsuku ezimbalwa ukuthi amathumbu aqale ukusebenza futhi ngemva kokuhlinzwa.
- Isikhwama se-Colostomy: Umhlengikazi oqeqeshwe ngokukhethekile (umhlengikazi we-stoma) uzokukhombisa ukuthi ungasisebenzisa kanjani, usihlanze futhi usishintshe kanjani. Ungakhathazeki, kuzothatha isikhathi ukujwayela.
Ngingaya nini ekhaya?
- Uma izinto ezifana nokushaya kwenhliziyo yakho kanye nomfutho wegazi zibuyela esimweni esijwayelekile.
- Uma ungavuka uhambe ngaphandle kosizo lwamuntu.
- Uma indle iqala ukuvuza esikhwameni se-colostomy.
- Uma ubuhlungu bungalawulwa ngamaphilisi.
- Uma ungashintsha isikhwama se-colostomy ngokwakho.
Yiziphi izingozi ezingaba khona kanye nemiphumela emibi?
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezihilelekile, futhi kubalulekile ukuxoxa ngazo nodokotela wakho.
- Izinkinga ezingaba khona: Ukutheleleka ngamanxeba, i-pneumonia, ukopha kwangaphakathi, amahlule egazi, ukwakheka kwe-hernia, njll.
- Okuqhamuka uma udla imishanguzo:
- Ukungasebenzi kahle kwamathumbu okwesikhashana (Ileus): Ngemva kokuhlinzwa, kungase kubambezeleke ukuthi amathumbu asebenze. Kulezo zinsuku, ukudla okunomsoco kunikezwa nge-saline.
- Ukuphuma kwendle: Ngisho noma indle ingaphumi, uketshezi olufana ne-mucus lungaphuma ngezinye izikhathi engxenyeni esele ye-rectum.
- Imiphumela ekusebenzeni kocansi: Akuvamile kakhulu, ukulimala kwemizwa endaweni yokuhlinzwa kungabangela izinguquko ekuzweleni noma ekusebenzeni kocansi. Uma unenkinga ngalokhu, khuluma nodokotela wakho ngokukhululekile.
Ingabe isikhwama se-colostomy singasuswa futhi? (Ukuhlinzwa Kokuguqula Umzimba)
Lena yinkinga enkulu kunazo zonke abantu abaningi abanayo. Yebo, abantu abaningi bangakubuyisela lokhu esimweni esijwayelekile.
Phakathi kwezinyanga eziyi-6 neziyi-12 ngemuva kwenqubo kaHartmann, udokotela wakho uzohlola kabusha impilo yakho. Uma ululama kahle futhi ungenazo ezinye izimo zezokwelapha ezingathi sína, kungase kwenziwe olunye ukuhlinzwa ukuze kususwe isikhwama se-colostomy bese kuhlanganiswa kabusha izingxenye ezimbili zamathumbu akho.
Kodwa-ke, abanye abantu bangase bangakwazi ukwenza lokhu kuhlinzwa kwesibili. Isibonelo:
- Uma umdlavuza ususakazekele kwezinye izingxenye zomzimba.
- Uma unezinye izifo ezinkulu njengesifo senhliziyo noma isifo samaphaphu.
- Uma ungakwazi ukukhokhela okunye ukuhlinzwa ngenxa yokuguga noma ukukhuluphala ngokweqile.
Udokotela wakho ohlinzayo ungumuntu ongcono kakhulu ukwenza lesi sinqumo.
Umlayezo Wokuya Nawe Ekhaya
- Inqubo kaHartmann ayiyona into okufanele uyesabe. Ivame ukwenziwa ukuze ikusindise entweni esongela ukuphila, njengomdlavuza noma ukutheleleka okukhulu.
- Kuthatha isikhathi ukujwayela ukuhlala nesikhwama se-colostomy, kodwa kulula ukusiphatha. Isibhedlela sizokunikeza iseluleko nokusekelwa okudingayo.
- Into ebaluleke kakhulu ukuthi kubantu abaningi lesi yisimo sesikhashana. Kunethuba lokuthi bazolulama ngemva kokuhlinzwa okunye ezinyangeni ezimbalwa.
- Kuyilungelo lakho ukukhuluma ngokukhululekile nodokotela wakho nganoma yimiphi imibuzo, ukwesaba, noma ukungabaza ongase ube nakho.
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