Kuthiwani uma unesifo esibi kakhulu, ukuvaleka, noma umdlavuza emathunjini akho futhi udinga ukuhlinzwa okukhulu? Ngezinye izikhathi, odokotela kufanele benze ukuhlinzwa okusindisa impilo ngokushesha okukhulu. Inqubo eyodwa ekhethekile esetshenziswa ezimweni ezinjalo ibizwa ngokuthi i-Hartmann's Procedure. Igama lingase lizwakale liyesabeka kancane, kodwa ake sixoxe ngokucacile nangokulula ngalokho okwenzekayo ngempela, ukuthi kungani kwenziwa, nokuthi kwenzekani ngemva kokuhlinzwa.
Kalula nje, iyini le nqubo kaHartmann?
Inqubo kaHartmann iwukuhlinzwa okwenziwa emathunjini ethu amakhulu (ikholoni). Ngokukhethekile, ihilela ukusika nokususa ingxenye egulayo yamathumbu ethu amakhulu, ikakhulukazi ingxenye yokugcina lapho kuphuma khona indle, okuyikholoni ye-sigmoid, futhi ngezinye izikhathi ingxenye engenhla ye-rectum.
Manje ake ucabange ukuthi ngemva kokususa ingxenye yamathumbu egulayo, izingxenye ezimbili ezisele eziphilile zidinga ukuhlanganiswa kabusha. Kodwa-ke, kuyingozi kakhulu ukuxhuma kabusha izingxenye ezimbili ngesikhathi esisodwa uma kukhona ukutheleleka okukhulu, ukuvuvukala, noma ezinye izinkinga. Ukwenza kanjalo kungabangela ukuthi ukutheleleka kuphinde kusabalale, okungaba yinkinga enkulu.
Yingakho odokotela benikeza izingxenye ezimbili ezisele zamathumbu isikhathi sokuphulukiswa.
1. Isiphetho samathumbu esixhunywe endunu (isiqu se-rectal) sithungwe okwesikhashana sivaliwe.
2. Isiphetho esinempilo samathumbu amakhulu, esingaphezulu, sinamathele embotsheni encane (stoma) eyenziwe odongeni lwesisu.
Yilapho indle iphuma khona ngale mbobo entsha esiswini. Lokhu kubizwa ngokuthi i-colostomy . Ukuze kuqoqwe le ndle, kufakwa isikhwama esikhethekile (isikhwama se-colostomy) ngaphandle kwaleso mbobo.
Lokhu kungase kuzwakale njengoshintsho olukhulu, kodwa khumbula, lokhu kuvame ukuba yisisombululo sesikhashana . Uma amathumbu esepholile kahle (cishe izinyanga eziyi-6-12), kungenziwa olunye ukuhlinzwa ukuze kuxhunywe kabusha izingxenye ezimbili zamathumbu ezazivalekile, kuvalwe i-colostomy.
Kungani udinga lokhu kuhlinzwa?
Kunezizathu eziningana eziyinhloko zokwenza inqubo kaHartmann. Kunezizathu ezahlukene zokususa ingxenye yamathumbu kanye nokufaka i-colostomy.
Kungani ingxenye yamathumbu isuswa?
- Ukuvaleka: Uma kukhona ukuvaleka endaweni ethile emathunjini okuvimbela indle ukuthi ingashukumi.
- Ukubhoboka: Uma kwakheka imbobo odongeni lwamathumbu futhi indle ivuza ingene emgodini wesisu, lokhu kungasakaza ukutheleleka kuyo yonke imbobo yesisu (i-peritonitis).
- Ukutheleleka noma isifo esingalawuleki: Ezinye izifo (isib. i-diverticulitis eyinkimbinkimbi) noma izifo ezifana nomdlavuza zingadinga ukususwa kwengxenye enesifo ukuze kuvinjelwe ukusabalala okwengeziwe.
Kungani kufakwa i-colostomy?
Njengoba kushiwo ngenhla, lapho kwenziwa ukuhlinzwa esimweni esiphuthumayo, umzimba wesiguli uba buthakathaka futhi ingozi yokutheleleka iphezulu kakhulu. Esimweni esinjalo, ukuxhuma izingxenye ezimbili zamathumbu (i-anastomosis) kuyingozi kakhulu. Ngakho-ke, umgomo wokuqala wodokotela ukusindisa impilo yesiguli. I-colostomy inikeza amathumbu isikhathi sokuphulukiswa, bese ivumela ukuhlinzwa okufanele, okungenangozi kakhulu, ukuze kubuyiselwe isimo esijwayelekile.
| Izimo zezokwelapha eziyinhloko eziholela ekuhlinzweni kukaHartmann | |
|---|---|
| Izizathu ezivame kakhulu |
|
| Ezinye izizathu | |
Indlela ukuhlinzwa okwenziwa ngayo kanye nenqubo
Lokhu kuhlinzwa kungenziwa ngezindlela ezimbili eziyinhloko:
1. Ukuhlinzwa Okuvulekile: Ukuhlinzwa kwenziwa ngokuvula ingaphakathi lesisu ngomsikelo omkhulu esiswini. Le ndlela ivame ukusetshenziswa ezimweni eziphuthumayo neziyinkimbinkimbi.
2. Ukuhlinzwa kwe-Laparoscopic: Ukuhlinzwa kwenziwa ngokusika okuncane okuningana esiswini, kusetshenziswa ikhamera namathuluzi akhethekile. Nakuba ukululama kushesha, le ndlela ayifanele bonke iziguli.
Ngaphambi kokuhlinzwa
Uma ulungiselelwa ukuhlinzwa, uzocelwa ukuba uzile ukudla amahora angu-6-12. Ungase futhi unikezwe uketshezi olukhethekile (ukulungiselela amathumbu) ukuze uhlanze amathumbu akho. Ngemva kokungeniswa esibhedlela, i-saline cannula izofakwa emthanjeni osengalweni yakho bese unikezwa uketshezi nemithi.
Ngesikhathi sokuhlinzwa
Ukuhlinzwa kwenziwa ngaphansi kwe-anesthesia ejwayelekile. Udokotela ohlinzayo ususa ingxenye yamathumbu egulayo, avale ingxenye engezansi ye-rectum, bese enamathisela enye ingxenye esiswini.I-stoma inamathele emngxunyeni. Ekugcineni, isikhwama se-colostomy siyanamathela bese inxeba lokuhlinzwa liyathungwa. Lonke lolu hlelo lungathatha cishe amahora amabili kuya kwamane.
Ngemva kokuhlinzwa
Ngemva kokuhlinzwa, uzoqala uyiswe egumbini lokululama bese udluliselwa ewadini uma isimo sakho sesizinzile. Kuzodingeka uhlale esibhedlela cishe izinsuku eziyi-7-10.
- Ezinsukwini zokuqala, imithi yokubulala izinhlungu, imithi elwa namagciwane, kanye noketshezi kuzonikezwa nge-saline.
- Kungathatha izinsuku eziningana ukuthi amathumbu aphinde asebenze.
- Okokuqala, banikezwa ukudla okumanzi bese kancane kancane befakwa ekudleni okuqinile.
- Umhlengikazi oqeqeshwe ngokukhethekile uzokufundisa wena nomndeni wakho indlela yokuhlanza nokushintsha isikhwama se-colostomy, kanye nendlela yokunakekela i-stoma (ukunakekelwa kwe-stoma).
Yiziphi izingozi ezingaba khona kanye nemiphumela emibi?
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezithile ezihilelekile, kodwa kubhekwa njengenqubo ephephile.
- Izingozi ezingaba khona: ukutheleleka ngamanxeba, ukutheleleka kwamaphaphu (i-pneumonia), ukopha kwangaphakathi, ukuvuza kwamathumbu, ukulimala kwezitho ezizungezile, ukwakheka kwe-hernia.
- Imiphumela emibi engaba khona:
- I-ileus yesikhashana: Kuthatha isikhathi ukuthi amathumbu aqale ukusebenza futhi ngemva kokuhlinzwa.
- Ukuphuma koketshezi endunu: Ngisho noma ungahambisi isisu, uketshezi olufana ne-mucus lungaphuma ngezinye izikhathi engxenyeni esele ye-rectum. Lokhu kuvamile.
- Ukungasebenzi kahle kocansi: Akuvamile ukuthi ukuhlinzwa kulimaze imizwa ehilelekile ekusebenzeni kocansi. Khuluma nodokotela wakho uma unenkinga ngalokhu.
Ukululama nokululama
Kuthatha isikhathi esithile ukululama ngokugcwele.
- Amaviki 4-6: Nciphisa ukusetshenziswa kwemithi yobuhlungu, buyela ekudleni okuvamile, bese uqala kabusha ukuzivocavoca okulula.
- Izinyanga ezi-3-6: Ukujwayela impilo ngesikhwama se-colostomy, uzizwe ululame ngokuphelele ngokomzimba.
Ingabe i-colostomy ingaguqulwa? (Ukuguqulwa)
Lena inkinga enkulu kubantu abaningi. Yebo, ezimweni eziningi ingaguqulwa.
Cishe ezinyangeni eziyi-6-12 ngemuva kokuhlinzwa kwakho kokuqala, udokotela wakho ohlinzayo uzohlola kabusha impilo yakho. Uma unempilo enhle, amathumbu akho epholile kahle, futhi ukwazi ukubekezelela okunye ukuhlinzwa, ungakhetha ukuhlinzwa okubuyiselwe emuva .
Kodwa-ke, uma umdlavuza ususakazeke emzimbeni wonke, uma kukhona isifo esibi kakhulu somzimba, noma uma isiguli sibuthakathaka kakhulu, udokotela angase angancomi ukuhlinzwa kwesibili. Ungakhuluma ngokukhululekile nodokotela wakho ngazo zonke lezi zinto.
Umlayezo Wokuya Nawe Ekhaya
- Inqubo yeHartmann iwukuhlinzwa okubaluleke kakhulu okusindisa impilo , okuvame ukwenziwa ezimweni eziphuthumayo.
- Lokhu kuhlinzwa kuhilela ukudala imbobo yesikhashana esiswini ukuze indle idlule. Lokhu kubizwa ngokuthi i-colostomy , futhi kuzodingeka ufunde ukuphila nayo.
- Ezigulini eziningi, lokhu kususwa kwezicubu kungokwesikhashana futhi kungabuyiselwa esimweni ngokuhlinzwa okunye ngemva kwezinyanga eziyi-6-12.
- Inqubo yokuphulukiswa ithatha isikhathi. Wena nomndeni wakho nizodinga ukwesekwa ukuze nizivumelanise nalolu shintsho, ngokomzimba nangokwengqondo.
- Kubaluleke kakhulu ukukhuluma ngokukhululekile nodokotela wakho nganoma yimiphi imibuzo noma ukwesaba onakho.
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