Ingabe uzizwa unesimila emphinjeni noma esifubeni sakho uma udla noma uphuza? Ingabe ngezinye izikhathi uzizwa wesaba ukudla ngoba uzizwa sengathi ukudla kwakho akwehlanga? Lokhu kungaba ngenxa yesimo esingavamile esibizwa ngokuthi i-Achalasia. Ukuphila nalesi simo akulula. Kunzima ukugwinya ukudla, futhi ukungadli kahle kungaholela ngisho nasekuntuleni ukudla okunempilo. Ngakho-ke namuhla sizokhuluma ngokuhlinzwa okubizwa ngokuthi i-Heller Myotomy, okwenziwa njengokwelashwa kwalokhu.
Kuyini ukuhlinzwa kwe-Heller Myotomy?
Kalula nje, i-Heller Myotomy iwukuhlinzwa okuncane kokwelapha i-Achalasia . I-Achalasia yisimo esingavamile esithinta umphimbo wethu, noma ipayipi lokudla. Lokhu kwenzeka lapho inqubo yokuthumela ukudla noketshezi kusuka kumphimbo iye esiswini ingasebenzi kahle.
Igama elithi "myotomy" lisho ukusika umsipha. Ku-Heller Myotomy, udokotela ohlinzayo usika izingcezu eziningana ezincane entanjeni yemisipha engezansi komsipha wakho, ebizwa ngokuthi i-Lower Esophageal Sphincter (LES) . I-LES umsipha ojiyile ohlala phakathi kwengxenye engezansi yomsipha wakho kanye nengxenye engenhla yesisu sakho. Kufana ne-valve.
Uma une-achalasia, imisipha ye-LES ayivuli futhi ayivaleki kahle. Lokhu kuvimbela ukudla ukuthi kungadluli kusuka emhubheni kuye esiswini. Ukuhlinzwa kwe-Heller Myotomy kusebenza ngokuphumuza imisipha ye-LES bese kuyivula.
Lokhu kuhlinzwa kuvame ukwenziwa kanye nenye inqubo ebizwa ngokuthi i-fundoplication . Lokhu kuhilela udokotela ohlinzayo ukuthatha ingxenye yesisu sakho ayigoqe eduze komhubhe wakho. Lokhu kunciphisa ingozi yokuthi i-asidi yesisu ibuye ingene emhubheni wakho (i-reflux).
Into ebalulekile ukuthi ukuhlinzwa kwe-Heller Myotomy akuyona ikhambi eliphelele le-Achalasia. Kunikeza impumuzo yesikhathi eside, noma kunjalo, kungadingeka ukuthi lokhu kuhlinzwa kuphindwe ngokuhamba kwesikhathi.
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Ukuze aqinisekise ukuthi uyafaneleka ukuhlinzwa, udokotela wakho uzoyala ukuhlolwa okuningana ngaphambi kokuhlinzwa. Isibonelo, ukuhlolwa kwegazi, i-X-ray yesifuba, kanye ne-ECG.
Ngaphambi kokuhlinzwa, udokotela wezinzwa ozokubulala izinzwa uzokhuluma nawe. Bazokubuza imibuzo efana nale:
- Wake wasebenzisa i-anesthesia ngaphambili futhi kwaba kanjani okuhlangenwe nakho?
- Yimaphi amakhambi, imithi, noma amavithamini owasebenzisayo?
- Uyasebenzisa ugwayi, utshwala, noma ezinye izidakamizwa?
Kunezinto ezimbalwa okudingeka uzenze ukuze ulungiselele ukuhlinzwa. Lokhu kufanele kuxoxwe ngakho futhi kuqinisekiswe nodokotela wakho.
| Okufanele ngikwenze | Kungani lokho kubalulekile? |
|---|---|
| Ukuyeka ukusebenzisa i-nicotine (noma yiluphi uhlobo, okuhlanganisa ugwayi kanye nogwayi kagesi) | I-Nicotine ithinta ukujikeleza kwegazi lakho, okungenza ukuthi amanxeba alulame kancane ngemva kokuhlinzwa. |
| Ukuzila ukudla. | Udokotela wakho angakutshela ukuthi ungadli lutho amahora ayisithupha noma ngaphezulu ngaphambi kokuhlinzwa. Ungase ukwazi ukuphuza uketshezi olucacile (njengamanzi) isikhashana ngaphambi kwenqubo. Kodwa qiniseka ukuthi ubuza udokotela wakho ngalokhu. |
| Ukuhlela ukuhlala esibhedlela. | Lokhu ukuhlinzwa okukhulu, ngakho kuzodingeka uhlale esibhedlela okungenani usuku olulodwa ngemva kokuhlinzwa. Futhi, hlela ukuthi othile akuyise ekhaya ngemoto futhi ahlale nawe amahora okuqala angu-24. |
| Ukuhlela ukululama. | Ngemva kokuhlinzwa, udokotela angase akunike imithi yokwelapha izinhlungu. Ngeke ukwazi ukushayela uze uyiphuze, ngakho thola umuntu ozokusiza ngaleyo misebenzi. |
Kwenziwa kanjani ukuhlinzwa?
Manje ake sibheke ukuthi kwenzekani ngaphakathi kokuhlinzwa. Ngokuvamile, lokhu kwenziwa nge-laparoscopically . Okusho ukuthi, ngosizo lwetheleskopu. Lapha, udokotela ohlinzayo usebenzisa ithuluzi elincane elinekhamera elinamathiselwe kulo ukuze abheke ngaphakathi komphimbo wakho kanye nezinsimbi ezincane kakhulu zokwenza ukuhlinzwa.
- Okokuqala, udokotela wezinzwa uzofaka intambo ye-IV (njengepayipi elinikeza usawoti) emthanjeni osengalweni yakho bese ekunika umuthi wokukulalisa. Ngeke uzwe lutho ngesikhathi sokuhlinzwa.
- Okulandelayo, udokotela ohlinzayo uzokwenza cishe izimbobo ezinhlanu ezincane kakhulu esiswini sakho (esiswini).
- Ngemuva kwalokho, isisu sakho sigcwele igesi ye-carbon dioxide. Lokhu kwenzelwa ukwenza kube lula ukuhambisa izinto zokuhlinza nokunikeza umbono ocacile womhubhe kanye nengxenye engenhla yesisu.
- Manje udokotela ufaka ikhamera kanye nezinto ezincane zokuhlinza ngalezo zimbobo .
- Kusetshenziswa la mathuluzi, ungqimba lwemisipha olungaphansi komphimbo lunqunywa ngobude bese i-LES ivulwa.
- Ngemuva kwalokho, kwenziwa inqubo ebizwa ngokuthi i-fundoplication. Lokhu kuhilela ukuthatha ingxenye yengxenye engenhla yesisu bese uyisonga eduze komphimbo. Lokhu kuvimbela i-asidi yesisu ukuthi ingakhuphuki.
- Ekugcineni, ikhamera kanye nemishini kuyasuswa, bese kuthi lezo zimbobo ezincane zithungwe.
Lonke lolu hlinzo luvame ukuthatha cishe amahora amabili.
Kwenzekani ngemva kokuhlinzwa?
Okuhlangenwe nakho ngemva kokuhlinzwa kungahluka kancane kumuntu nomuntu. Kodwa ngokuvamile, uzolala esibhedlela ubusuku bonke. Phakathi nalesi sikhathi, uzonikezwa uketshezi kanye nokudla okunempilo ngokusebenzisa umugqa we-IV. Ngemva kwalokho, isikhathi sokululama siyaqala.
Into ebaluleke kakhulu ukuthi umphimbo wakho ungase uvuvuke ngemva kokuhlinzwa. Kungathatha cishe izinyanga ezimbili ukuthi lokhu kuvuvukala kwehle ngokuphelele. Ngakho kuzodingeka ushintshe ukudla kwakho kancane kancane.
Ithimba lakho lezokwelapha lizokuchazela lokhu, kodwa uhlelo lokudla olujwayelekile lulandelayo.
| Isikhathi | Ukudla kuyatholakala |
|---|---|
| Usuku lokuqala nolwesibili | Uketshezi olucacile. Isibonelo: umhluzi wenkukhu/wenyama yenkomo (oxutshwe), ijeli, amaphakethe eqhwa, amanzi. |
| Kusukela ngosuku lwesithathu kuya osukwini lwesikhombisa | Ukudla kobisi. Isibonelo: i-ayisikhilimu, isobho likakhilimu ohluziwe, ama-porridge afana ne-Cream of Wheat noma i-Cream of Rice. |
| Kusukela ngosuku lwesishiyagalombili kuze kube ukuhlolwa kwamasonto amabili | Ukudla okuthambile. Udokotela wakho uzokutshela ukuthi ungaqala nini ukufaka ukudla okuqinile. |
Yiziphi izinzuzo nezingozi zalokhu kuhlinzwa?
Izinzuzo
Abantu abaningi abane-achalasia basebenzisa i-Heller Myotomy lapho ezinye izindlela zokwelapha ezingadingi ukuhlinzwa zingaphumeleli. Inzuzo enkulu yale nqubo ukuthi izimpawu ze-achalasia ziyanyamalala ngemva kokuhlinzwa.
Ukuhlaziywa kwamuva kocwaningo kukhombisile ukuthi phakathi kuka-87% no-92% wabantu abaye bathola lokhu kwelashwa izimpawu zabo ziye zaphela. Kodwa-ke, njengoba sesishilo ngaphambili, lokhu akukuqedi ngokuphelele i-achalasia. Izimpawu zingase ziphinde zivele eminyakeni engu-5-10 ngemva kokuhlinzwa.
Izingozi
Njenganoma yikuphi ukuhlinzwa okukhulu, i-Heller Myotomy inezingozi. Izingozi ezijwayelekile zifaka phakathi ukopha ngokweqile kanye nokutheleleka. Ngaphezu kwalokho, izinkinga ezithile ezingase zenzeke zifaka:
- Umphimbo kaBarrett
- Ukutheleleka kwe-Esophageal
- I-GERD (isifo se-gastroesophageal reflux)
- Ukuqhekeka komlomo wesibeletho
Uzobona nini udokotela
Uma unezinye zezimpawu ezilandelayo ngemva kokuhlinzwa, shayela udokotela wakho ngokushesha, noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
- Uma indawo yokuhlinzwa ibomvu futhi ivuvukele.
- Uma ubomvu buvela enxebeni lokuhlinzwa.
- Uma ungakwazi ngisho nokugwinya uketshezi.
- Uma imithi yokwelapha ubuhlungu enikezwa udokotela ingabuqedi ubuhlungu.
Umehluko phakathi kokuhlinzwa kwe-Heller Myotomy kanye ne-POEM
Kungenzeka ukuthi uke wezwa ngenqubo ebizwa ngokuthi i-POEM. I-POEM isifinyezo se -Peroral Endoscopic Myotomy . Njenge-Heller Myotomy, lokhu kuyindlela yokwelapha isimo i-Achalasia.
Umehluko phakathi kwalokhu okubili ukuthi ekuhlinzweni kwe-POEM, akukho ukusikwa okwenziwa esiswini sakho. Esikhundleni salokho, udokotela wakho ufaka i-endoscope (ithubhu enekhamera enamathiselwe) ngomlomo wakho bese yehla ngomhubhe wakho. Imisipha ye-LES ibe isinqunywa ngaphakathi. Ku-Heller Myotomy, lokhu kwenziwa ngaphandle ngokusikwa okuncane esiswini sakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Heller Myotomy ukuhlinzwa okwenziwa ukwelapha i-achalasia, isimo esibangela ubunzima bokugwinya.
- Lokhu kuvame ukwenziwa nge-laparoscopically ngokusebenzisa ukusikwa okuncane esiswini, lapho i-sphincter engezansi yomphimbo ikhululeka khona.
- Nakuba lokhu kuhlinzwa kunikeza impumuzo yesikhathi eside ezimpawini, akuyona ikhambi eliphelele le-Achalasia.
- Ngesikhathi sokululama ngemva kokuhlinzwa, kuzodingeka ulandele ukudla okukhethekile amasonto amaningana.
- Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho njengoba nje inikezwa ngaphambi nangemva kokuhlinzwa.
- Funa usizo lwezokwelapha ngokushesha uma uhlangabezana nanoma yiziphi izimpawu eziyisixwayiso, njengokuvuvukala, ubomvu, noma ukungakwazi ukugwinya uketshezi endaweni yokuhlinzwa.
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