Kuvamile ukuzizwa unesicanucanu nokwesaba uma uzwa igama elithi "ukuhlinzwa kwesibindi." Ngoba isibindi singesinye sezitho ezibaluleke kakhulu nezinkulu emzimbeni wethu. Kodwa kwezinye izifo, ikakhulukazi izimo ezibucayi njengomdlavuza, ukususa ingxenye yesibindi egulayo kuyisisombululo esingcono kakhulu sokusindisa impilo yakho. Ngakho-ke namuhla, ake sixoxe ngalokhu 'kuhlinzwa kwesibindi', noma ukuhlinzwa kokususa ingxenye yesibindi, ngendlela elula necacile ezosusa konke ukungabaza kwakho.
Kungani udinga ukwenza lolu hlobo lokuhlinzwa?
Kulungile, ake siqale sibone ukuthi odokotela banquma ukwenza lo msebenzi ngaphansi kwaziphi izimo. Kunezizathu ezimbili eziyinhloko. Esinye siwukwelashwa kwesifo sesibindi. Esinye siwukunikelwa kwengxenye yesibindi kumuntu ogulayo (i-Living Donor Liver Transplantation).
Ngezifo zesibindi
Lokhu kuhlinzwa kuvame ukwenziwa ukuze kususwe izimila ezakheke esibindini. Lezi zimila zingaba nomdlavuza, zingabi nomdlavuza, noma zibe yingozi. Kunezinhlobo ezimbili zomdlavuza wesibindi.
1. Okuyinhloko: Lokhu kusho ukuthi umdlavuza uqala esibindini.
2. Okwesibili: Lokhu kusho ukuthi umdlavuza uqale kwenye indawo emzimbeni (isibonelo, ikholoni) futhi ususakazekele esibindini.
Izinhlobo eziyinhloko zomdlavuza olashwa ngalokhu kuhlinzwa yilezi:
- I-carcinoma ye-Hepatocellular - Lolu uhlobo oluyinhloko lomdlavuza oluqala esibindini.
- I-Cholangiocarcinoma - Lona futhi umdlavuza oqala esibindini.
- Umdlavuza we-colon osakazeka kalula - Ukusabalala komdlavuza we-colon esibindini.
Lokhu kuhlinzwa akwenziwa nje kuphela ngenxa yomdlavuza, kodwa futhi nakwezinye izimo zezokwelapha:
- Amatshe enyongo emigudwini yenyongo ngaphakathi kwesibindi (imigudwini ye-intrahepatic).
- Izimila ezivamile njenge-adenoma.
- Ama-cyst esibindi.
Umuntu ophilile unikela ngengxenye yesibindi sakhe
Lokhu kuyinto enhle kakhulu. Uma isibindi somuntu sesicishe sonakale ngokuphelele futhi sidinga ukufakelwa isibindi, umuntu ophilile anganikela ngengxenye yesibindi sakhe kuleso siguli. Kulolu hlobo lomnikelo, ingxenye yesibindi somnikeli iyasuswa ngokuhlinzwa. Into emangalisayo ukuthi kokubili isibindi esisele somnikeli kanye nesibindi esisha sesiguli esifakelwe isilwane sikhula sibe yisibindi esiphelele.
Kuyingozi kangakanani lokhu kuhlinzwa? Ingabe zikhona izingozi?
Yebo, ukuhlinzwa kokususa ingxenye yesibindi kuwukuhlinzwa okuyinkimbinkimbi kakhulu futhi okunzima ngokobuchwepheshe.Kubhekwa kanjalo. Isizathu esiyinhloko salokhu ukuthi kunenqwaba yemithambo yegazi esakazeke esibindini. Ngakho-ke, ukopha ngokweqile kungenzeka ngesikhathi sokuhlinzwa. Ngakho-ke, odokotela abahlinzayo abenza lokhu kuhlinzwa kumele babe nokuqeqeshwa okukhethekile ukuze bagweme ukulimaza imithambo yegazi futhi balawule ukopha.
Kodwa kukhona lokhu:
- Ukususwa Okuncane: Uma kususwa ingxenye yesibindi, ingozi iphansi. Ukuhlinzwa okunjalo manje kungenziwa kusetshenziswa amasu angangenisi kakhulu njenge- laparoscopy noma ukuhlinzwa kwerobhothi .
- Ukususwa Okukhulu: Uma kudingeka kususwe ingxenye yesibindi, kunzima kakhulu futhi kuyingozi.
Ngakho-ke, into ebaluleke kakhulu okufanele uyikhumbule ukuthi uma uzohlinzwa, kubalulekile ukukhetha isibhedlela esinethimba lezokwelapha elinolwazi oluphezulu .
Kwenzekani ngaphambi kokuhlinzwa?
Ngaphambi kokuba wenze lokhu kuhlinzwa, ithimba lezokwelapha lizocabangela ngokucophelela izici eziningana. Kulapho-ke kuphela lapho bezonquma khona ukuthi lokhu kuhlinzwa kuyindlela efanele yokwelapha.
Izinto odokotela abazicabangayo:
- Ingabe impilo yakho yomzimba inamandla ngokwanele ukumelana nokuhlinzwa okukhulu kangaka?
- Ingabe isimila noma ingxenye yesibindi enesifo ingasuswa ngokuhlinzwa?
- Uma kungumdlavuza, ingabe ususakazekele kwezinye izingxenye zomzimba ngaphandle kwesibindi?
Ngezinye izikhathi, uma isimila somdlavuza sikhulu, kungenzeka ukwenza ukuhlinzwa kube lula futhi kuphephe ngokunikeza ukwelashwa okufana nokwelashwa ngemisebe noma ngamakhemikhali ngaphambi kokuhlinzwa ukuze kuncishiswe isimila.
Futhi, odokotela kudingeka banqume ukuthi udinga ukufakelwa isibindi ingxenye noma ukufakelwa isibindi sonke. Lezi zici zizothinta leso sinqumo:
- Isimila sisabalale kangakanani?
- Isibindi sakho siphilile kangakanani?
- Ingabe ingxenye yesibindi esele ngemva kokuhlinzwa yanele ukusebenza komzimba?
Ukuhlolwa kwangaphambi kokuhlinzwa
Ukuze wazi konke lokhu ngokuqinisekile, udokotela wakho uzoyala ukuhlolwa okuningana, okufana nalokhu:
- Ukuhlolwa kwezithombe: I-CT scan noma i-MRI scan.
- Ukuhlolwa kokusebenza kwesibindi: Lokhu ukuhlolwa kwegazi okuvamile.
- Ukuhlolwa kwesibindi: Ukuthatha ingxenye encane kakhulu yesibindi ukuze ihlolwe.
Yiziphi izindlela eziyinhloko zokwenza ukuhlinzwa?
Ukuhlinzwa kwe-Hepatectomy kungenziwa ngezindlela ezintathu eziyinhloko. Udokotela wakho ohlinzayo uzonquma indlela efanelana kahle nesimo sakho.
| Indlela yokuhlinzwa | Incazelo | Kufanelekela |
|---|---|---|
| Ukuhlinzwa Okuvulekile | Ukuhlinzwa kwenziwa ngokwenza ukusika okude, okukhulu esiswini, okuvula umgodi wesisu. Odokotela bangabona isibindi ngqo. | Kwamathumba amakhulu, ayinkimbinkimbi noma izimo ezibucayi. |
| Ukuhlinzwa kwe-Laparoscopic | Ukuhlinzwa kwenziwa ngokwenza imicu emincane kakhulu engu-4-6 esiswini, kufakwe ikhamera ngesinye bese kufakwa amathuluzi akhethekile ngezinye. Udokotela wenza ukuhlinzwa ngenkathi ebuka isikrini. | Kokuhlinzwa okuncane nokungayinkimbinkimbi. Isikhathi sokululama sifushane. |
| Ukuhlinzwa Kwerobhothi | Kufana ne-laparoscopy, kodwa amathuluzi okuhlinza alawulwa yingalo yerobhothi elawulwa udokotela. Lokhu kuvumela ukuhlinzwa okunembe kakhudlwana. | Ngisho nokuhlinzwa okuyinkimbinkimbi kakhulu manje kungenziwa kusetshenziswa le ndlela. |
Kwenzekani engxenyeni yesibindi esusiwe? Ingabe izophinde ikhule?
Yebo! Lena yinto emangalisa kakhulu ngesibindi. Isibindi sinekhono elimangalisayo lokuzilungisa nokuzivuselela.
Cabanga nje, noma ngabe izingxenye ezimbili kwezintathu zesibindi esinempilo zisusiwe, ingxenye esele enempilo ingahlukana futhi, ikhule, futhi ikhule ibe usayizi wayo wokuqala phakathi kwamasonto noma izinyanga ezimbalwa. Njengoba nje umsila wesilwane ukhula kabusha uma uphukile. Kodwa ijubane lalokhu kukhula kabusha lincike ezintweni eziningana.
- Uma uke wathola i-chemotherapy ngaphambilini.
- Uma kukhona ukunqwabelana kwamafutha esibindini (isibindi esinamafutha).
- Uma unesifo sesibindi esingamahlalakhona njenge-cirrhosis.
Ezimweni ezinjalo, izinga lokuvuselelwa kwesibindi lingase lihambe kancane.
Yiziphi izinyathelo zokuhlinzwa?
Nakuba kunezinguquko ezincane kuye ngokuthi inqubo yokuhlinzwa kanye nenani lezicubu ezisusiwe, ukuhlinzwa ngokuvamile kuhamba kanje:
1. I-Anesthesia: Uzolaliswa ngokuphelele (i-anesthesia ejwayelekile) ngaphambi kokuhlinzwa.
2. Ukwenza i-incision: Ekuhlinzeni okuvulekile, kwenziwa i-incision ende esiswini. Ku-laparoscopy, kwenziwa i-incision eziningana ezincane.
3. Ukulungiselela isibindi: Udokotela ohlinzayo uzobona ingxenye eqondile yesibindi okufanele isuswe. I-ultrasound yangaphakathi kokuhlinzwa ingasetshenziswa ngesikhathi sokuhlinzwa. Uma ingxenye okufanele isuswe iseduze nenyongo, inyongo nayo ingadinga ukususwa.
4. Ukususwa kwesibindi: Udokotela uhlukanisa ngokucophelela izicubu zesibindi, ahlonze imithambo yegazi kanye nemisele yenyongo, bese eyivala ngeziqeshana noma ngezihlanganisi. Kusetshenziswa amathuluzi akhethekile ukulawula ukuphuma kwegazi.
5. Ukususwa kwengxenye: Ingxenye yesibindi ehlukanisiwe isuswa emzimbeni. Ngendlela ye-laparoscopic, kungadingeka ukusikwa okwengeziwe okungaba amasentimitha angu-2-5 ukuze kususwe le ngxenye.
Ngokuvamile, lokhu kuhlinzwa kungathatha amahora amabili kuya kwayisithupha .
Kwenzekani ngemva kokuhlinzwa? Esibhedlela
Ngemva kokuhlinzwa, uzoqala ngokugcinwa egunjini elikhethekile (iyunithi yangemva kokuhlinzwa) uze uvuke ekubulaweni yizinzwa, bese udluliselwa egunjini elivamile. Uma ukuhlinzwa bekuyinkimbinkimbi kakhulu, kungadingeka uhlale egunjini lokunakekelwa okujulile (ICU) usuku olulodwa noma ezimbili.
Ezinsukwini zokuqala, uzoba namapayipi amaningana afakwe emzimbeni wakho. Lawa azokhipha uketshezi, anikeze impumuzo esiswini sakho, futhi anikeze ukudla okunomsoco. Ithimba lezokwelapha lizohlala liqapha umfutho wegazi lakho, amazinga kashukela, kanye nokopha kwegazi.
Uma isimo sakho sesizinzile, cishe uzohlala esibhedlela izinsuku ezimbalwa noma isonto. Phakathi nalesi sikhathi:
- Kancane kancane, beqala ngokudla okumanzi, bazoqala ukudla ukudla okuqinile.
- Uzovuka embhedeni aqale ukuhamba.
- Amapayipi afakiwe azosuswa kancane kancane.
- Uzonikezwa imithi edingekayo yokulawula ubuhlungu.
Lapho ngibuya esibhedlela, nganikwa usuku lokuzobona udokotela futhi cishe emavikini amabili.
Izingozi Nezinkinga Zokuhlinzwa
Njenganoma yikuphi ukuhlinzwa okukhulu, kunezingozi nezinkinga ezingase zenzeke, futhi kubalulekile ukuzazi.
| Inkinga | Incazelo elula |
|---|---|
| Ukutheleleka | Ukusikwa kungase kutheleleke nge-pneumonia noma ukutheleleka komgudu womchamo. Ama-antibiotic angayilapha le nto. |
| Ukopha | Ukuhlinzwa kwesibindi kunengozi enkulu yokopha. Kungadingeka ukumpontshelwa igazi ngemva kokuhlinzwa. |
| Ukuvuza kwenyongo | Uma umsele wenyongo wonakele ngesikhathi sokuhlinzwa, inyongo ingavuza ingene esiswini. Lokhu kudinga ukuthi kufakwe ipayipi elengeziwe ukuze kususwe inyongo. |
| Ukuphuma kwe-Pleural | Uketshezi lunganqwabelana emaphashini, okubangela ubuhlungu esifubeni kanye nobunzima bokuphefumula. |
| Ama-Ascites | Ukunqwabelana koketshezi esiswini. Lokhu kungelashwa ngemithi noma ngokufaka ipayipi ukuze kukhishwe uketshezi. |
| Ukuqhekeka kwegazi (i-deep vein thrombosis) | Amahlule egazi angakheka emilenzeni ngenxa yokuba sembhedeni isikhathi eside ngemva kokuhlinzwa. |
| Ukwehluleka kwesibindi | Lesi simo singase senzeke uma isibindi esisele singanele ukusebenza kahle emzimbeni. Kulesi simo, kungadingeka ukufakelwa isibindi okuphuthumayo. |
Ngokwezibalo, cishe abantu abangu-2% abenza lokhu kuhlinzwa bafa ngenxa yezinkinga. Kodwa-ke, esigulini somdlavuza, izinzuzo zokuhlinzwa zidlula kakhulu izingozi ezihambisana nomdlavuza.
Kuthatha isikhathi esingakanani ukululama ngemva kokubuyela ekhaya?
Kungathatha amasonto amane kuya kwayisishiyagalombili ukululama ngokuphelele ekhaya. Kuzodingeka uthathe ikhefu emsebenzini phakathi nalesi sikhathi.
- Gwema ngokuphelele ukuphakamisa izinto ezisindayo nokuzivocavoca okunzima .
- Kungathatha cishe amasonto ayi-12 ukuqala kabusha yonke imisebenzi evamile yansuku zonke.
- Uma kwenziwe ukuhlinzwa kwe-laparoscopic noma kwerobhothi, isikhathi sokululama singase sisheshe kancane.
Ukuze kusheshiswe inqubo yokuphulukiswa, kubalulekile ukudla ukudla okucebile ngamaprotheni nokwenza ukuzivocavoca okulula (njengokuhamba) . Zama ukuhamba okungenani imizuzu engama-30 ngosuku, kodwa phumula uma uzizwa ukhathele.
Uma unalezi zimpawu, bona udokotela ngokushesha.
Uma uhlangabezana nanoma yiziphi izimpawu ezingavamile ngemva kokubuyela ekhaya, yazisa udokotela wakho ngokushesha.
- Uketshezi olufana negazi noma ubomvu obuphuma esilondeni.
- Umkhuhlane oqhubekayo.
- Ukuhlanza noma uhudo.
- Ukuqunjelwa okuhlala isikhathi esingaphezu kwezinsuku ezintathu.
- Ukuvuvukala kwesisu.
- Ukuphuzi kwamehlo nesikhumba (i-Jaundice).
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlinzwa kwesibindi, okuhlanganisa nokususwa kwengxenye yesibindi, kuyindlela ebucayi, kodwa kuyindlela ephumelela kakhulu yokusindisa izimpilo ezifweni ezifana nomdlavuza.
- Isibindi sethu sinekhono elimangalisayo lokuzivuselela, ngakho-ke ungesabi ingxenye esusiwe.
- Ukukhetha udokotela ohlinzayo onolwazi kanye nethimba lezokwelapha kubaluleke kakhulu ukuze lokhu kuhlinzwa kuphumelele.
- Kuthatha isikhathi ukululama ngemva kokuhlinzwa, ngakho lalela umzimba wakho bese uwunika ukuphumula okudingayo.
- Landela imiyalelo kadokotela wakho njalo. Ungesabi ukubuza uma unemibuzo.
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