Kunezikhathi lapho wonke umphimbo wethu kanye ne-rectum kudingeka kususwe ngenxa yezimo ezithile zezokwelapha. Uma lokho kwenzeka, umbuzo omkhulu abantu abaningi abanawo uthi, "Ngizokhipha kanjani indle manje?" Ngokuvamile, ikhambi lalokhu ukuba nesikhwama esibekwe esikhumbeni sesisu ukuze indle idlule. Kodwa namuhla, sizokhuluma ngokuhlinzwa okukhethekile okudala ikhambi ngaphakathi emzimbeni, ngaphandle kwesikhwama sangaphandle esinjalo, futhi kusiza abantu ukukhipha indle ngokujwayelekile nge-anus. Lokho ukuhlinzwa kwe-J-Pouch.
Kalula nje, iyini le J-Pouch?
Cabanga ukuthi amathumbu akho amakhulu, ingxenye yokugcina ye-rectum yakho, lapho kuhlala khona indle okwesikhashana, akhishwe ngokuhlinzwa. Khona-ke bekungeke kube khona indawo emzimbeni wakho yokuqoqa nokugcina indle.
Isikhwama se-J siyisikhwama esincane esidalwa udokotela ohlinzayo ngaphakathi emzimbeni wakho esebenzisa ukuphela kwamathumbu akho amancane . Ngokuqondile, ukuphela kwamathumbu amancane kubizwa ngokuthi "ileum." Ngakho lesi sikhwama sakhiwe ngale "ileum."
Lesi sikhwama senziwe ngokugoqa ingxenye yamathumbu akho amancane ibe ngesimo sohlamvu "J" bese usithunga ngaphakathi. Sibizwa ngokuthi i-J-Pouch ngenxa yesimo "J". Lesi sikhwama sibe sesixhunywe endunu yakho. Manje, esikhundleni se-rectum yakho esusiwe, i-J-Pouch isebenza njengendawo yokugcina indle yesikhashana yokuqoqa nokugcina indle. Ngakho-ke uzizwa udinga ukugoqa ngendlela evamile, futhi ungaya endlini yangasese ukuyogoqa.
Uyini umehluko phakathi kwe-J-Pouch ne-Ileostomy?
Abantu abaningi bayadideka laba ababili. Ake sicacise nalokho futhi.
- Isikhwama se-J: Lesi yisikhwama esenziwe ngaphakathi emzimbeni . Sixhunywe ngqo endunu, ukuze ukwazi ukunyakaza kwamathumbu ngendlela evamile . Akukho lutho olubonakalayo ngaphandle, akukho sikhwama.
- Ileostomy: Lokhu kuhilela ukuletha ingxenye yamathumbu amancane ngqo ebusweni besikhumba sesisu, okudala umgodi omncane (stoma) ukuze indle idlule kuwo. Indle iqoqwa esikhwameni sangaphandle esixhunywe kumgodi. Isikhwama kumele sikhishwe uma sesigcwele.
Kalula nje, uma i-rectum yakho isesimweni esihle, i-J-Pouch iyindlela engcono kakhulu yokuphila ngaphandle kwesikhwama sangaphandle (i-ileostomy ehlala njalo).
Ubani lo kuhlinzwa ofaneleka kakhulu?
Ukuhlinzwa kwe-J-Pouch kunconywa kuphela kubantu abaye bahlinzwa i-proctocolectomy ephelele (ukuhlinzwa kokususa wonke umphimbo kanye ne-rectum). Kodwa-ke, akuwona wonke umuntu. Kunezici eziningana ezinganquma ukuthi ungumuntu ofanele yini kule nqubo.
- Imisipha nezinzwa ze-rectal ezisebenza kahle:Lokhu kubalulekile ekulawuleni ukuhamba kwamathumbu. Udokotela wakho uzohlola isimo salokhu.
- Yiba nempilo enhle ukuze umelane nokuhlinzwa okuningi: Ukuhlinzwa kwe-J-Pouch kuvame ukwenziwa ngezigaba ezimbili noma ezintathu, ngakho-ke udinga ukuba nempilo enhle ukuze umelane nakho.
- Ezinye izimo zezokwelapha noma imithi: Odokotela bazophinde banakekele ngokukhethekile uma unezinye izimo zezokwelapha noma uphuza imithi ethile.
Udokotela wakho ohlinzayo kuphela ongakunikeza iseluleko esingcono kakhulu sokuthi lokhu kuhlinzwa kulungile yini kuwe, ngakho khuluma naye ngokukhululekile ngakho.
Ukuhlinzwa kwe-J-Pouch kwenziwa kanjani?
Lokhu akusikho ukuhlinzwa okwenziwa kanye kuphela. Ngokuvamile kwenziwa ngezigaba ezimbili noma ezintathu . Ake sibone ukuthi yiziphi lezo zinyathelo.
1. Isigaba 1: Isinyathelo sokuqala ukususa ikholoni yakho enesifo kanye ne-rectum (i-proctocolectomy ephelele). I-J-Pouch ingadalwa phakathi nalokhu kuhlinzwa noma ngokuhlinzwa okuhlukile kamuva.
2. Ukwakha isikhwama: Udokotela ohlinzayo uthatha izihibe ezimbili zamathumbu akho amancane, angaba amasentimitha angu-1.2 ubude, bese ezigoqa phakathi ukuze zakhe u-"U." Bese kuthi ingaphakathi lengxenye egoqiwe livulwe bese kuthi imiphetho emibili ithungwe ndawonye ukuze kwakheke isikhwama.
3. Ukuxhuma isikhwama: Lesi sikhwama sehliswa sisuka esiswini bese sixhunywa endunu. Igama lezokwelapha lalokhu kuxhumana yi-``ileal pouch-anal anastomosis`` noma ``(IPAA)```.
4. Ukudala I-Ileostomy Yesikhashana: I-J-Pouch esanda kudalwa idinga isikhathi sokuphulukiswa. Ngakho-ke, ukuze kuvinjwe indle ukuthi ingadluli kuyo phakathi naleso sikhathi, amathumbu amancane ayasikwa ngaphezu kwe-J-Pouch bese kwenziwa i-ileostomy yesikhashana ebusweni besikhumba sesisu (`(ileostomy yesikhashana yesikhashana)`). Ngakho-ke, cishe izinyanga ezi-2-3, indle yakho izophuma kulesi sikhwama sesikhashana. Phakathi nalesi sikhathi, i-J-Pouch entsha izophola kahle.
5. Ukuhlola isikhwama: Ngemva kwezinyanga ezingu-2-3, kwenziwa ukuhlolwa okukhethekile ukuze kubonakale ukuthi isikhwama siphole kahle yini nokuthi kukhona yini imigodi noma ukuvuza. Lokhu kubizwa ngokuthi "isikhwama sokuhlola". Kulokhu, uketshezi olukhethekile lugcwaliswa esikhwameni ngepayipi elifakwe nge-anus bese kuthathwa i-X-ray.
6. Isigaba Sokugcina: Uma isikhwama sesipholile kahle futhi kungekho zinkinga, udokotela wakho uzohlela ukuhlinzwa kwakho kokugcina. Lokhu kuhilela ukususa i-ileostomy yesikhashana nokuvala imbobo esiswini sakho. Ukuhamba kwamathumbu akho sekuqediwe! Indle yakho izoqala ukudlula ngendlela evamile kwi-J-Pouch yakho entsha.
Yini ongayilindela ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, umzimba wakho uzothatha isikhathi ukujwayela lesi simiso esisha. Lokhu kuyinto evamile, ngakho ungakhathazeki ngakho.
Ekuqaleni, i-J-Pouch incane kakhulu. Ngakho-ke ingaphatha indle encane kakhulu. Lokhu kusho ukuthi kuzodingeka uye endlini yokugezela kaningi ngosuku . Mhlawumbe izikhathi ezingaphezu kweziyi-10 ngosuku. Kungase kudingeke uvuke izikhathi eziningana ebusuku. Kodwa ungakhathazeki, ngokuhamba kwesikhathi isikhwama sizonwebeka kancane kancane futhi sibe sikhulu , futhi inani lezikhathi okudingeka uye ngazo endlini yokugezela lizoncipha kancane kancane. Ngokuvamile, sizolawulwa sibe phakathi kwezikhathi ezi-5-10 ngosuku.
Futhi, imisipha esesinqeni sakho ingase ibe buthakathaka kancane ngoba yayingasetshenziswanga ngaphambi kokuhlinzwa. Kuzodingeka uyiqeqeshe kabusha ukulawula ukuhamba kwakho kwamathumbu. Udokotela wakho uzokufundisa ukuzivocavoca, njengokuzivocavoca kweKegel, ukusiza ngalokhu.
Yiziphi izingozi nezinkinga zalokhu kuhlinzwa?
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezithile ezihilelekile, futhi kubalulekile ukuzazi.
| Ingozi/Inkinga | Kuchazwe kalula |
|---|---|
| Ukuvuza kwe-Anastomotic | Ukuvuza kwendle esiswini lapho isikhwama sinamathele khona endunu. Lokhu kungaholela ezifweni ezinkulu, amathumba, noma izimo ezisongela ukuphila njenge- sepsis . |
| Ukunamathela Kwesisu | Ngemva kokuhlinzwa, izicubu zesilonda zingakheka phakathi kwezitho ezingaphakathi kwesisu, okubangela ukunamathelana. Lokhu kungaholela ekuvinjweni kwamathumbu. |
| Ukungasebenzi kahle kocansi | Uma imizwa endaweni yokuhlinzwa yonakele, abesifazane bangase babe nobuhlungu ngesikhathi socansi kanti amadoda angase abe nokungasebenzi kahle kokuchama. Kodwa-ke, lokhu kuvame ukuxazululeka ngokuhamba kwesikhathi. |
| I-Pouchitis(Ukuvuvukala kwesikhwama) | Ukuvuvukala nokuvuvukala ngaphakathi kwe-J-Pouch ngenxa yokutheleleka noma ezinye izimbangela. Izimpawu zingase zihlanganise ubuhlungu besisu, ukushesha, kanye nokopha. Lokhu kungelashwa kaningi ngama-antibiotic. |
| Ukuqina/i-Stenosis (ukuncipha) | Izicubu zezibazi zinciphisa indawo lapho isikhwama sinamathele khona endunu. Lokhu kungenza kube nzima ukuphuma kwendle. |
Ungakwazi yini ukuphila impilo evamile nge-J-Pouch?
Yebo, kungenzeka ngempela! Eqinisweni, abantu abaningi bathi izinga lempilo yabo lithuthuke kakhulu ngemva kwalokhu kuhlinzwa. Ngoba abasenazo izimo ezingamahlalakhona ababezihlupha ngazo, futhi akusadingeki bagcine isikhwama sangaphandle.
Kodwa kufanele ujwayele izinguquko ezimbalwa ezincane:
- Ukuvama kokuya endlini yangasese: Kufanele uye endlini yangasese izikhathi eziningi ngosuku kunangaphambili.
- Ukuthungwa kwendle: Njengoba amathumbu amakhulu engasamunci amanzi, indle yakho izoba uketshezi oluningi kunangaphambili.
- Phuza amanzi amaningi: Njengoba umzimba wakho ulahlekelwa uketshezi oluningi, kubalulekile ukuphuza amanzi amaningi kanye noketshezi usuku lonke ukuze uvimbele ukuphelelwa amanzi emzimbeni. Ngisho nezinto ezifana nejusi zingadingeka ezigabeni zokuqala.
Ingabe ngidinga ukushintsha indlela engidla ngayo ngemva kokuhlinzwa?
Akukho ukudla okuqondile komuntu one-J-Pouch. Kodwa-ke, ukudla ukudla okunempilo nokunomsoco kungasiza ekusheshiseni ukuphulukiswa nokunciphisa ukungakhululeki. Nazi amathiphu ambalwa:
- Qala kancane: Uma uqala ukudla ukudla okuqinile futhi ngemva kokuhlinzwa, qala ukudla ukudla okuncane okulula ukukugaya, okunezinongo ezimbalwa, futhi okunamafutha amancane. Faka kancane kancane ukudla okusha ekudleni kwakho.
- Phuza amanzi amaningi: Lokhu kubaluleke kakhulu. Zama ukuphuza okungenani amalitha angu-2-3 amanzi ngosuku. Izinto ezifana nesobho elicwengekileyo, iphalishi, kanye namajusi ezithelo nazo zinhle.
- Lawula uhudo: Uma indle yakho ibonakala imanzi kakhulu, yidla ukudla okunesitashi okuningi njengobhanana, amazambane, ilayisi, nesinkwa ukuze kusize ekuqiniseni umzimba kancane. Nciphisa ushukela, i-caffeine, ukudla okunamafutha kanye notshwala, njengoba kungenza uhudo lube lubi kakhulu.
- Ukudla okulawula ukuvuvukala: Yidla ukudla okusiza ukuvimbela ukuvuvukala esikhwameni. Ukudla okufana nokudla kwaseMedithera, okuhlanganisa izinto ezifana namafutha omnqumo, inhlanzi, imifino, izithelo, namantongomane, kutholakale ukuthi kuhle kakhulu kulokhu.
Ukuhlinzwa kwe-J-Pouch kuyisinyathelo esikhulu empilweni yakho. Kuvamile ukuzizwa wesaba futhi ungaqiniseki ngakho. Ngakho-ke, ngaphambi kokwenza isinqumo, yenza ucwaningo lwakho bese ubuza udokotela wakho yonke imibuzo oyidingayo. Uma unquma ukuthatha lolu hambo, umndeni wakho nabangani bazoba umthombo omkhulu wamandla. Ngosizo lwabo, ungayinqoba nakanjani le nselele.
Umlayezo Wokuya Nawe Ekhaya
- Isikhwama se-J siyisikhwama esakhiwe ngaphakathi emzimbeni ngemva kokususwa kwekholoni, okukuvumela ukuthi ube nokuhamba kwamathumbu okuvamile ngaphandle kwesikhwama sangaphandle (ileostomy).
- Lokhu kuhlinzwa kuvame ukwenziwa ngezigaba eziningana, lapho kusetshenziswa khona isikhwama sangaphandle sesikhashana.
- Nakuba kungase kudingeke uye endlini yangasese njalo ezigabeni zokuqala ngemva kokuhlinzwa, ngokuhamba kwesikhathi umzimba wakho uzojwayela futhi isimo sizothuthuka.
- Njengoba uketshezi oluningi lulahleka emzimbeni, kubalulekile ukuphuza amanzi amaningi noketshezi usuku lonke.
- Izinga lempumelelo yalokhu kuhlinzwa liphezulu ngamaphesenti angama-95%. Ngeseluleko esifanele sezokwelapha kanye nezinguquko zendlela yokuphila, ungaphila impilo ejwayelekile ngokuphelele.
- Uma unemibuzo mayelana nalokhu kuhlinzwa, ungesabi ukukhuluma nodokotela wakho.
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