Ngenxa yezimo ezithile zezokwelapha, ikakhulukazi izinkinga zamathumbu amakhulu, kudingeka ukuhlinzwa ukuze kususwe leyo ngxenye. Bese kuba nembobo encane esikhumbeni sesisu ukuze kuvunyelwe imfucuza ukuba iphume emzimbeni. Ngakho-ke, indle iqoqwa esikhwameni esinamathiselwe kulesi mbobo. Ukuhlala nalesi sikhwama kungaba yinto engakhululekile kwabanye abantu. Kungazwakala njengesithiyo lapho uhlangana nabantu, ugqoka izingubo, futhi wenza imisebenzi yansuku zonke. Ngakho-ke kuthiwani uma bekukhona indlela yokuqoqa imfucuza emzimbeni ngaphandle kwalesi sikhwama sangaphandle bese uyithulula noma nini lapho sifuna? Isixazululo salokho yisikhwama seKock esikhuluma ngaso namuhla.
Kalula nje, iyini le sikhwama se-Kock (isikhwama se-K)?
Cabanga nje, esikhundleni sokuba nesikhwama esilenga ngaphandle komzimba wakho, kuthiwani uma ungakha isikhwama esincane esingaqoqa futhi sigcine imfucuza emzimbeni wakho? Yilokho okushiwo isikhwama seKock.
Ngemva kokuhlinzwa kwe-colectomy, ingxenye yamathumbu akho amancane, i-ileum, ilethwa ebusweni besikhumba esiswini sakho bese kuba nomgodi omncane. Lokhu kubizwa ngokuthi i-ileostomy. Lo mgodi ubizwa ngokuthi i-stoma. Lokhu kuvame ukwenziwa ngokunamathisela isikhwama sangaphandle ku-stoma.
Kodwa enkambisweni yesikhwama se-Kock, udokotela ohlinzayo usebenzisa ingxenye yamathumbu akho amancane ukudala isikhwama esincane emzimbeni wakho . Lesi sikhwama sixhunywe ngqo embotsheni (stoma) esiswini sakho. Ngakho awudingi isikhwama sangaphandle ukuze uqoqe indle yakho. Uma udinga, ithubhu elincane (i-catheter) lingafakwa ngale mbobo bese imfucuza eqoqwe esikhwameni ingathululwa.
Lokhu kufana "nesinqe sangaphakathi" ngaphakathi emzimbeni esingasikhipha noma nini. Siqanjwe ngodokotela ohlinzayo uNils Kock.
Yiziphi izindlela zokusebenzisa isikhwama se-Kock?
Le ndlela isetshenziswa kakhulu kubantu okumele baphile ne-'ileostomy' ehlala njalo kodwa abangafuni ukusebenzisa isikhwama sendle yangaphandle. Inzuzo enkulu yalokhu ukuthi bangakwazi ukulawula ukuhamba kwendle.
Ku-ileostomy evamile, indle ingaqongelela esikhwameni nganoma yisiphi isikhathi. Asikwazi ukuyilawula. Kodwa i-ileostomy enesikhwama se-Kock ibizwa ngokuthi i-continence ileostomy. Lokho kusho ukuthi "iyalawuleka." Kulesi simo, indle iqongelela esikhwameni ngaphakathi, kunokuba iphume, ngakho-ke unenkululeko yokuyithulula noma nini lapho ufuna.
- Ulwazi olwengeziwe: Isikhwama se-Kock ekuqaleni saklanywa njengesikhwama sangaphakathi sokuqoqa umchamo weziguli ezikhishwe izinyembezi zazo. Leyo ndlela isasetshenziswa nanamuhla, kodwa sekuthuthukiswe izindlela eziningi ezintsha.
Lokhu kuhlinzwa kwenziwa kanjani?
Udokotela wakho ohlinzayo angakha isikhwama se-Kock ngesikhathi esifanayo ne-ileostomy yakho, noma angakwenza ngokuhlinzwa okuhlukile ngosuku olulandelayo. Lokhu kusho ukuthi uma usuvele une-ileostomy, usengashintshela esikhwameni se-Kock ngosuku olulandelayo.
Ngamagama alula, inqubo imi kanje:
1. Ukudala isikhwama: Udokotela uzothatha cishe amasentimitha angu-18 ekugcineni kwamathumbu akho amancane bese ewagoqa abe ngesimo "sika-U". Ngemuva kwalokho, amathumbu azovulwa phakathi nalesi siphetho bese kuthi imiphetho ithungwe ndawonye. Lokhu kuzodala isikhwama.
2. Ukwenza iValvu: Lena yingxenye ebaluleke kakhulu. Kusetshenziswa amathumbu asele ekugcineni kwesikhwama, kwenziwa ivalvu ekhethekile (`ivalvu yendlela eyodwa`). Ifana nomnyango ovuleka ohlangothini olulodwa kuphela. Uma imfucuza igcwala ngaphakathi, le valve ivala ngokuzenzakalelayo. Ngakho-ke, indle, uketshezi, noma umoya akuphumi.
3. Ukuxhumana: Ekugcineni, isiphetho esine-valve sinamathele embotsheni (stoma) eyenziwe esiswini sakho. Udokotela uzohlola ukuqinisekisa ukuthi konke kusebenza kahle futhi akukho ukuvuza.
Kwenzekani ngemva kokuhlinzwa? Kuthatha isikhathi esingakanani ukululama?
Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela cishe izinsuku ezintathu kuya kwezinhlanu. Phakathi nalesi sikhathi, kuzofakwa amapayipi ahlukahlukene emzimbeni wakho ukuze akusize ululame ngokushesha.
- Ishubhu le-`IV` lokunikeza usawoti
- `Ukudla okunempilo` kwe-IV kokudla okunempilo
- Amapayipi okudonsa amanzi asusa imfucuza enxebeni
- I-catheter yomchamo
- `Iphampu Yobuhlungu` yokulawula ubuhlungu
Ungakhathazeki ngalezi zinto, zonke zingezesikhashana.
I-catheter efakwa ku-stoma yakho izoshiywa endaweni yayo amasonto ambalwa. Lokhu kuzovumela imfucuza ukuthi iphume esikhwameni esisanda kudalwa kuze kube yilapho inxeba liphola. Umhlengikazi uzokufundisa indlela yokunakekela i-catheter.
Ngemva kokubuyela ekhaya uphumule amasonto ambalwa, udokotela wakho uzolikhipha leli payipi. Ngemuva kwalokho, umhlengikazi uzokufundisa ukuthi ungalithulula kanjani isikhwama ngokwakho usebenzisa ipayipi elijwayelekile (i-catheter).
Ekuqaleni, kungadingeka ukuthi ukhiphe isinye sakho cishe izikhathi ezingu-8 ngosuku. Kodwa ungakhathazeki, ezinyangeni ezimbalwa ezizayo, lesi sikhwama esisha emzimbeni wakho sizokhula kancane kancane. Ngemva kwalokho, kungadingeka ukuthi usikhiphe izikhathi ezingu-2-4 kuphela ngosuku.
Izinzuzo kanye nezinkinga ezingaba khona zesikhwama seKock
Njenganoma iyiphi inqubo yezokwelapha, kunezinzuzo kanye nezingozi. Ake sizibheke.
| Izinzuzo | Izinkinga Ezingaba Khona |
|---|---|
| Asikho isidingo sesikhwama sangaphandle: Akudingeki ukuthi ugqoke noma uphathe isikhwama sangaphandle se-ileostomy. | Izinkinga zevalvu: Ngezinye izikhathi ivalvu ingase ikhululeke futhi ibangele ukuvuza kwendle. Noma ivalvu ingase ivaleke futhi ipayipi lingase lingakwazi ukufakwa. Ukuvaleka kwamathumbu ngokuphelele kuyisimo esiphuthumayo. Uma lokhu kwenzeka, kufanele uye e-ETU (Emergency Treatment Unit) ngokushesha. |
| Inkululeko eyengeziwe kanye nobumfihlo: I-stoma ingambozwa ngento encane, njenge-gauze pad. Lokhu ngeke kubonakale ngaphandle. | Ama-Fistula: Imigudu engafanele ingakheka kusukela esikhwameni iye esikhumbeni noma kwezinye izitho zomzimba. Lokhu kungabangela ubuhlungu kanye nokutheleleka. |
| Ukulawula: Ungakhipha indle yakho noma nini lapho ufuna, endaweni efanelekile, ngaphandle kokuvuza indle usuku lonke. | I-Pouchitis: Ukuvuvukala noma ukutheleleka kwesikhwama. Lesi yisimo esivamile. Ngokuvamile singelashwa ngokushesha ngama-antibiotic. |
| Ukulala okunethezekile: Kulula kakhulu ukulala ebusuku. Ngeke kudingeke uvuke phakathi nobusuku ukuze uthulule isikhwama sakho. | Ukuncishiswa kwembobo (Stricture/stenosis): Ukushaqeka kungenza i-stoma ibe mncane futhi kwenze kube nzima ukufaka ithubhu. |
| I-Parastomal hernia: Ingxenye yamathumbu iphuma nge-stoma. Lokhu kungabangela nokuvaleka. |
Uma lezi zinkinga zenzeka, kunezikhathi lapho kungase kudingeke khona olunye ukuhlinzwa (`ukuhlinzwa kokubuyekezwa`) ukuze kulungiswe. Endabeni yesikhwama se-Kock, ikakhulukazi ngenxa yezinkinga ze-valve, izinga lokuhlinzwa kokubuyekezwa okunjalo liphakeme kancane kunezinye izindlela (cishe u-30%). Kodwa udokotela wakho uzokuchazela konke lokhu ngokugcwele.
Uyini umehluko phakathi kwesikhwama se-Kock nesikhwama se-J?
Nakuba zombili lezi ziyizinhlobo zamasaka akhiwe ngaphakathi emzimbeni, indlela asebenza ngayo ihluke ngokuphelele.
- Isikhwama seKock (isikhwama se-K): Lesi senziwa nge-'ileostomy', okuyisikhala (`stoma`) esiswini. Indle ikhishwa ngepayipi (`catheter`) elifakwe ngesikhala esiswini.
- Isikhwama se-J: Lesi esinye isidakamizwa esingasetshenziswa esikhundleni se-ileostomy. Lapha, kwakheka isikhwama esisuka ekugcineni kwamathumbu amancane bese sixhunywa ngqo endunu (umsele wamathumbu). Lokhu kuqeda isidingo se-stoma (ukuvulwa kwesisu). Isiguli singaya endlini yangasese futhi sizikhulule ngendlela evamile.
Ezimweni eziningi, iziguli ezifuna ukususwa kokubili ikholoni kanye ne-rectum zikhetha inqubo ye-J-pouch. Kodwa-ke, ukuze i-J-pouch iphumelele, imisipha e-rectum kumele isebenze kahle. Kulabo abangakwazi ukuba ne-J-pouch ngesizathu esithile, noma kulabo abaye baba ne-J-pouch ehlulekile, i-Kock pouch iyindlela enhle kakhulu.
Uyafuna ukwenza izinguquko ekudleni kwakho?
Yebo, ukudla ukudla okunempilo nokulinganiselayo kubaluleke kakhulu ukuze usheshe ukululama. Uma indle yakho ijiyile kakhulu noma imanzi kakhulu, ungenza izinguquko ezincane ekudleni kwakho. Kungasiza kakhulu ukufuna iseluleko kuchwepheshe wezokudla. Udokotela wakho angakudlulisela kumuntu ofanele.
Umlayezo Wokuya Nawe Ekhaya
- Isikhwama se-Kock siyindlela enhle kulabo abangafuni ukuhlala nesikhwama se-ileostomy sangaphandle.
- Lokhu kuzokusiza ukulawula ukuhamba kwakho kokuphuma kwesisu futhi kukunikeze inkululeko eyengeziwe kanye nenduduzo lapho uhlangana nabantu.
- Kodwa-ke, njengakuzo zonke izinhlobo zokuhlinzwa, kunezingozi nezinkinga, ikakhulukazi izinkinga ze-valve.
- Ngaphambi kokunquma ukuthi le ndlela ikufanele yini, kubaluleke kakhulu ukukhuluma nodokotela wakho futhi uqonde kahle zonke izinzuzo nezingozi.
💬 Comments (0)
No comments yet. Be the first to share your thoughts here.
Add Your Comment