Uma amathumbu akho amakhulu kufanele asuswe ngokuhlinzwa ngenxa yesimo sempilo, kuzodingeka ube nesikhwama sangaphandle (stoma) esinamathiselwe embotsheni ekhethekile (stoma) eyenziwe esikhumbeni sesisu sakho ukuze kuvunyelwe indle (indle) ukuba iphume emzimbeni wakho. Ukuhlala nalesi sikhwama sangaphandle nsuku zonke kungaba yinto engakhululekile futhi ecindezelayo kwabanye abantu. Kodwa bewazi ukuthi kukhona okunye okuhlukile kunalokho? Namuhla sikhuluma ngesikhwama esikhethekile (isikhwama) esenziwe ngaphakathi emzimbeni.
Iyini le Kock Pouch?
Kalula nje, iKock Pouch iyisikhwama esincane esidalwa udokotela ohlinzayo ngaphakathi emzimbeni wakho, esebenzisa ingxenye yamathumbu akho amancane. Siyindlela ehlukile kunesikhwama sangaphandle se-ileostomy.
Ku-ileostomy evamile, ingxenye yamathumbu amancane ilethwa ebusweni besikhumba esiswini, okwenza kube ne-stoma. Ngenxa yokuthi indle ihlala iphuma ngale mbobo, isikhwama sangaphandle kumele sigqokwe ngaso sonke isikhathi ukuze siqoqwe.
Kodwa eKock Pouch, njengoba lesi sikhwama singaphakathi emzimbeni, indle ayiphumi yonke ngesikhathi esisodwa. Kunalokho, iqoqana ngaphakathi kwesikhwama. Ungathulula lesi sikhwama izikhathi eziningana ngosuku, noma nini lapho ufuna, ngokufaka ithubhu elincane (i-catheter) nge-'stoma'. Lokhu kubizwa nangokuthi "i-Continence Ileostomy" . Lokhu kusho ukuthi ungakwazi ukulawula ukudlula kwendle. Le ndlela yaqala ukwethulwa udokotela ohlinzayo ogama lakhe linguNils Kock. Yingakho ibizwa ngokuthi iKock Pouch.
Cabanga ukuthi kungaba impumuzo engakanani ukuba nokulawula indlela olahla ngayo imfucuza yakho nganoma yisiphi isikhathi, ngaphandle kokuphatha isikhwama sangaphandle. Leyo yinzuzo eyinhloko yeKock Pouch.
Ukuhlinzwa kweKock Pouch kwenziwa kanjani?
Lokhu kuhlinzwa kuyinkimbinkimbi kancane. Udokotela wakho ohlinzayo uzokwenza kanje:
- Okokuqala, thatha cishe amasentimitha angu-18 ekugcineni kwamathumbu akho amancane (ileum) bese uwagoqa abe ngesimo "sika-U".
- Okwesibili, ingxenye egoqiwe ivulwa phakathi bese imiphetho ihlanganiswa futhi ithungwe ndawonye. Lokhu kudala isikhwama. Ingxenye encane yamathumbu ishiywa ekugcineni.
- Okwesithathu futhi okubaluleke kakhulu, kusetshenziswa amathumbu asele, kwakhiwa ivalvu enendlela eyodwa eduze komlomo wesikhwama. Lokhu kubaluleke kakhulu ngoba yilo valve evimbela ukungcola noma umoya ukuthi ungaphumi esifubeni uma isikhwama sigcwele.
- Ekugcineni, ukuphela kwevalvu kunamathele ngaphakathi kwe-stoma edalwe esiswini. Ekupheleni kokuhlinzwa, odokotela bayahlola ukuze babone ukuthi ivalvu isebenza kahle yini.
Kwenzekani ngemva kokuhlinzwa? Kuthatha isikhathi esingakanani ukululama?
Ngemva kokuhlinzwa, uzohlala esibhedlela cishe izinsuku ezintathu kuya kwezinhlanu. Phakathi nalesi sikhathi, kuzofakwa amapayipi ahlukahlukene ukuze akusize ululame ngokushesha.
- Umugqa we-IV (ipayipi elifakwe emthanjeni) ukuze unikeze usawoti
- Amapayipi okudonsa amanzi amanxeba
- Ipayipi lomuthi wobuhlungu (Ipompo yobuhlungu)
- I-catheter yomchamo
Kuzodingeka ugcine i-catheter endaweni yayo amasonto ambalwa. Lokhu kuzovumela uketshezi olusesikhwameni esisanda kudalwa ukuthi luphume futhi kuvumele inxeba ukuthi liphilise kahle. Umhlengikazi uzokukhombisa ukuthi ungayinakekela kanjani i-catheter ekhaya.
Emasontweni ambalwa ngemva kokuba ubuyele ekhaya, udokotela uzokhipha ipayipi. Ngemva kwalokho, umhlengikazi uzokufundisa indlela yokukhipha amanzi esikhwameni nge-catheter evamile, ozoyisebenzisa kusukela manje kuqhubeke.
Ekuqaleni, kungadingeka ukuthi uthulule isikhwama cishe izikhathi ezingu-8 ngosuku. Kodwa ungakhathazeki. Ngemva kwezinyanga ezimbalwa, lapho isikhwama sesikhule kancane futhi selulama kahle, kungadingeka ukuthi usithulule kabili noma kane ngosuku.
| Izinzuzo zeKock Pouch | Izinkinga Ezingaba Khona |
|---|---|
| Asikho isidingo sokugqoka isikhwama sezimbali ngaphandle. | Izinkinga zamavalvu: Ngezinye izikhathi ivalvu ingaba yizigebengu futhi ivuza imfucuza. Lokhu kungadinga ukuhlinzwa okunye ukuze kulungiswe. |
| I-stoma ingambozwa nge-gauze pad ukuze ingabonakali ngaphandle. | I-Fistula: Ukuxhumana okungavamile (njengomhubhe) phakathi kwesinye, isikhumba, noma esinye isitho. |
| Banamandla okulawula indle noma nini lapho befuna. | I-Pouchitis: Ukuvuvukala kwesikhwama okubangelwa ukutheleleka. Ngokuvamile kungelashwa ngama-antibiotic. |
| Kulula ukulala ebusuku, futhi akudingeki uvuke ukuze uthulule isikhwama. | Ukuncishiswa kwembobo (Stricture/Stenosis): Izicubu zezibazi zinganciphisa i-stoma, okwenza kube nzima ukufaka ipayipi. |
| Izinga lempilo kanye nokuzethemba kuyakhula. | I-Parastomal Hernia: I-hernia lapho ingxenye yamathumbu iphuma khona nge-stoma. Lokhu kudinga nokulungiswa ngokuhlinzwa. |
Masiqaphele futhi inkinga enkulu.
Uma ivalvu ikhululeka futhi ukuvulwa kwesikhwama kuvaliwe futhi ipayipi lingakwazi ukufakwa, kuyisimo esiphuthumayo. Esimweni esinjalo, kufanele uye e- Emergency Treatment Unit (ETU) yesibhedlela ngokushesha. Futhi, uma kufanele uhlinzwe ngokuphindaphindiwe ngenxa yezinkinga ezinjalo, kunengozi yokuthi amathumbu amancane abe mafushane futhi abe nokuntuleka kokudla okunempilo (i-Short Bowel Syndrome).
Uyini umehluko phakathi kweKock Pouch neJ-Pouch?
Kungenzeka ukuthi uke wezwa nangesikhwama se-J. Nakuba zombili ziyizinhlobo zezikhwama zangaphakathi, zisebenza ngendlela ehlukile.
- Isikhwama se-J: Lokhu kuhilela ukunamathisela isikhwama emgudwini wakho wendunu. Lokhu kusho ukuthi awudingi i-stoma. Usengakhipha indle ngendunu yakho njengenjwayelo. Abantu abaningi bakhetha le ndlela. Kodwa-ke, indunu yakho kanye nemisipha ezungezile kumele kube nempilo enhle.
- Isikhwama seKock: Isikhwama seKock siyindlela engcono kakhulu kumuntu ongakwazi ukusebenzisa i-J-Pouch (isibonelo, uma indunu nayo isusiwe) noma kumuntu osebenzise i-J-Pouch kodwa yehlulekile.
Ingabe ngidinga ukushintsha indlela engidla ngayo ngemva kwalokhu kuhlinzwa?
Yebo, ukudla ukudla okunomsoco nokulinganiselayo kubaluleke kakhulu ukuze usheshe ukululama. Ngaphambilini, kungenzeka ukuthi wawunokudla okulinganiselwe ngenxa yokugula kwakho. Manje usungakwazi ukwandisa kancane kancane lokho kudla.
Uma indle yakho ijiyile kakhulu noma imanzi kakhulu, ungakulungisa lokhu ngokushintsha indlela odla ngayo. Kuhle ukufuna iseluleko sikadokotela wezokudla ngalokhu. Udokotela wakho angakudlulisela kwenye.
Umlayezo Wokuya Nawe Ekhaya
- Isikhwama seKock siyindlela engcono kakhulu esikhundleni sesikhwama se-ileostomy sangaphandle. Singayithuthukisa kakhulu ikhwalithi yempilo yakho kanye nenhlalakahle yengqondo.
- Lesi yisikhwama sangaphakathi esakhiwe ngokuhlinzwa kusuka emathunjini akho amancane. Singakusiza ukulawula ukunyakaza kwamathumbu akho.
- Njengakuzo zonke izinhlobo zokuhlinzwa, kunengozi yezinkinga, ezingadinga ukuhlinzwa kokubuyekezwa ukuze zilungiswe.
- Indlela engcono kakhulu yokuthola ukuthi le nqubo ikufanele yini nokuthi yiziphi izinzuzo nezingozi ukuba nengxoxo evulekile nethembekile nodokotela wakho ohlinzayo. Ungesabi ukubuza udokotela wakho noma yimiphi imibuzo ongase ube nayo.
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