Uma udokotela wakho ekutshela ukuthi udinga ukuhlinzwa isisu, noma i-APR, ungase uzizwe ukwesaba nokukhathazeka okukhulu. Ungase ube nemibuzo eminingi engqondweni yakho, njengokuthi "Luhlobo luni lokuhlinzwa lolu?", "Ingabe kuzolimaza kakhulu?", "Impilo yami izobe injani ngemva kokuhlinzwa?" Kujwayelekile kakhulu. Ngakho-ke namuhla, ake sixoxe ngokuthi lokhu kuhlinzwa kwe-APR kuyini, ukuthi ungakulungiselela kanjani, nokuthi kwenzekani ngemva kokuhlinzwa. Ukwazi lezi zinto ngokucacile kuzosiza ekunciphiseni ukwesaba kwakho ngezinga elikhulu.
Kuyini ngempela ukuhlinzwa kwe-Abdominoperineal Resection (APR)?
Kalula nje, lokhu kuhilela ukususwa ngokuhlinzwa kwendunu yakho, i-rectum, kanye nengxenye engezansi yamathumbu akho amakhulu (i-sigmoid colon) . Isizathu esiyinhloko salokhu kuhlinzwa umdlavuza okhula kancane kakhulu ku-rectum, eduze kakhulu ne-anus.
Ezimweni eziningi, kungenzeka ukuthi uke wahlinzwa imisebe kanye/noma i-chemotherapy izikhathi eziningana ukuze ulawule umdlavuza ngaphambi kwalokhu kuhlinzwa. Ngemva kokuba ukwelashwa sekuncishisile amangqamuzana omdlavuza, udokotela ohlinzayo uzosusa yonke indawo ngalokhu kuhlinzwa.
Kufanele ngilungiselele kanjani ukuhlinzwa?
Udokotela wakho uzokuqondisa ngokucophelela ukuze ulungiselele lokhu. Uzokubuza ngomlando wakho wezokwelapha ophelele. Qiniseka ukuthi utshela udokotela wakho nganoma yimiphi imithi, amavithamini, noma izithasiselo ozithathayo njengamanje.
Futhi, uma unesifo sokuphefumula esibangelwa ukulala , kufanele usitshele ngaso. Uma usebenzisa umshini we-CPAP, ulethe esibhedlela ngosuku lokuhlinzwa.
Kubaluleke kakhulu ukuyeka ngokuphelele ukubhema nokuphuza utshwala amasonto ambalwa ngaphambi kokuhlinzwa. Le mikhuba ingayibambezela ukuphola kwenxeba futhi yandise ingozi yezinkinga ezinkulu, okuhlanganisa nezinkinga zamaphaphu. Thembeka kudokotela wakho ngalokhu futhi ungangabazi ukucela usizo lokuyeka le mikhuba uma kudingeka.
Ukuhlinzwa kwenziwa kanjani?
Lokhu kuhlinzwa kwenziwa esibhedlela, ngaphansi kwe-anesthesia ejwayelekile. Lokhu kusho ukuthi ngeke uzwe lutho ngesikhathi sokuhlinzwa, futhi uzobe ulele ngokuphelele. Ukuhlinzwa kwenziwa ngezinyathelo eziningana eziyinhloko.
1. Ukulungiselela amathumbu ukuthi asuswe
Okokuqala, udokotela ohlinzayo wenza izimbobo eziningana ezincane esiswini (i-laparoscopy), athole futhi asike imithambo yegazi eyinhloko ehambisa igazi ezingxenyeni zekholoni ukuze zisuswe. Ngemuva kwalokho, ingxenye engezansi yekholoni (ikholoni ye-sigmoid) kanye ne-rectum kuyakhululwa ezicutshini ezizungezile. Okulandelayo, ingxenye ezosuswa ihlukaniswa nengxenye esele enempilo yekholoni.
2. Ukususwa kwendunu
Okulandelayo, udokotela ohlinzayo wenza esinye isilonda endaweni ye-perineal bese esusa i-anus. Lokhu kususa yonke i-anus, i-rectum, kanye ne-colon. Isikhumba esingaphezu kwe-anus siyathungwa sivalwe.
3. Ukudala i-Colostomy
Manje ungase uzibuze, "Indle izophuma kanjani ngemva kokususwa kwendunu kanye ne-rectum?" Yingakho kwenziwa i -colostomy ehlala njalo.
Kalula nje, lokhu kuhilela ukuletha ingxenye enempilo yengxenye engenhla yekholoni lakho ebusweni besikhumba sakho sesisu nokudala imbobo entsha evulekela ngaphandle. Le mbobo entsha ibizwa ngokuthi 'i-stoma' . Ngokuvamile imbobo epinki ephakathi kwe-1 ne-1 ½ inches ngobukhulu.
Manje imfucuza yomzimba wakho, okungukuthi, indle nomoya, iphuma kulesi stoma. Kufanele ugqoke isikhwama esikhethekile (isikhwama se-ostomy) phezu kwaso. Lesi sikhwama siqoqa imfucuza. Njengoba ungenayo i-anus, awusenawo amandla okulawula ukudlula kwendle. Ngakho-ke, kufanele ugqoke lesi sikhwama ngaso sonke isikhathi.
Isikhathi sokululama sinjani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela izinsuku ezimbalwa. Isikhwama se-ostomy sizobekwa phezu kwe-stoma yakho ngokushesha ngemva kokuhlinzwa. Kodwa-ke, kuzothatha izinsuku ezimbalwa ukuthi uhlelo lwakho lokugaya ukudla luphinde lusebenze. Ngakho-ke uzonikezwa uketshezi lokuphuza ekuqaleni. Njengoba amathumbu akho eqala ukusebenza, kancane kancane uzojwayela ukudla okuqinile.
Ngesikhathi usesibhedlela, odokotela nabahlengikazi bazokufundisa ukuthi ungayinakekela kanjani i-stoma yakho, ukuthi ungayishintsha kanjani isikhwama sakho, nokuthi ungasigcina kanjani isikhumba sakho sihlanzekile. Ngakho-ke akukho okufanele ukhathazeke ngakho uma usuya ekhaya. Into ebaluleke kakhulu ukulandela imiyalelo yabo ngqo.
Yiziphi izinzuzo zokwenza lokhu kuhlinzwa nge-laparoscopically?
Kunezinzuzo eziningana zokwenza lokhu kuhlinzwa ngokusebenzisa indlela ye-keyhole noma ye-laparoscopic kunokuhlinzwa okuvulekile kwendabuko.
- Ukusikwa kuncane kakhulu: Esikhundleni sokusikwa okukodwa okukhulu, kusetshenziswa ukusikwa okuncane okumbalwa kuphela.
- Ubuhlungu obunciphile: Ubuhlungu obuzwakalayo ngemva kokuhlinzwa buncane kakhulu.
- Ukopha okunciphile: Kulahleka igazi elincane emzimbeni ngesikhathi sokuhlinzwa.
- Ingozi encishisiwe yezinkinga:Mancane amathuba okuba nezinto ezifana nokutheleleka kwenxeba.
- Ukululama okusheshayo: Isikhathi sokuhlala esibhedlela sifushane, futhi ungabuyela empilweni evamile ngokushesha.
Yiziphi izinkinga ezingaba khona ngenxa yalokhu kuhlinzwa?
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezincane, kodwa lezi azibonakali njalo.
- I-hernia ye-perineal ingenzeka lapho isikhumba sidonswa emuva ngemva kokususwa kwe-anus. Uma kudingeka, lokhu kungalungiswa ngokuhlinzwa okunye.
- Ukopha ngokweqile.
- Izinkinga ezihambisana nokusikwa (amanxeba ayavuvukala, awapholi).
- Uma inxeba selipholile, kusala imbobo encane esikhumbeni (i-perineal sinus).
Uma kwenzeka into efana nale, odokotela bayayiphatha ngemithi yokwelapha efana nokunikeza ama-antibiotic noma, uma kudingeka, ukwenza ukuhlinzwa okuncane, kuye ngokuthi inzima kangakanani.
Ngokuvamile kuthatha amasonto amathathu kuya kwayisithupha ukululama ngokuphelele kulokhu kuhlinzwa. Kodwa-ke, lesi sikhathi singahluka kuye ngezici ezifana nempilo yakho iyonke. Buza udokotela wakho ukuthi ungabuyela nini emsebenzini.
| Uma kuvela lezi zimpawu, shayela udokotela wakho ngokushesha. | |
|---|---|
| Isibonakaliso | Incazelo |
| Ubuhlungu obukhulu besisu | Ubuhlungu obungaphezu kokuvamile, obungabekezeleleki. |
| Isicanucanu nokuhlanza | Ukucanuzela nokuhlanza okuqhubekayo. |
| Izinguquko ezindleleni zokusika | Ukubomvu, ukuvuvukala, ubuhlungu obukhulu, noma ubomvu obuphuma emigqonyeni. |
| Akukho mfucuza engena esikhwameni se-ostomy | Akukho mfucuza noma umoya okufanele uphume ungene esikhwameni se-ostomy izinsuku ezintathu. |
| Imfiva | Umkhuhlane ongaphezu kuka-100.5° F (38° C). |
| Ubunzima bokuchama | Ubunzima noma ubuhlungu lapho uchama. |
Kuvamile ukuzizwa ukhathazekile futhi ukhathazekile ngokuthi kufanele wenze ukuhlinzwa okukhulu kangaka. Ngakho-ke, vula umlomo nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho. Futhi, uma ungajoyina amaqembu okusekelana nabantu abaye benza ukuhlinzwa okunjalo futhi manje abalulama, uzothola amandla amaningi engqondo nesibindi ngokuhlangenwe nakho kwabo.
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlinzwa kwe-APR kuyindlela yokuhlinzwa esusa i-anus, i-rectum, kanye nengxenye ye-colon. Kwenzelwa ikakhulukazi umdlavuza we-rectum engezansi.
- Ngemva kwalokhu kuhlinzwa, kwakheka imbobo ehlala njalo esiswini, ebizwa ngokuthi i-stoma, ukuze kudlule indle.
- Ukuhlinzwa kwe-laparoscopic akubuhlungu kakhulu, kunezimbobo ezincane, futhi kungaphola ngokushesha.
- Kubaluleke kakhulu ukulandela imiyalelo kadokotela (ikakhulukazi ukubhema, ukuyeka utshwala, kanye nokudla) ngaphambi nangemva kokuhlinzwa.
- Ungesabi noma yiziphi izimpawu ezingavamile ezenzeka ngemva kokuhlinzwa, bese wazisa udokotela wakho ngokushesha.
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